Diabetes Knowledge Research Articles

Understand How Diabetes Contributes to the Development of Kidney Disease: A Single Center Study

Background: This study investigates the relationship between Diabetes and renal disease. It will review the epidemiological patterns of diabetes-related kidney disease and how various treatment choices, lifestyle changes, and expanding preventative measures might lower the risk of kidney disease in diabetics. Additionally, it will go through the symptoms and effects of kidney disease on those with Diabetes and the likelihood of effective treatment and preservation of kidney function. We'll also discuss how this study may affect patients, healthcare professionals, and decision-makers. Methodology: From January 2022 to January 2023, this research was carried out in the nephrology department of the Miangul Abdul Haq Jahanzeb renal hospital in Swat. The study identified pertinent themes on how Diabetes leads to the development of kidney disease by using several sources, including medical papers, news articles, and web resources. The Cochrane Library and PubMed, and other pertinent research sources were examined. Additionally, qualitative interviews with healthcare experts were done, including endocrinologists, nephrologists, and other medical specialists with knowledge of Diabetes and kidney disease. Results: According to the findings, Diabetes considerably raises the risk of renal disease. Glomerulonephritis, diabetic nephropathy, and hypertension-related kidney disease accounted for most kidney conditions associated with Diabetes. Options for treatment exist to lower risk factors, control kidney disease complications, and enhance general health and well-being in people with Diabetes. The most significant lifestyle changes that people with Diabetes may do to lower their risk of kidney disease include weight reduction, regular exercise, a healthy diet, quitting smoking, and consuming less salt and alcohol. A further key role in lowering the risk of kidney disease and its development is the increased accessibility of preventative methods, such as good pre-diabetes and diabetes screening, optimal diabetes treatment, and vaccination against influenza and pneumococcal illness. Conclusion: Diabetes has a significant role in the development of renal disease. The increased accessibility of preventive screening, proper diabetes management, and immunization against infectious diseases play an important role in lowering the overall risk of developing kidney disease in people with Diabetes, even though treatment options and lifestyle changes exist to reduce risk factors for the disease's progression. Keywords: Epidemiology, risk factors, therapy, lifestyle changes, preventive, healthcare providers, pre-diabetes screening, diabetes management, vaccination, renal disease

Diabetes Mellitus: Assessment of Knowledge about Disease Before and after Implementing an Education Program

Background: Provision of diabetes knowledge and awareness helps the diabetic patients take a better self-care, manage their disease well and identify symptoms of and prevent chronic complications. The purpose of this comparative study was to evaluate the knowledge that diabetic patients had about their disease before and after diabetes knowledge increasing sessions. Methods: We enrolled 166 patients of either gender and age 31-70 years- who attended diabetes OPD at a tertiary care hospital for having DM for 2 years or more. Only consent providing patients were enrolled. Using visual aid and published material education sessions were delivered. A 40 items (9 sub-sections) questionnaire was used to pre and post sessions knowledge. Results: The analysis of pre-session and post-session was tested using student’s t-test which revealed statistically very significant increase in all sub-sections of knowledge. The mean ± SD age was 51.09 ± 8.16 years. The patients’ knowledge regarding their disease increased significantly (p<0.05); especially considering the general topics concerning concept of the disease, physiopathology and treatment, physical activity and nutrition. The increase in knowledge after imparting the education/ awareness sessions ranged from 36% (Eating sub-section) to 114% (Special situations sub-section) of overall knowledge. Total mean score of knowledge increased from pre-session score 15.80 ± 3.387 to post-session score 28.03 ± 5.817 (p value 0.00059). Conclusion: Young age, male and upper socioeconomic status patients had more increase in mean scores.

Linguistic and Cultural Validation of the Diabetic Retinopathy Knowledge and Attitudes Scale (DRKA) in a Chinese Population.

