Improve Diabetes Management Research Articles

Social network interventions for dietary adherence among adults with type 2 diabetes: a systematic review and meta-analysis protocol

IntroductionOptimal adherence to recommended diets is crucial to achieving long-term glycaemic control among individuals with type 2 diabetes (T2D) individuals. However, there is limited evidence on the effectiveness of interventions...

The intelligent diabetes telemonitoring using decision support to treat patients on insulin therapy (DiaTRUST) trial: study protocol for a randomized controlled trial

BackgroundDiabetes affects 10.5% of adults globally, with type 2 diabetes accounting for 90–95% of cases. Achieving optimal glycemic control is crucial yet challenging, particularly with insulin therapy, where 30–50% of patients fail to meet treatment targets. Telemedicine can improve diabetes management but generates vast amounts of data, burdening healthcare professionals. Integrating clinical decision support tools into telemonitoring systems may enhance care efficiency and glycemic control.MethodsThe trial is a multicenter 3-month, three-arm, open-label, randomized controlled trial. The trial aims to enroll 51 participants with type 2 diabetes on insulin therapy. Participants will be divided with a 3:1:1 ratio into telemonitoring with decision support, telemonitoring without decision support, and usual care groups. The study employs connected insulin pens, continuous glucose monitors (CGMs), and activity trackers to enable telemonitoring. Outcomes measured include CGM time in range, HbA1c, hypo- and hyperglycemia incidents, total daily insulin dose, body weight, treatment satisfaction, and adherence.DiscussionTelemonitoring with decision support has the potential to revolutionize diabetes management by offering personalized treatment suggestions, thereby reducing the burden on healthcare professionals, and improving patient outcomes. This study will provide valuable insights into the effectiveness of such an approach in achieving glycemic control in people with type 2 diabetes on insulin therapy. By evaluating both clinical outcomes and patient and healthcare professionals’ satisfaction, the study aims to contribute to the development of efficient, scalable telehealth solutions for diabetes care.Trial registrationClinicalTrials.gov NCT06185296. Registered on December 14, 2023.

Diabetes knowledge and behaviour: a cross-sectional study of Jordanian adults.

Diabetes mellitus is a significant global health concern that is projected to affect 7.7% of the global population by 2030. Understanding factors that influence diabetes knowledge and management adherence is crucial for effective diabetes mellitus management and prevention. This study investigates the relationships between demographic and clinical factors and their impact on diabetes knowledge and behaviour, as well as the potential influence of diabetes knowledge on management behaviours. The study comprised a cross-sectional survey of 1050 adults, collecting data on age, sex, marital status, education, employment, hypertension, dyslipidaemia (any lipid imbalance, such as high cholesterol, high LDL-cholesterol or low HDL-cholesterol), smoking and diabetes status. Two multiple linear regression models were used to identify factors associated with diabetes knowledge and behaviour, and a simple linear regression model was used to assess the relationship between knowledge and behaviour. Significant associations were found between diabetes knowledge and the following factors: age (44.32 ± 9.53 for ≥50 years vs 39.73 ± 9.95 for 18 to <25 years; p<0.0001), sex (49.00 ± 12.35 for women vs 45.09 ± 13.27 for men; p<0.0001), marital status (50.92 ± 11.69 for married vs 45.39 ± 13.10 for single; p<0.0001), smoking status (45.78 ± 13.22 for smokers vs 48.22 ± 12.15 for non-smokers; p=0.003), hypertension (46.46 ± 13.11 for present vs 47.31 ± 12.87 for absent; p=0.007) and diabetes status (69.49 ± 17.35 for present vs 62.76 ± 16.88 for absent; p<0.001). Behaviour scores correlated similarly with these factors except for diabetes and smoking status. The adjusted simple linear regression model revealed that diabetes knowledge was significantly associated with better management behaviours (coefficient=0.0794, p<0.001) after adjusting for demographic and clinical factors. This study highlights the importance of demographic and clinical factors in the context of diabetes knowledge and behaviours, underscoring the need for targeted educational and preventive programmes to improve diabetes management, especially in vulnerable populations. Additionally, the strong association between diabetes knowledge and management behaviours supports a knowledge-attitude-behaviour (KAB) model of diabetes management.

