Michigan Diabetes Knowledge Test Research Articles

Diabetes knowledge among Malaysian adults: A scoping review and meta-analysis.

Optimal self-care promotes glycaemic control and prevents diabetes complications. Its performance is facilitated by an adequate level of diabetes knowledge. This review aimed to evaluate diabetes knowledge among Malaysians by assessing diabetes knowledge scores and their associated factors. A comprehensive bibliographic search for Malaysian studies on diabetes knowledge was conducted in PubMed, Scopus and Google Scholar. Relevant literature was systematically selected and described; pertinent data were extracted; and data on diabetes knowledge levels and their associated factors were synthesised. The quality of the identified studies was assessed using a Joanna Briggs Institute critical appraisal tool. Thirty Malaysian cross-sectional studies that measured diabetes knowledge levels were retrieved. Nineteen of them used a named diabetes knowledge measurement tool, with 14 using the 14-item Michigan Diabetes Knowledge Test. A low knowledge level was prevalent among patients with diabetes mellitus (pooled mean knowledge score=6.92, proportion of patients with a low knowledge level=47.97%). The knowledge score was associated with some sociodemographic variables, health literacy, self-care and glycaemic control. The association of diabetes knowledge with diabetes outcomes (e.g. self-care and glycaemic control) reflects the potential of the former as a target of intervention. Periodic measurement of diabetes knowledge in healthcare settings and among populations can help in assessing the effectiveness of diabetes educational interventions. Concerted efforts to improve diabetes knowledge among Malaysians have the potential to fill knowledge-practice gaps.

Difference Disease Knowledge Level in Type 2 Diabetes Mellitus Patients at Siloam Lippo Village General Hospital

<p><strong>Background:</strong> In Indonesia, Diabetes Mellitus (DM) with complications is the third leading cause of death. Risk of complication increases tremendously in uncontrolled diabetes. The level of knowledge is one of the factors affect glycaemic control. However, little study has been done regarding the difference in disease knowledge level in type 2 DM patients. This study aims to find out the difference between the level of DM knowledge and glycaemic control in type 2 diabetes mellitus patients at Siloam Lippo Village General Hospital.</p><p><strong>Methods:</strong> Analytical observational with a cross-sectional study was conducted. 46 type 2 diabetes mellitus patients qualified for the inclusion criteria and were given the self-administered Michigan Diabetes Knowledge Test (MDKT) for General Knowledge Part (GKP) questionnaire and HbA1c test results taken in the past six months to evaluate glycaemic control. Purposive sampling method was used in this study for data collection. Student T-test was done to measure the difference with 95% significancy.</p><p><strong>Result:</strong> In 46 samples were shown that 60.90% women, a majority in the 50-59 age group, and 65.20% with more than 5 years of DM history. Among 46 samples, 26 have uncontrolled glycaemic with a mean score of 6.65 ± 1.83 in knowledge, and 20 have controlled glycaemic with a mean score 7.80 ± 1.61. Student T-test showed significant difference in level of knowledge between controlled and uncontrolled glycaemic levels with p = 0.032.</p><p><strong>Conclusions:</strong> It is concluded that there is a difference in disease knowledge level in type 2 DM patients at Siloam Lippo Village General Hospital. </p>

Diabetes Health Literacy, Drug Adherence and Factors Associated with Them among Urban Patients in Kerala, India.

The study aimed to assess diabetes health literacy, adherence to diabetes medication, and its associated factors in Kerala, India, the most advanced Indian state in epidemiological transition with the highest literacy level in India. We conducted a community-based cross-sectional study among 280 diabetes patients (mean age 62 years, male 42%) selected by multistage cluster sampling. Information on sociodemographic variables was collected using a pretested structured interview schedule. Diabetes health literacy was assessed using the revised Michigan Diabetes Knowledge test. Adherence to diabetes medication was assessed using the Hill-Bone subscale. Binary logistic regression analysis was done to find out the factors associated with diabetes health literacy and medication adherence. Good diabetes health literacy was reported by 35.7% [95% confidence interval (CI): 30.1-41.6] of the patients. Perfect adherence to diabetes medication was reported by 33.2% of patients (CI: 27.7-39.1). Patients who reported regular newspaper reading [adjusted odds ratio (AOR) 3.16; CI: 1.57-6.30], using the internet (AOR 2.23; CI: 1.11-4.50) and insulin use (AOR 2.60; CI: 1.35-5.00) were more likely to report good diabetes health literacy compared to their counterparts. Patients who reported reading health magazines (AOR 2.75; CI: 1.01-7.60) were more likely to report perfect medication adherence compared to those who did not. Why diabetes health literacy and medication adherence were low among diabetes patients in the most literate state needs further investigation. Interventions to enhance diabetes health literacy and medication adherence may be undertaken among diabetes patients encouraging them to read newspapers and health magazines regularly and use the internet.