To linguistically and culturally adapt the 31-item Singaporean Diabetic Retinopathy Knowledge and Attitudes (DRKA) questionnaire for a Chinese population and assess its reliability and validity using classical and modern psychometric theory. A total of 230 patients with diabetic retinopathy (DR) were recruited, and of these, 202 valid responses were analyzed. Rasch analysis and classical test theory (CTT) methods were used to analyze the fit statistics of the Knowledge (n = 22 items) and Attitudes (n = 9 items) scales, including the functionality of the response categories, fit statistics, person and item reliability and separation, unidimensionality, targeting, differential item functioning (DIF), internal consistency, convergent validity, and known-group validity. After revision, both the Knowledge and Attitudes scales were unidimensional and had good measurement precision (Person Separation Index = 2.18 and 1.72) and internal consistency (Cronbach's α = 0.83 and 0.82). While the items in the Knowledge scale aptly targeted participants' ability level, targeting of the Attitudes scale was slightly suboptimal, with items too easy on average for participants' ability level. There were no issues with DIF and item fit, and the scales showed good known-group validity (scores increased as education level increased) and convergent validity (high correlation with the DRKA Practice questionnaire). After a thorough language and cultural verification process, the Chinese version of the DRKA is culturally appropriate and has good psychometric performance. The DRKA questionnaire may be useful to assess patients' DR-related knowledge and attitude level, as well as inform specific education interventions and optimize patients' ability to manage their condition.

Effects of Messaging Framing on the Self-Management Activities and Self-Efficacies of Patients with Type 2 Diabetes Mellitus.

Message framing is a low-cost and effective intervention method to improve diabetics' health behaviors. The study aimed to investigate the impacts of positive and negative message framing interventions on the self-management activities and self-efficacy of patients with type 2 diabetes mellitus (T2DM). Overall, 102 T2DM patients from Jinhua People's Hospital of China were recruited and divided into three groups: positive and negative message framing intervention groups and a control group. A 12-week experiment was implemented on the first two groups. Then, the differences of the patients' self-management activities and self-efficacies were analyzed between the experimental and control groups. Finally, the mediating effect of self-efficacy between two types of message framing interventions and patients' self-management activities was investigated. Both positive and negative message framing interventions could significantly improve the T2DM patients' self-management activities in diet, blood glucose testing, foot care, and medication taking (P<0.05), meanwhile significantly improving their self-efficacies along the nutrition, physical exercise and weight, medical treatment, blood sugar, and feet check (P<0.05). Results of the difference analysis for both within-group and inter-group showed that, compared with the positive messaging framing intervention, the negative one had more significant effects on enhancing the patients' self-management activities and self-efficacy. Self-efficacy had only a mediating effect between negative messaging framing intervention and self-management activities (β = 0.94, 95% CI: 0.0934 - 0.456). Negative messaging framing intervention could better enrich T2DM patients' diabetes knowledge through offering threatening information, thereby enhancing their self-efficacies, and ultimately improve their self-management activities.

FACTORS AFFECTING MEDICATION ADHERENCE LEVEL IN DIABETES MELLITUS PATIENS: A LITERATURE REVIEW

Introduction. Diabetes Mellitus is a disease that affects many Indonesian people. This research aims to review articles regarding factors associated with the level of adherence to diabetes mellitus treatment. Method. The data was obtained from an electronic database of Google Scholar between 2015-2021, with the keywords "Diabetes Mellitus, medication adherence factor." From the 9950 articles found, 950 articles were relevant and 10 articles were selected for review. Results &amp; Analysis. This literature study was obtained from 10 articles that met the inclusion and exclusion criteria. Based on the review of the article, it is known that there are factors related to the treatment of diabetes mellitus, including age, knowledge, motivation, social (family support and health workers), education, and psychological factors. Discussion. Family support, high level of knowledge, role of health workers, age, gender, and high motivation to conduct the treatment have an effect on treatment adherence of diabetes mellitus patients.

Continuous glucose monitoring with data sharing in older adults: A qualitative study.