Long-term effects of non-pharmacological interventions in adolescents and young adults with type 1 diabetes: A systematic review and meta-analysis.

Consistent diabetes control is crucial for patients with type 1 diabetes (T1D) to prevent diabetic complications. Analyzing the long-term effects of non-pharmacological interventions can improve diabetes management. To examine the long-term effects of non-pharmacological interventions in adolescents and young adults with T1D through a systematic review and meta-analysis of randomized controlled trials (RCTs). The searches, without any year limitations, were conducted in seven databases. Two reviewers independently performed data extraction and risk of bias assessments. The meta-analysis was conducted using the RevMan 5.4 program and R Studio. The study was registered with PROSPERO (CRD42024503185). A total of 40 studies were included in the systematic review, of which 28 were included in the meta-analysis. Notably, non-pharmacological interventions were effective in improving glycated hemoglobin (HbA1c) at 6 months and self-care at >12 months of follow-up. Subgroup analyses revealed that combined interventions encompassing self-care behavior management, education, and psychological interventions could enhance self-care. Additionally, a combination of face-to-face and telephonic communication was effective in improving HbA1c. Non-pharmacological interventions are effective in improving HbA1c levels and self-care in adolescents and young adults undergoing long-term treatment. However, few studies have analyzed their effects on cardiovascular disease risk factors. Future studies should investigate the long-term effects of non-pharmacological interventions.

Diabetes Control and Clinical Outcomes among Children Attending a Regional Paediatric Diabetes Service in Australia.

Australian children with diabetes commonly struggle to achieve optimal glycaemic control, with minimal improvement observed over the past decade. The scarcity of research in the rural and regional Australian context is concerning, given high incidence rates and prominent barriers to healthcare access in these areas. We conducted a retrospective audit of 60 children attending a regional Australian paediatric diabetes service between January 2020 and December 2023. The majority of patients had type 1 diabetes (n = 57, 95.0%); approximately equal numbers were managed with continuous subcutaneous insulin infusion (CSII) pumps vs. multiple daily injections (MDIs), whilst 88.3% (n = 53) also utilised continuous glucose monitoring (CGM). The mean age at last visit was 14.0 years (SD, 3.4), mean diabetes duration 5.8 years (SD, 4.6), and mean HbA1c level 8.1% (65.3 mmol/mol); only 36.8% achieved the national target of 7.5% (58 mmol/mol). Mean BMI-SDS was 0.8 (SD, 1.0); almost half (n = 27, 45.0%) were overweight or obese. Many patients had mental health conditions (31.7%), which were associated with higher hospitalisation rates (p = 0.007). The attendance rate was 83.2%, with a mean of 3.3 clinic visits per year (SD, 0.7); higher attendance rates were associated with increased CGM sensor usage (r = 0.395, p = 0.007 Overall, the diabetes service performed similarly to other clinics with regards to glycaemic control. Whilst achieving treatment targets and addressing comorbidities remains a challenge, the decent attendance and the high uptake of healthcare technologies is commendable. Further efforts are needed to improve diabetes management for this regional community.

Exploring the perceptions and experiences of diabetes management and self-regulation in young adults using a continuous glucose monitoring device