Nursing internship students' knowledge regarding the care and management of people with diabetes: A multicenter cross-sectional study

BackgroundNursing students in their final year of study will soon become responsible for the care and management of people with diabetes, and they need to be knowledgeable to provide adequate information. ObjectivesThe aim of this study was to assess nursing students' knowledge regarding diabetes care and management. DesignA descriptive cross-sectional multicenter study. Settings and participantsA convenience sample of all nursing students' internship enrolled at three government universities in Saudi Arabia. Methods306 Saudi nursing students were surveyed with a self-administered questionnaire of the sociodemographic characteristics of the participants. The second part contained 23 multiple-choice questions of the Michigan Diabetes Knowledge Test. Data were collected from July to September 2022. ResultsThe overall percentage of correct responses was 49.28 %. There was a significant difference between sex, the university attended, attendance in courses related to diabetes, and diabetes management guidelines in any course and their knowledge about diabetes care and management (p = 0.024, 0.001, 0.036, and 0.038, respectively). There was a significant difference between nursing students' general knowledge and insulin use knowledge (p = 0.001). A multiple regression analysis revealed that the university attended was the only statistically significant factor (p = 0.001). ConclusionNursing internship students are likely to be responsible for providing people with diabetes care and management once they qualify. Inappropriate knowledge negatively affects the care and management of people with diabetes. Information related to diabetic insulin therapy should be provided in more detail in the nursing curriculum.

Impact of culturally tailored shared medical appointments on diabetes self-care ability and knowledge in African Americans.

Type 2 diabetes mellitus (T2DM) continues to disproportionately affect African Americans, significantly impacting morbidity and mortality. Research suggests that addressing barriers that stem from socioeconomic circumstances, systemic inequalities, biological factors, and cultural factors may positively influence biometric indicators of health and diabetes control. The aim of this study was to evaluate a diabetes shared medical appointment (SMA) model program that has been culturally tailored to address the unique social determinants of health barriers faced by an inner city African American population in Norfolk, Virginia. A pilot study using a within-group pretest-posttest design was conducted. Information was collected from self-report surveys that included the Modified Michigan Diabetes Knowledge Test, the Diabetes Self-Efficacy Scale, and researcher generated surveys before and after a single-session three-hour SMA program. The program increased perceived diabetes self-care confidence and perceived overall diabetes knowledge levels. Increases in knowledge scores were seen but not statistically significant. Participants reported high levels of satisfaction with the program model. Findings indicate that this model is an effective and engaging method of improving self-care ability and diabetes disease management knowledge among African Americans. Addressing unique circumstances and barriers experienced by this population may be more effective than usual traditional care approaches.

Diabetes Cognizance among Adults in Selected Rural Village in Thiruvallur District

India has experienced a large increase in non-communicable diseases (NCDs) in the past several decades. It has become important to assess the knowledge and aware of diabetes among the adults in order for early prevention of the disease and risk factors. The present study was conducted among 200 adults in selected rural area using Michigan diabetes knowledge test (MDKT). 55.5% of the adults had acceptable cognizance on diabetes.

Knowledge of diabetes and associated factors in rural Eastern Cape, South Africa: A cross sectional study.

Diabetes management is complex and requires several lifestyle modifications and engagement in self-management behaviours to prevent complications and to improve health outcomes. Adequate disease knowledge is required in order to engage in appropriate self-management behaviours. Yet, patients' knowledge of diabetes and associated factors are scarcely investigated. Context-specific data on diabetes knowledge are crucial for designing appropriate interventions for improving knowledge and treatment outcomes. This study examined the level of diabetes knowledge and its associated factors among persons with diabetes in Eastern Cape Province, South Africa. We conducted a cross-sectional study among 399 individuals attending diabetes care at six randomly selected primary healthcare facilities in Eastern Cape. Demographic data were obtained through questionnaire interviews while diabetes knowledge was assessed using the validated Michigan Diabetes Knowledge Test questionnaire. Descriptive and inferential statistics were used to assess the mean diabetes knowledge and its associated factors. Participants' median age was 63 (IQR: 54-70) years, and the median diabetes duration was 6 (IQR: 3-13) years. From a total score of 20, participants' knowledge of diabetes ranged from 0 to 17 with an average score of 7.5 (SD±2.2). After controlling for relevant covariates, being employed was positively associated with higher diabetes knowledge (p<0.001). However, health facility level was negatively associated with diabetes knowledge (p = 0.001). Participants receiving care at the community healthcare centres had a lower level of diabetes knowledge compared to those receiving care at the primary healthcare clinics. There was a low level of knowledge on the various components of diabetes management among individuals with diabetes in this setting. Therefore, context-specific interventions to improve the knowledge of diabetes is required and should target unemployed individuals and the community health centres in the region.