This study examined the perceptions of the SHARE plus intervention and its effects on communication, collaboration, and involvement in day-to-day diabetes management in older adults with Type 1 diabetes (T1D) and their care partners. The SHARE plus intervention includes continuous glucose monitoring with a data sharing app that allows care partners to view glucose data on a smartphone and receive alerts. People with T1D and their care partners are educated about communication strategies, problem-solving strategies, and action planning when using glucose data sharing. Qualitative descriptive design. Older adults with T1D wore a continuous glucose monitor for 3 months (n = 10). Care partners (n = 10) used a data-sharing app. The SHARE plus intervention consisted of one 90-min education session. Semi-structured interviews were conducted across 10 dyads (person with diabetes and care partner) following the 12-week study. A qualitative description and a constant comparison approach were used to examine similarities and differences in experiences. Interviews were transcribed, coded, and analysed for common themes. The manuscript adheres to COREQ EQUATOR checklist. The SHARE plus intervention increased diabetes knowledge across the dyads, improving confidence and helping partners understand how to navigate symptoms and behaviours and when to intervene. Dyads worked together to optimise diabetes management through improved communication, collaboration, and management of disagreements. Although the majority of persons with diabetes and their care partners reported no conflictual communication, disagreements about diabetes management remained in some dyads. The SHARE plus intervention impacted care partners in various ways from a psychological perspective. While live-in-care partners felt peace of mind, care partners living away from persons with diabetes had some increased worry and concern. The SHARE plus intervention results can help guide future development of diabetes dyadic care and education interventions using diabetes technology. The SHARE plus intervention is a brief, practical intervention that can help diabetes clinicians improve communication and collaboration among spouses living with older adults with T1D who use continuous glucose monitoring with data sharing. A person with diabetes was part of the research team and assisted with design of the intervention and subsequent interviews and analysis.

Knowledge about diabetes and its association with adherence to self-care and glycemic control in patients with type 1 diabetes in Southern Brazil.

To evaluate the association between knowledge about the disease, adherence to self-care, and glycemic control in people diagnosed with type 1 diabetes mellitus. A cross-sectional study of patients aged over 18 years diagnosed with type 1 diabetes mellitus, treated at an outpatient clinic of a Brazilian university hospital. Participants with other types of diabetes, cognitive impairment, pregnancy, and outpatient discharge were excluded. Data were collected from January to March 2021 (by telephone call), with questions about the participants' profile, diabetes knowledge questionnaire (DKN-A), and self-care inventory revised (SCI-R) translated into and adapted for Brazilian Portuguese. Data analysis involved chi-square associations, Mann-Whitney U tests, and Poisson regression. Among 198 adult participants, the mean age was 42 ± 12 years, 53.5% were women, the mean glycated hemoglobin was 8.6 ± 1.6%, 140 (70.8%) had satisfactory knowledge about diabetes, 65 (32.8%) had adherence to self-care, and 46 (23.2%) had adequate glycemic control. We found an association between knowledge and adherence to self-care (p < 0.001). Knowledge was not associated with glycemic control (p = 0.705). Knowledge about diabetes was associated with greater adherence to self-care in people with type 1 diabetes mellitus, but it did not reflect in better glycemic control.

567-P: Impact of Diabetes Prevention Education Program on Diabetes Knowledge among Adults with Prediabetes—A Cluster Randomized Controlled Trial in Nepal

Background: Diabetes knowledge is important for diabetes prevention but has been less studied among people with prediabetes. This study aimed to assess the impact of a community-based lifestyle intervention program called Diabetes Prevention Education Program (DiPEP) on diabetes knowledge among adults with prediabetes in Nepal. Method: This study is a part of a two-arm open cluster randomized controlled trial conducted from October 2019-September 2021 in two urban areas of Nepal. Participants of the intervention arm received four 1-hour weekly education sessions, follow-up for the next 5 months, diabetes prevention education brochure, exercise calendar and daily food logbook. The control arm received an education brochure at baseline and 1-hour education session after endline data collection. The change in diabetes knowledge was assessed using Nepali validated 24-items Diabetes Knowledge Questionnaire (DKQ), with higher score representing better disease knowledge. Linear mixed model was used to analyze the impact of the DiPEP on diabetes knowledge score with intent-to-treat approach. Results: A total of 291 participants were recruited in the trial with mean age of 50.3±7.6 years and 67% were female. Only 290 participants had baseline DKQ (158 intervention, 132 control), out of these 258 completed the endline DKQ (139 intervention, 119 control). At baseline, mean DKQ score was 9.2 (SD 5.2) in intervention and 10.6 (SD 4.8) in control arm. After the intervention, mean change in the score between intervention and control group was 0.4 (95% CI -1.0-1.7) among those with good compliance to DiPEP. The results did not change from main analysis for those who attended ≥3 of all 4 sessions. Conclusion: Diabetes knowledge did not improve significantly after the intervention among the participants. Regular and frequent engagement of participants might help to improve diabetes knowledge among the individuals. Disclosure P.Shakya: None. A.Shrestha: None. B.M.Karmacharya: None. A.Shrestha: None. M.Bajracharya: None. B.E.Kulseng: None. E.Skovlund: None. A.Sen: None. Funding Norwegian University of Science and Technology, Department of Public Health and Nursing (81850087)