Young adults face many pressures as they start being independent and responsible for their own actions and decisions. The use of continuous glucose monitoring has been shown to improve medical outcomes in diabetes management, but the mechanism of these improvements needs further investigation. This study aimed to examine the self-regulatory experiences and behaviours of a group of young adults using continuous glucose monitoring to manage type 1 diabetes. An exploratory qualitative approach was taken, using six virtual semi-structured interviews with young adults living with type 1 diabetes and using continuous glucose monitoring. A thematic analysis was used to identify themes from the gathered data. In this study, three themes demonstrated reciprocal determinism in that the observation of the continuous glucose monitoring results led to changes in the behaviours of the participants. The concepts of feedback and feedforward were also evident in the information provided by continuous glucose monitoring and the adjustment of the participants to achieve their personal blood glucose goals. The results of this study thus support the fact that self-regulation of those living with type 1 diabetes can be improved using continuous glucose monitoring as a tool for observation of blood glucose fluctuations and can, as a result, lead to changes in diabetes management behaviours and health outcomes. Continuous glucose monitoring provides the opportunity to observe the consequences of diabetes management behaviours, which activates the self-regulation processes of feedback and feedforward. This process has the potential to improve diabetes management behaviours in this vulnerable group.

Iontophoresis and electroporation-assisted microneedles: advancements and therapeutic potentials in transdermal drug delivery.

Transdermal drug delivery (TDD) using electrically assisted microneedle (MN) systems has emerged as a promising alternative to traditional drug administration routes. This review explores recent advancements in this technology across various therapeutic applications. Integrating iontophoresis (IP) and electroporation (EP) with MN technology has shown significant potential in improving treatment outcomes for various conditions. Studies demonstrate their effectiveness in enhancing vaccine and DNA delivery, improving diabetes management, and increasing efficacy in dermatological applications. The technology has also exhibited promise in delivering nonsteroidal anti-inflammatory drugs (NSAIDs), treating multiple sclerosis, and advancing obesity and cancer therapy. These systems offer improved drug permeation, targeted delivery, and enhanced therapeutic effects. While challenges remain, including safety concerns and technological limitations, ongoing research focuses on optimizing these systems for broader clinical applications. The future of electrically assisted MN technologies in TDD appears promising, with potential advancements in personalized medicine, smart monitoring systems, and expanded therapeutic applications.

A Culturally Sensitive Mobile App (DiaFriend) to Improve Self-Care in Patients With Type 2 Diabetes: Development Study.

Mobile apps designed with cultural sensitivity have demonstrated higher user acceptability and greater effectiveness in enhancing self-care skills. However, a significant gap exists in developing such apps for specific populations, such as Portuguese Americans living in southern Massachusetts, home to the second-largest Portuguese community in the United States. This group possesses unique cultural traditions, particularly in dietary practices, including a tendency toward high carbohydrate intake. Tailoring diabetes self-care apps to address these specific cultural requirements could substantially improve diabetes management within this population. The aim of this app development project was to develop a prototype diabetes management app for Portuguese Americans with type 2 diabetes mellitus using the design thinking methodology, incorporating user-centered design principles and cultural sensitivity. This paper describes the phase-2 results, focusing on app design and development. Phase 2 of this app development project adhered to the design thinking methodology delineated by the Hasso Plattner Institute of Design at Stanford University, focusing on 2 critical steps: ideation and prototyping. This phase started in March 2022 and continued until April 2024. The project was driven by a multidisciplinary team consisting of 2 nurse educators; an app development specialist; and 2 graduate research assistants from the university's Computer and Information Sciences Department, both well-versed in mobile app development. Data collected during phase 1, which will be published separately, informed the app design and development process. The prototype of the DiaFriend app (version 1) was designed and developed. The app comprises five features: (1) blood glucose monitoring, (2) weight tracking, (3) carbohydrate tracking, (4) exercise log, and (5) medication reminder. The carbohydrate tracking feature was explicitly tailored to correspond to Portuguese food culture. This paper presents the front-end interface flowchart, demonstrating how the user navigates through each screen. It also discusses the challenges faced during the backend development, such as data not being able to be stored and retrieved. The DiaFriend app (version 1) distinguishes itself from conventional diabetes self-care apps through its emphasis on cultural sensitivity. The development of this app underscores the importance of cultural considerations in health informatics. It establishes a foundation for future research in developing and evaluating culturally sensitive mobile health apps. The adaptation of such technologies has the potential to enhance self-care practices among Portuguese Americans with type 2 diabetes mellitus, with improved glycated hemoglobin levels as a potential outcome. The last step of the design thinking methodology, testing the app, will be conducted in phase 3 and the results will be published elsewhere.