Impact of diabetes-related knowledge and medication adherence on quality of life among type 2 diabetes patients in a tertiary health facility in Multan, Pakistan

Purpose: To assess the impact of drug adherence and diabetes-related knowledge on the quality of life (QoL) of type 2 diabetes patients in a hospital in Pakistan.Methods: A cross-sectional study was conducted in City Hospital, Multan, Pakistan between March and September 2020. A total of 151 patients diagnosed with type 2 diabetes mellitus (T2DM) were recruited. Medication adherence, diabetes-related knowledge, and QoL were assessed by Drug attitude inventory-10 (DAI-10), the Michigan Diabetes Knowledge Test (MDKT), and EQ-5D-3L tools, respectively. The association between sociodemographic data and study variables was assessed by independent t-test and one-way ANOVA.Results: Among the 151 patients, 53 % were males. The mean MDKT score was 0.33 ± 0.18, indicating poor knowledge of diabetes. An overall moderate level of adherence was observed among the participants (mean adherence score, 6.14 ± 1.39). Mean QoL score was 1.31 ± 0.28, and the Visual Analog Scale score (VAS) was 59.6 ± 12.21, indicating a good to moderate QoL among the study participants. Study participants with a longer duration of diabetes and poor adherence to their medications showed poor QoL (p = 0.01, p = 0.004 respectively).Conclusion: Overall, the patients reported poor knowledge, moderate adherence, and good to moderate QoL. Moreover, patients with poor adherence to medication, longer duration of diabetes, and poorly controlled HbA1c showed poor QoL.

The Diabetes Knowledge Assessment in Type 2 Diabetic Patients: A Survey in West Coast Division of Sabah

The main concern in Type 2 Diabetes Mellitus (T2DM) management is to control the glycaemic level and thus prevent complications by behavioural modifications as a part of the government’s national strategic plan. The patient should know about the disease for behavioural modification to be implemented. Thus, this study evaluated the level of knowledge among T2DM patients in primary healthcare in the West Coast Division of Sabah. This is a cross-sectional study conducted in 2015 involving 15 primary healthcare clinics. A validated Malaysian version of the Michigan Diabetes Knowledge Test (MDKT) questionnaire was used to assess patients’ diabetes knowledge. The mean age of 369 patients is 54.9 years old (SD = 11.04). The means of knowledge scores were significantly different among the age group, education level, and employment status. No significant differences in knowledge were found in the group regarding the duration of diabetes and glycaemic control. Of 369 diabetic patients, 26.3% had poor knowledge, 65.0% had adequate knowledge, and only 8.7% had good knowledge. Overall, patients with T2DM in primary healthcare clinics have adequate knowledge regarding diabetes. Our study’s findings indicate that patients’ knowledge is associated with age group, level of education, and employment status. Healthcare providers should plan a good strategy to educate their patients based on these differences.

Assessing the mechanisms contributing to self-care behaviours in young and usual-onset diabetes.

Context: Young-onset diabetes (YOD) (age of onset 21-39 years) is associated with a poorer metabolic profile and a higher risk of complications, and poor self-care behaviours play a significant role. However, few studies have comprehensively examined the mechanisms (self-efficacy, dietary barriers, illness perceptions, knowledge, diabetes-related distress) that may contribute to poor self-care behaviours in YOD. Objectives: Our study aims to compare these mechanisms and self-care behaviours between participants with YOD and usualonset diabetes (age of onset 40-59 years). Study design: A cross-sectional survey was conducted in primary care clinics in participants with YOD or UOD, and type 2 diabetes for 10 years or less. Survey tools included the Diabetes Empowerment Scale short-form (DES-SF), dietary barriers of the Personal Diabetes Questionnaire (PDQ-DB), Brief Illness Perceptions Questionnaire (BIPQ), revised Michigan Diabetes Knowledge Test (DKT), diabetes distress scale (DDS), Summary of Diabetes Self-care Activities (SDSCA), International Physical Activity Questionnaire (IPAQ-SF) and medication adherence report scale (MARS-5), and means of both groups were compared using independent T-tests and effect sizes were analysed (Cohen's d). Results: 97 participants with YOD and 312 with UOD completed the survey. Compared with UOD, participants with YOD reported a lower adherence to a specific diet (d=0.45), with no significant differences in levels of physical activity or medication adherence. Participants with YOD experienced greater diabetes-related distress (d=0.35), especially with emotional (d=0.37), regimen-related (d=0.43) and interpersonal (d=0.39) distress. At the same time, perception of self-efficacy was significantly lower (d=0.27) and more dietary barriers were perceived (d=0.76). Participants with YOD also perceived that diabetes affected their lives more severely (consequence) (d=0.26), had a larger effect on their emotions (emotional representation) (d=0.28), will last longer (timeline) (d=0.37), and perceived that treatment was less likely help their diabetes (treatment control) (d=0.26). Conclusions: Participants with YOD experienced greater diabetes-related distress, lower self-efficacy and reported lower dietary adherence with more dietary barriers than those with UOD. Patients with YOD have distinctly different issues from UOD, and in providing care for YOD, clinicians should actively seek to identify and address these issues.