19-OR: Monitoring Stage 2 to Stage 3 Transition in Type 1 Diabetes Using Continuous Glucose Monitoring (CGM)

Introduction: CGM can be used to monitor evolution of dysglycemia in presymptomatic, stage 2 type 1 diabetes (T1D) and to target early initiation of insulin upon reaching stage 3 T1D. Methods: Participants (N=31) with dysglycemia by A1c, OGTT, CGM and/or home glucose testing (HGT) measures (Table 1) were randomized 2:1 into 6 months unblinded CGM-guided education intervention vs blinded CGM and monitoring only. Surveys included PHQ8, PedsQLFamilyImpact, Tolerance of Uncertainty and Diabetes Knowledge (30 point scale). Results: Intervention and control group were similar in baseline characteristics (Table), except younger age and significantly higher 2-hour OGTT glucose level in the intervention group. Diabetes knowledge was not significantly different between intervention and control at baseline (22±6 vs 20±7, p=0.61) or 3-month follow-up (23±6 vs 20±4, p=0.28). There were no differences between groups for PHQ8, PedsQLFamilyImpact or Tolerance of Uncertainty at baseline or follow-up to date. Of those diagnosed with stage 3 T1D, CGM average sensor glucose and time &amp;gt;140 mg/dL were higher than at study entry. All participants met ADA stage 3 diagnostic criteria; however, none had A1c≥6.5%. Conclusion: CGM facilitates early recognition of stage 3 T1D before elevation in HbA1c and metabolic decompensation. Unblinded CGM does not appear to negatively impact quality of life. Disclosure B.I.Frohnert: Advisory Panel; Provention Bio, Inc. F.Sepulveda: None. J.E.Stoughton: None. A.Steck: None. K.M.Simmons: Advisory Panel; Provention Bio, Inc., Consultant; Dexcom, Inc., Provention Bio, Inc., Research Support; Novartis. Funding The Leona M. and Harry B. Helmsley Charitable Trust (G-1911-03463)

537-P: Virtual Patient Simulation Assesses the Levels of Competency and Improves Performance of Advance Practice Providers in the Field of Diabetes and Cardiometabolic Medicine

Introduction: A high level of medical knowledge of Advanced Practice Providers is extremely important to secure their role in the contemporary healthcare environment. Continuing Medical Education is the key element in improving their skills and level of competency. Hypothesis: We hypothesized that a mobile and desktop VPS application that provides a self-propelled simulation of disease progression and the effects of treatments, would allow precise assessment of providers’ medical knowledge. Methods: We used the Edocate® virtual patient simulation (VPS) platform to compare the level of competency in treating patients with type 2 diabetes and cardiovascular problems in two groups of nurse practitioners: diabetes-trained (DNP) and family medicine-trained (FNP). All participants completed the same VPS case before being asked to address a second case with similar problems, thus enabling us to assess improvement in their knowledge as well. For each case, the NPs received personalized and detailed feedback on their actions. Results: DNP were significantly more likely to achieve good glycemic control (78.6% vs. 46.8% in the FNP cohort), control of hyperlipidemia (57.1% vs. 40.0%), control of blood pressure (78.5% vs. 46.6%), and were more likely to use SGLT2i or GLP1 RA in patients with cardiovascular problems (78.4% vs. 66.7%). Both groups improved their performance markedly while working with their second patient, reaching levels of competency in key clinical areas between 83 and 100% in both groups. Conclusion: Working with the VPS, DNP demonstrated a higher level of medical knowledge in diabetes and cardiovascular disease management than FNP. However, training with the VPS platform significantly improved the levels of competency in both groups supporting the notion that virtual simulation provides excellent tools for enhancing providers’ knowledge, critical for their real practice skills. Disclosure I.Iancu: None. R.Shental: None. L.Zehavi: None. B.Draznin: None.