Using technology to support diabetes care in hospital: Guidelines from the Joint British Diabetes Societiesfor Inpatient Care (JBDS-IP) group and Diabetes Technology Network (DTN) UK.

This article summarises the Joint British Diabetes Societies for Inpatient Care (JBDS-IP) Group guidelines on the use of technology to support diabetes care in hospital. The guideline incorporates two main areas: (i) use of wearable technology devices to improve diabetes management in hospital (including continuous glucose monitoring and insulin pump therapy) and (ii) information technology. Although it is reasonable to extrapolate from the evidence available, that devices developed to enhance diabetes care outside hospital will show similar benefits, there are challenges posed within the inpatient setting in hospital. This guidance provides a pragmatic approach to supporting self-management in individuals using wearable technology admitted to hospital. Furthermore, it also aims to provide a best practice guide for using information technology to monitor diabetes care and communicate between health professionals.

National trends in type 2 diabetes mellitus stratified by central adiposity using waist-to-height ratio in South Korea, 2005–2022

Studies investigating the association between type 2 diabetes mellitus and central adiposity are lacking. Therefore, this study aimed to investigate trends in type 2 diabetes mellitus stratified by central adiposity using waist-to-height ratio (WHtR). Trends in type 2 diabetes mellitus were examined by central adiposity, using WHtR, with data from the Korea National Health and Nutrition Examination Survey (2005–2022). Individuals aged 30 years and over who participated in the survey were selected. Type 2 diabetes mellitus was identified based on serum glucose or HbA1c levels, the use of diabetes medications, or a prior diagnosis by a physician. Weighted β-coefficients or odd ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess changes in disease prevalence. A total of 79,368 participants were included in the database (female: 45,163 [56.9%]). from 2005 to 2022, the prevalence of type 2 diabetes mellitus increased from 3.3 to 5.8% in the healthy central adiposity group, from 11.2 to 17.1% in the increased central adiposity group, and from 18.0 to 26.7% in the high central adiposity group. Males, older population, lower education level, lower household income, and smoking are associated with a higher risk of type 2 diabetes. In the high central adiposity group, overweight and obese individuals had higher susceptibility than underweight or normal-weight individuals, with ORs of 5.85 (95% CI, 2.54–13.47) and 8.24 (3.79–17.94), respectively. The prevalence of type 2 diabetes mellitus has increased in all central adiposity groups in the past decade. This underscores the need for tailored interventions to address disparities and improve diabetes management in at-risk populations.

Implementation strategy of insulin therapy under sparse state feedback

Traditional continuous glucose monitoring is often costly and inconvenient, necessitating more efficient methods. This paper proposes a novel approach to diabetes management by utilizing sparse monitoring data for insulin injection decisions. A differential equation-based model is developed to estimate plasma glucose levels and optimize insulin dosages and injection intervals using limited feedback data. This method ensures that glucose levels remain within a safe range. Numerical simulations demonstrate the effectiveness of this approach, offering a viable alternative for improving diabetes management.

Criteria for Personalised Choice of a Continuous Glucose Monitoring System: An Expert Opinion.

Despite the growing evidence supporting the outpatient use of continuous glucose monitoring (CGM) for improving glycaemic control and reducing hypoglycaemia, there is a need for a detailed understanding of the specific features of CGM devices that best meet individual patient needs. This expert opinion, based on a comprehensive literature review and the personal perspectives of clinicians, aims to provide thehealthcare professionals (HCPs) with a comprehensive framework for selecting CGM devices. It evaluates the current state of CGM technology, categorizing features into essential features, major drivers of choice, and additional/useful features. Moreover, the practical model presented outlines a patient's journey with CGM, emphasising the importance of aligning device features with patient needs. This includes understanding the patient's lifestyle, clinical conditions, and personal preferences to optimize CGM use and improve diabetes management outcomes.

