Association between diabetes education and diabetes management in an under‐resourced community: A pilot study

Abstract

Aims : Evaluate the effects of limited resources and access to education on diabetic disease outcomes and management in an under-served community. Place and Duration of Study : Data of diabetic Peruvian Amazon patients was collected during a 4-day health clinic conducted through the Michigan State University College of Osteopathic Medicine's (MSUCOM) Peru Global Outreach Project developed in partnership with local Peruvian doctors of Iquitos, Peru (District of Maynas) in August 2019. Methodology : A community-based cross-sectional study employed a convenience sampling of patients from underserved communities of the Peruvian Amazon. Demographic information, lifestyle habits, disease control, and education were collected through a survey. Clinical data were collected during the examination and from the respective patient's chart. Patients who were mentally disabled or incapacitated were not included. (IRB approval: STUDY00002982). Results from the survey were correlated to clinical data related to diabetes symptoms and sequelae. Data are expressed as Mean±SEM (N=11). Statistical analysis was performed by the Chi-square test and Pearson correlation coefficient (CI95). Results : 64% were women. 91% classified themselves as being in low or very low class and had no high school education. Age 56.9±4.8. 100% of the patients have diabetes (random glucose 303.9±43.7mg/dL). 18% were insulin-dependent. 36% were using only metformin. 46% were not using medication to treat diabetes. BMI: 22.5±1.5. Blood pressure: 119±5.8/73.4±2.9mmHg. No correlation (P>.05) was observed between blood pressure, BMI, and age vs. random glucose levels. 100% of the patients wished they had received more education regarding their diabetes diagnosis. 72.7% report visiting their primary care physician. Conclusion The lack of control of glucose levels in patients, despite a majority of patients having a primary care provider as well as receiving treatment, demonstrates the poor quality of understanding and management of the disease by the patients. It was not possible to establish a relationship between diabetes sequelae and random blood glucose levels. However, all subjects desired to receive more education in order to better understand and manage their disease. This pilot study demonstrated the shortcomings of healthcare for people with diabetes in the Peruvian Amazon and the educational barrier that should be addressed to improve disease management and patient outcomes.