1166-P: Identifying Knowledge Strengths and Deficits of Young Adults with Type 1 Diabetes (T1D)

Among challenges that young adults with T1D face in their care are expectations for independence with healthcare system navigation and diabetes knowledge competency. This is a particular concern given increased hemoglobin A1c (HbA1c) and complications among young adults. A 50-item diabetes-specific knowledge assessment (KA) was developed and utilized in a young adult diabetes program to identify the areas of strength and deficits to guide education and care. To identify the competency of diabetes knowledge, KA items were categorized to describe strengths, deficits, and variable responses. A retrospective chart review was performed in patients with T1D transferring from Texas Children's Hospital to a single adult endocrinology program. Inclusion criteria included T1D for &amp;gt;1 year and completion of KA by diabetes educator or provider. Each KA item was scored on a 1-4 scale (4 = high). Scores were grouped into 3 categories: strengths as &amp;gt;80% of the young adults scoring ≥3, deficits as &amp;gt;50% score &amp;lt;3, and Variable (V) not meeting criteria for strength nor deficit. Over 4.5 years, 142 patients had KAs (M age 20.5 ± 1.4 yrs, HbA1c = 8.8 ± 1.9%, T1D duration = 10.4 ± 4.7 yrs, 54% pump, 52% CGM). KA strengths (18) included questions addressing insurance card, safe sex practices, teaching treatment of mild hypoglycemia, and insulin pump management. KA deficits (11) included diabetes specific knowledge, alcohol use, tobacco, pregnancy, and acute and chronic complications of diabetes. Variable questions (21) included diabetes pathophysiology, identifying an adult PCP and hospital, and counting carbohydrates. Complications of diabetes, the effect of alcohol on blood glucose, glucagon administration, and pregnancy and diabetes should be re-educated upon transfer to adult healthcare. Questions related to insurance cards, safe sex, and insulin pump management may not need to be immediately prioritized at transfer. Further research with this KA will validate it for implementation in clinics and research. Disclosure E.A.Kubota-mishra: None. N.Miranda: None. M.E.Hilliard: None. S.Mckay: None.

59-LB: Patient-to-Peer Education—An Unconventional Prescription for Teens with Type 1 Diabetes

Introduction: Type 1 diabetes (T1D) is a chronic condition affecting nearly 200,000 youths in the US with increasing incidence. There is often decreased adherence to therapy in adolescents because of challenges in managing T1D combined with social and metabolic changes. Therefore, addressing the individual and social factors affecting treatment is essential in teens with T1D. To date, scant research exists on how to improve patient’s self-care in the context of their relationships to peers without T1D. Objectives: We aimed to test feasibility of a brief socio-educational intervention designed to improve patient perceived social support, diabetes self-care behaviors, and glycemic levels among teens with T1D. Methods: A medical student encouraged participants to 1) develop a SMART goal for improving self-care of T1D, 2) recruit peers without T1D to help achieve the goal, and 3) educate peers on the goal’s importance to their health. Participants were surveyed prior to goalsetting and 3-4 months post-intervention to assess social support, self-care, self-efficacy, and intervention acceptability; measures of glycemia were also gathered from the EMR. Thematic analysis of participant goals and plans with peers was performed. Results: All 13 participants who attended an info meeting consented to join the study; 8 completed study surveys. On average, there was a 0.9% decrease in HbA1c among the small cohort. Survey results reflect participants were satisfied with the intervention and were more interested in working with others to care for their T1D. Thematic analysis revealed teens primarily wanted assistance, reminders, and encouragement from peers for completing their T1D self-care goals. Conclusions: This intervention is a potentially low cost and feasible tool that may improve teens with T1Ds’ perceived social support, diabetes knowledge, treatment adherence, and overall health. More research into the effects of encouraging positive patient-peer interactions is warranted. Disclosure R. Pack: None. L. N. Aronson: None. N. V. Vyas: None. J. Pierce: None.