The Growing Diabetes Epidemic: A Primary Health Concern for Nigeria’s Diverse Population

Diabetes mellitus has become a significant public health concern in Nigeria, driven by a complex interplay of genetic, lifestyle, and socioeconomic factors. With a population exceeding 200 million, Nigeria is witnessing a notable rise in diabetes prevalence, particularly Type II Diabetes Mellitus (T2DM), which is linked to urbanization, lifestyle changes, and socioeconomic transitions. This review provides a comprehensive analysis of the diabetes epidemic in Nigeria, highlighting its epidemiology, contributing factors, health impacts, management challenges, and current strategies. The prevalence of diabetes in Nigeria is estimated at 4-5% among adults, with urban areas experiencing higher rates due to lifestyle factors such as sedentary behavior and increased consumption of processed foods. Ethnic variations also play a role, with certain groups showing higher prevalence rates due to genetic and cultural factors. The rising incidence of diabetes is associated with increased risks of cardiovascular diseases, neuropathy, nephropathy, retinopathy, and other complications, imposing a significant burden on the healthcare system and exacerbating socioeconomic disparities. Challenges in managing diabetes include limited healthcare access, financial barriers, inadequate infrastructure, and cultural beliefs. Current strategies involve national guidelines, specialized care centers, and community-based interventions, but face challenges in implementation due to resource constraints and logistical issues. Technological innovations, such as telemedicine and mobile health applications, offer promising solutions for enhancing diabetes care. Recommendations for improving diabetes management in Nigeria include strengthening healthcare infrastructure, expanding access to care, increasing public awareness, and addressing socioeconomic disparities. Future research and policy should focus on epidemiological studies, genetic research, and the integration of technology into diabetes care. By adopting a multifaceted approach and fostering collaboration among government, healthcare providers, and communities, Nigeria can better address the diabetes epidemic and improve health outcomes for its diverse population. Keywords: Diabetes; Type II Diabetes Mellitus; epidemiology; healthcare challenges; management strategies; technology, public health.

Development of Family Empowerment Model in Diabetes Management Among Type 2 DM Patients

Background: Diabetes management has not been optimally implemented by patients, considering the high incidence of diabetes complications. Therefore, family empowerment is important for diabetes management. Objective: This study aims to determine factors related to diabetes management, inhibiting, and supporting factors for diabetes management to develop a family-based educational model in diabetes management through expert testing.Methods: This research used Mixed Methods design with an Explanatory Sequential Design approach. A cross-sectional approach to 207 people with DM selection using a multistage sampling technique. Data was collected by questionnaire, in-depth interview, and Delphi study. Data analysis using chi-square and logistic regression. The development of family empowerment model is based on the theory Ladder of Empowerment, Social Cohesion, and Family Support. Results: Research results showed that good knowledge of patients, good family empowerment, and absence of DM risk factors are related to diabetes management. Model development and expert testing (Delphi Study) of the model find that a family-based diabetes management module is needed. Conclusion: A good family-based diabetes management module includes aspects of Self-Instructional, Self-Contained, Stand Alone, Adaptive, and User-Friendly aspects. This module is expected to improve diabetes management for patients and their families so that diabetes complications can be prevented and the patient's quality of life increases.

Empowering young people with diabetes: co-researching interventions for improved diabetes management

Empowering young people with diabetes: co-researching interventions for improved diabetes management

Prevalence and Risk Factors of Diabetes in Ghana: Analyzing the Growing Health Challenge

The rising prevalence of diabetes in Ghana presented significant challenges for public health and healthcare delivery. This article examined the implications of the diabetes epidemic on the healthcare system, economic stability, and public health strategies in Ghana. It discussed the strain placed on healthcare resources, particularly in rural areas, and the economic burden of managing diabetes and its complications. Public health challenges, including the need for effective prevention strategies and increased awareness, are highlighted, alongside the importance of improving healthcare delivery through enhanced primary care and training for healthcare professionals. Additionally, the article explored the integration of traditional and modern healthcare practices as a means to improve diabetes management. The methodology involved a comprehensive review of existing literature and data on diabetes prevalence, risk factors, and healthcare delivery in Ghana. This analysis underscored the need for a multifaceted approach to address the growing diabetes crisis in Ghana, with an emphasis on improving access to care, raising awareness, and integrating traditional and modern medical practices. Keywords: Diabetes Mellitus, Ghana, Prevalence, Risk Factors, Public Health.

The use of Telehealth in Managing Diabetes

The rising prevalence of diabetes, particularly type 2, has put enormous strain on worldwide healthcare systems. Telehealth is becoming an increasingly important aspect of modern healthcare, and it offers a viable approach to improve diabetes management by improving patient outcomes, access to care, and medication compliance. This study investigates the use of telehealth technologies in diabetes management, focussing on their benefits, problems, and future potential. Telehealth can help to overcome geographical boundaries, provide regular monitoring, and deliver personalised care. However, it has limits, such as discrepancies in technology access and data security. Understanding these aspects is critical to optimising telehealth’s role in diabetes care. Keywords: Telehealth, Diabetes Management, Type 2 Diabetes, Remote Patient Monitoring, Healthcare Access.

Knowledge and Awareness of Type 2 Diabetes Complications in Conflict-Affected Regions: A Cross-Sectional Study in Homs, Syria.

Background Diabetes mellitus is a significant global health problem characterized by high blood sugar levels due to either a lack of insulin or insensitivity to it. Concerns about diabetes complications are growing both globally and locally, making effective preventive measures crucial to tackle these complications. This research aimed to determine the level of knowledge and awareness regarding type 2 diabetes complications among patients in Homs, Syria, during the ongoing conflict. Methods A cross-sectional study was conducted among 1016 diabetic patients aged 16 years and above attending internal medicine and diabetes clinics in Homs City through a structured questionnaire administered via social media, telephone interviews, and paper forms. The data collected were analyzed using SPSS version 23.0 (IBM Corp., Armonk, USA). Descriptive statistics were used to summarize the demographic characteristics. In contrast, inferential statistics such as the chi-square test were used to test for associations between different variables with p-value < 0.05 as the significance level. Results The study found that 478 (47.1%) of participants were male, and 538 (53%) were female. The majority 652 (64.2%) were between 46 and 70 years old, and 422 (41.5%) had primary-level education. Most were married 750 (73.8%) and lived in urban areas 856 (84.2%). Diabetes knowledge varied significantly by age, education, occupation, and residence. Housewives and those with lower education levels had the least knowledge, while urban residents and those with 1-5 years since diagnosis had better awareness. Individuals with relatives in the medical field had higher knowledge levels.Results indicate that gender did not significantly influence diabetes knowledge (p = 0.19), while younger adults showed poorer awareness compared to older age groups (p < 0.05). Higher education levels were associated with better knowledge (p < 0.05), and a family history of diabetes correlated with greater awareness of complications. Occupation significantly impacted knowledge, with employed individuals and urban residents demonstrating higher awareness levels (p < 0.05). Diabetes knowledge peaked during the 6-10 year disease duration (p < 0.05). Conclusion This study assesses diabetes knowledge and management practices among 1016 participants in Homs, Syria, focusing on demographic and socioeconomic factors. Our findings underscore the need for targeted educational initiatives to improve diabetes management, particularly among younger, less educated, and rural populations in Homs.The analysis reveals significant knowledge gaps about diabetes across different demographics in Homs, highlighting the need for targeted educational programs, especially for younger individuals, the less educated, and rural residents. The study emphasizes the importance of education and medical practice in understanding diabetes, particularly in conflict-affected areas.

Prevalence, Awareness, Treatment, and Control of Type 2 Diabetes in South Korea (1998 to 2022): Nationwide Cross-Sectional Study.