676-P: Diabetes Distress, Medical Education, and Gamification in a Pediatric/Young Adult Diabetes Center

Purpose: It is well known that children, adolescents, and young adults with diabetes face numerous obstacles to adherence. Diabetes distress can lead to diabetes burnout, which worsens diabetes nonadherence. We initiated diabetes distress screening to determine the impact of diabetes distress on our patients and developed games and animated videos in an attempt to assess diabetes knowledge and decrease visit stress. Methods: Diabetes patients aged 10 and older were given the two-question diabetes distress screening scale (DDS2) during their routine follow-up visits. Two games were created to play at the beginning of each appointment and two animated medical education videos were created on how to recognize and manage diabetes distress. Results: A total of 207 patients received DDS2 screening questionnaires. The mean DDS2 score was 5.6 (Type 1, n=178) and 5.5 (Type 2, n=29) out of 12 possible points. Only a weak correlation was found between the DDS2 score and hemoglobin A1C (Type 1:R2=0.34, Type 2:R2=0.18) with essentially no correlation noted between diabetes duration and DDS2 score (Type 1:R2=0.001; Type 2:R2=0.01). Ninety-seven percent of patients liked the “pin the bone on your A1C” game, while 93% enjoyed the medical education quiz game, 80% felt they learned something from it, and 89% felt that it made them more relaxed for their visit. Conclusions: Diabetes distress can lead to diabetes burnout, thus it is important to identify when present. Our data suggest that distress may sometimes be hidden, hence we should specifically screen for diabetes distress in all our pediatric patients that are tweens and older as no significant correlation was found between DDS2 score, hemoglobin A1C, and duration of diabetes. Therapy can be then directed to ameliorating the stress and burnout associated with living with diabetes while the use of easily created educational games and animated videos can be helpful adjuncts to assess patient knowledge while simultaneously lessening appointment stress. Disclosure T.Imai: None. T.Nguyen: None. T.S.Stanic: None. D.Diaz: None. D.Lopez: None. R.Kinman: None.

Type 2 Diabetes Patients' Views of Local Pharmacists and Fulfilment with Pharmaceutical Diabetes Care in Syria's Latakia Governorate: An Online Survey Research.

Assessing the attitudes of diabetic patients towards community-pharmacy services and determining the demand for new services could help monitor and evaluate the therapeutic response. This study aimed to evaluate type 2 diabetes patients' satisfaction regarding pharmacy care in community pharmacies and shed a light on the reasons for diabetic patients' non-adherence to treatments. An online survey was conducted on a random sample of patients (n = 196) at the national Diabetes Centre in Latakia, Syria, from April to November 2022. The questionnaire consisted of four primary parts: (1) demographic characteristics of responders, (2) patients' therapeutic behaviors, (3) diabetes knowledge, and (4) the general level of satisfaction with pharmacy diabetes services. The data were analyzed using descriptive analysis. Around 89% of respondents were satisfied with the information provided by community pharmacists. The patients' non-adherence showed a maximum as a function of the number of concomitantly taken medicines, which indicated that in most serious cases patients' adherence was increasing. Overall, most patients were delighted with community pharmacists' expertise and pharmacy services. This positive image allows pharmacists to expand their duties as healthcare providers in diabetes care, and increase the patient therapeutic adherence by performing a reconciliation of the patient's medicines, which involves reviewing all patients' drugs and identifying realistic solutions to their adherence issues.

A Nurse-Led Telehealth Program for Diabetes Foot Care: Feasibility and Usability Study.