Type 2 diabetes poses an increasing disease burden in South Korea. The development and management of type 2 diabetes are closely related to lifestyle and socioeconomic factors, which have undergone substantial changes over the past few decades, including during the COVID-19 pandemic. This study aimed to investigate long-term trends in type 2 diabetes prevalence, awareness, treatment, and control. It also aimed to determine whether there were substantial alterations in the trends during the pandemic and whether these changes were more pronounced within specific demographic groups. This study examined the prevalence, awareness, treatment, and control of type 2 diabetes in a representative sample of 139,786 South Koreans aged >30 years, using data from the National Health and Nutrition Examination Survey and covering the period from 1998 to 2022. Weighted linear regression and binary logistic regression were performed to calculate weighted β coefficients or odds ratios. Stratified analyses were performed based on sex, age, region of residence, obesity status, educational background, household income, and smoking status. β (difference) was calculated to analyze the trend difference between the prepandemic period and the COVID-19 pandemic. To identify groups more susceptible to type 2 diabetes, we estimated interaction terms for each factor and calculated weighted odds ratios. From 1998 to 2022, a consistent increase in the prevalence of type 2 diabetes was observed among South Koreans, with a notable rise to 15.61% (95% CI 14.83-16.38) during the pandemic. Awareness followed a U-shaped curve, bottoming out at 64.37% (95% CI 61.79-66.96) from 2013 to 2015 before increasing to 72.56% (95% CI 70.39-74.72) during the pandemic. Treatment also increased over time, peaking at 68.33% (95% CI 65.95-70.71) during the pandemic. Control among participants with diabetes showed no substantial change, maintaining a rate of 29.14% (95% CI 26.82-31.47) from 2020 to 2022, while control among treated participants improved to 30.68% (95% CI 27.88-33.48). During the pandemic, there was a steepening of the curves for awareness and treatment. However, while the slope of control among participants being treated increased, the slope of control among participants with diabetes showed no substantial change during the pandemic. Older populations and individuals with lower educational level exhibited less improvement in awareness and control trends than younger populations and more educated individuals. People with lower income experienced a deceleration in prevalence during the pandemic. Over the recent decade, there has been an increase in type 2 diabetes prevalence, awareness, treatment, and control. During the pandemic, a steeper increase in awareness, treatment, and control among participants being treated was observed. However, there were heterogeneous changes across different population groups, underscoring the need for targeted interventions to address disparities and improve diabetes management for susceptible populations.

Evaluating diabetic foot care knowledge and practices at education level.

Diabetic foot is one of the complications in type 2 diabetes mellitus. Adequate knowledge and practice are an important aspect to control further deteriorating conditions such as ulcers and amputations. Thus, the objective of this cross-sectional study was to investigate the impact of the education levels of diabetic patients on diabetic foot care knowledge and practice. This cross-sectional study with a convenient sampling technique was conducted on 534 patients with diabetes mellitus from public and private care hospitals. The data was collected using a validated, pretested and structured bilingual (Arabic, English) questionnaire. There were 534 patients interviewed, 39.1% of whom were males and 60.9% of whom were females and 61.4% of the patients had had T2DM for over 10 years. There was a significant difference in education levels between the male and female patients (53.8% and 46.2%, P = .001). Furthermore, 83.9% patients were married. The difference in education between the married and the single, divorced, and widowed patients was significant (P = .007). Patients with uncontrolled HbA1c were 2.43 times more likely to have hypertension (RR = 2.43, P = .03), while patients with highly uncontrolled diabetes had 3.1 times more chances of hypertension (RR = 3.1, P = .009). Heart disease prevalence was 3.27 times higher in diabetes patients with uncontrolled HbA1c and 3.37 times higher in patients with highly uncontrolled HbA1c. Patients with diabetes who have been diabetic for more than 10 years have a greater risk of heart disease (RR = 2.1; P = .03). Patients with lower education levels exhibited more diabetic complications compared to patients with higher education levels (P < .05). The present study highlights the importance of education and awareness campaigns targeting diabetic patients, especially those with lower education levels, to improve diabetes control and prevent, or manage, comorbidities. Healthcare providers should also prioritize patient education and medication adherence to improve diabetes management and reduce the risk of complications.