Diabetes mellitus can lead to severe and debilitating foot complications, such as infections, ulcerations, and amputations. Despite substantial progress in diabetes care, foot disease remains a major challenge in managing this chronic condition that causes serious health complications worldwide. The primary aim of this study was to examine the feasibility and usability of a telehealth program focused on preventive diabetes foot care. A secondary aim was to descriptively measure self-reported changes in diabetes knowledge, self-care, and foot care behaviors before and after participating in the program. The study used a single-arm, pre-post design in 2 large family medical practice clinics in Texas. Participants met individually with the nurse practitioner once a month for 3 months using synchronous telehealth videoconferencing. Each participant received diabetes foot education guided by the Integrated Theory of Health Behavior Change. Feasibility was measured with rates of enrollment and program and assessment completion. Usability was measured with the Telehealth Usability Questionnaire. Diabetes knowledge, self-care, and foot care behaviors were measured with validated survey instruments at baseline, 1.5 months, and 3 months. Of 50 eligible individuals, 39 (78%) enrolled; 34 of 39 (87%) completed the first videoconference and 29 of 39 (74%) completed the second and third videoconferences. Of the 39 who consented, 37 (95%) completed the baseline assessment; 50% (17/34) of those who attended the first videoconference completed the assessment at 1.5 months, and 100% (29/29) of those who attended the subsequent videoconferences completed the final assessment. Overall, participants reported a positive attitude toward the use of telehealth, with a mean Telehealth Usability Questionnaire score of 6.24 (SD 0.98) on a 7-point scale. Diabetes knowledge increased by a mean of 15.82 (SD 16.69) points of 100 (P<.001) from baseline to 3 months. The values for the Summary of Diabetes Self-Care Activities measure demonstrated better self-care, with participants performing foot care on average 1.74 (SD 2.04) more days per week (P<.001), adhering to healthy eating habits on average 1.57 (SD 2.12) more days per week (P<.001), and being physically active on average 1.24 (SD 2.21) more days per week (P=.005). Participants also reported an improvement in the frequency of foot self-examinations and general foot care behaviors. The mean scores for foot care increased by a mean of 7.65 (SD 7.04) points (scale of 7 to 35) from baseline to 3 months postintervention (P<.001). This study demonstrates that a nurse-led telehealth educational program centered on diabetes foot care is feasible, acceptable, and has the potential to improve diabetes knowledge and self-care, which are precursors to preventing debilitating foot complications.

A Scoping Review of the Relation Between Toothbrushing and Diabetes Knowledge, Glycemic Control, and Oral Health Outcomes in People With Type 2 Diabetes.

Given the bidirectional relationship between type 2 diabetes and periodontal disease, this study sought to compile the available data regarding the relationship between home oral hygiene, specifically toothbrushing, and glycemic control and oral health in people with type 2 diabetes. A systematic scoping review was conducted using a combination of controlled vocabulary and keyword terms for type 2 diabetes and home oral care in PubMed and CINHAL. Publications from the past 20 years were considered for inclusion. Study data were summarized. A total of 11 studies met our inclusion criteria. In all survey research identified, self-report of more frequent toothbrushing in people with type 2 diabetes was always found to be associated with self-report of better glycemic control and was often associated with better clinician-conducted measures oral health. In the interventional studies identified, health coaching about oral health was associated with improvements in glycemic control, and health coaching compared with health education was found to be associated with enhanced improvement in glycemic control and self-reported toothbrushing behavior. The available data suggest that improved engagement in toothbrushing behavior may be associated with improved oral health and better glycemic control in people with type 2 diabetes. Whether improvement in glycemic control is a direct result of change to the oral environment, succeeding with one behavior change stimulating engagement in other health behavior changes, a combination of the two, or something else cannot be determined from this review. Additional studies are needed to further explore the potential for oral health coaching to improve the well-being of people with type 2 diabetes.

Assessing hypertension and diabetes knowledge, attitudes and practices among residents in Akatsi South District, Ghana using the KAP questionnaire.

Low awareness of hypertension and diabetes is a public health concern in Ghana. Assessing the general population's behaviour via knowledge, attitude, and practice (KAP) will be invaluable in these diseases, where prevention and control need a lifelong commitment to a healthy lifestyle. Hence, our goal was to assess the behaviour of Akatsi South residents towards the diseases to assist health providers in implementing tailored intervention programs. This was a population-based cross-sectional study with 150 adults (18-70 years) from November to December 2021. A semi-structured questionnaire with face-to-face interviews was used to obtain data. All variables in the model had descriptive statistics. The Chi-square (χ2) test was used to examine correlations between variables, and a value of p < 0.05 was considered statistically significant. The factors associated with checking blood sugar levels and blood pressure were determined using binary logistic regression. The respondents' mean age and BMI were 32.40 years (± 12.07) and 24.98 kg/m2 (± 2.36), respectively. Only 46.67% of the respondents frequently monitor their blood pressure and 17.33% their blood glucose (at least once a year). Less than half of those surveyed had a good knowledge of hypertension (42.7%) and diabetes (32.0%), whereas nearly 3/4 had poor attitudes regarding both conditions. A binary logistic regression analysis revealed that having a good attitude toward hypertension (exp B = 2.479, p = 0.036) and diabetes (exp B = 4.547, p = 0.009) were the participants' strongest predictor of blood pressure and sugar level checks. However, being overweight (exp B = 0.046, p = 0.002,) or obese (exp B = 0.144, p = 0.034) negatively influenced the frequency with which our respondents checked their blood glucose levels. In the study, we found that the population generally has poor knowledge, which affects their behaviour (attitudes and practices) towards the diseases. To enable healthcare practitioners to reduce disease-associated mortality and morbidity in the future, frequent public health education and promotion about the conditions is critical to closing the knowledge gap.

Knowledge of Complications of Diabetes Mellitus among Patients with Type 2 Diabetes in Saudi Arabia: A Descriptive Study.

The objective of this study was to assess the knowledge of diabetes- related complications among patients with type 2 diabetes (T2D) in Saudi Arabia. In this study, 237 patients with T2D, who visited the diabetic clinic at Prince Sultan Military Medical City, Saudi Arabia, from December 2021 to March 2022, were recruited by adopting the non-probability sampling technique. A structured questionnaire was used to collect data on the sociodemographic features of the group in this study and their knowledge regarding T2D-related complications. From the 237 patients with T2D in this study, a higher percentage had hypertension (64.1%), heart disease (67.1%), retinopathy (79.7%), nephropathy (69.7%), diabetic foot (75.9%), and neuropathy (68.4%). Overall, a high number of these patients (122 or 51.5%) expressed inadequate knowledge of complications related to diabetes. Only 40 (16.9%) revealed adequate knowledge of diabetes-related complications, while 75 (31.6%) mentioned genuine ignorance regarding their complications. Patients educational status (p = 0.045), occupation (p = 0.026), and duration of diabetes (p = 0.037) were significantly associated with knowledge of diabetic complications. From the multinomial regression, substantial differences were evident concerning the duration and occupation of the population under study. The knowledge patients with T2D possess concerning diabetes-related complications was generally poor. This study indicates that through improved knowledge of diabetes, the risks of diabetes-related complications among T2D patients can be minimized.

A hospital-based assessment of glycemic control and medication adherence in type 2 diabetes mellitus in Eastern Nepal.

Poor glycemic control in type 2 diabetes mellitus (T2DM) causes damage to various organs and leads to the development of disabling and life-threatening complications. To find out the prevalence of glycemic control and medication adherence (MA) and the factors affecting them. A cross-sectional study was conducted among patients with T2DM. The patients were categorized as good glycemic control (HbA1c <7.0%) and poor glycemic control (HbA1c ≥7.0%). MA was categorized as low (score <6), medium (score 6 or 7), and high (score 8). The Statistical Package for Social Science (version 11.5) was used for statistical analysis at a P value less than 0.05. Of 129 patients, 65 (50.39%) were females. The mean age was 48.33 ± 12.86 years. The combination of metformin and glimepiride was prescribed to 37 (28.68%) patients. Diabetic knowledge was poor in 84 (65.12%) patients. Glycemic control was good in 108 (83.72%) patients. MA was medium in 72 (55.81%) patients. Patients taking regular fruit, having shorter duration of drug therapy, and having good diabetic knowledge had good glycemic control and were statistically significant (P value < 0.05). Patients having family support, nonalcoholic, taking regular fruit, being involved in daily jogging, having shorter duration of drug therapy, and having good diabetic knowledge had high MA and were statistically significant (P value < 0.05). The majority of the diabetic patients had good glycemic control and medium MA. Patients taking regular fruit, being involved in daily jogging, having a shorter duration of drug therapy, and having good diabetic knowledge were identified as factors that affect both glycemic control and MA.

P309 UK cystic fibrosis physiotherapists’ knowledge and understanding of cystic fibrosis-related diabetes in relation to physical activity and exercise-national survey

Cystic Fibrosis Diabetes (CFRD) is the most common complication affecting approx. 40–50% of adults with cystic fibrosis (CF). Physical activity (PA) and exercise are recommended for the management of CF and can also benefit the management of blood glucose levels (BGL). Physiotherapists (PT) routinely counsel patients with CFRD about taking regular PA and supervise exercise sessions.