Knowledge of Diabetic Patients in Al-Kut City According to Revised Michigan Diabetes Knowledge Test

Background: Diabetes Mellites is a public health concern in Iraq. It was known that when patients have better knowledge about their illnesses, it is leading to more treatment adherence and finally fewer complications so the current study aims to assess the diabetic patient’s knowledge about their disease using Michigan Diabetes Knowledge Scale. Methods: This is a cross-sectional study performed among 384 randomly selected patients attending the diabetic center at Al-Zahraa Teaching Hospital in Wasit. All patients were formally consented to answer an Arabic revised Michigan Diabetes Knowledge Test. Results: The mean age and slandered deviation for patients was (43.85±17.25) years old. The female patients represented 58.6%, about two-thirds of cases (66.1%) were married, 40.1% with high educational level, about three quarters didn’t do any exercise (76.3%), only 17.4% of them are smokers. The majority (78.91%) of patients had a good knowledge score and 21.09% had low knowledge scores. The major source of knowledge mentioned by patients (75.52%) was from hospitals and physicians. The knowledge score was significantly associated with the type of medication and smoking status (p-value 0>.001 and 0.019), respectively. Conclusions: The good knowledge score was found in the majority of patients visiting the diabetic center in AL-Zahraa Teaching Hospital. Most of the patients were adherence to their treatment which reflects the knowledge´s effect on their behaviors.

Illness knowledge of type 2 diabetes patients: the Hungarian validation of Diabetes Knowledge Test

According to the Hungarian Central Statistical Office, more than 1 million diabetic patients live in Hungary. It is essential to enhance and sustain the knowledge, skills and self-efficacy of patients. The most widely used measurement of illness knowledge is the 23-item Michigan Diabetes Knowledge Test (DKT). Its first 14 items measure general knowledge: the nutritional value of food, and causes of change in blood glucose level. Its further 9 items are about insulin usage. To examine the reliability and the validity of the Hungarian version of DKT2 as well as its association with sociodemographic and illness-related variables. In our cross-sectional quantitative study, 129 patients (84 women, mean age: 59.67; SD = 12.6) diagnosed with type 2 diabetes mellitus using insulin therapy filled in a questionnaire online. The α coefficient for the test is 0.603, which is acceptable. The mean of the correct answer rate is 81.66%, which resembles the American results, but it is higher than that of other specific groups. Problem areas for our patients included interpreting ketoacidosis, the nutritional value of foods and the effect of foods on blood glucose level. The score of the Hungarian test - in accordance with the literature - correlates negatively with age, positively with the year of insulin-usage and with the number of daily insulin intake and of blood glucose measurement. Illness knowledge was independently predicted only by the number of daily blood glucose measurement. The convergent validity of the Hungarian test is supported by its weak but significant association with Brief Health Literacy Screen questions. The Hungarian DKT2 properly measures the illness knowledge of diabetic patients. Their high level of knowledge can be traced back to the speciality of the subjects as well as to the overall education of insulin users. Nevertheless, our results draw attention to the necessity of enhancing the level of dietetic knowledge of patients. Orv Hetil. 2020; 162(22): 870-877.

Efficacy and Safety of a Decision Support Intervention for Basal Insulin Self-Titration Assisted by the Nurse in Outpatients with T2DM: A Randomized Controlled Trial.

ObjectiveThe main aim of this study was to evaluate a combined fasting blood glucose based dosage self-titration setting and decision supported telephone coaching intervention on glycemic control and diabetes self-management skills, compared to the conventional care.MethodsA 12-week, single-blinded, randomized controlled trial was conducted on adults with type 2 diabetes (T2DM) primarily treated with basal insulin. After randomization, the intervention group (IG, n = 426) received a basal insulin self-titration decision support intervention administered by the Diabetes Specialty Nurses while the control group (CG, n = 423) received conventional care for 12 weeks, both included five telephone interviews. The primary efficacy endpoint was the effect of intervention on glycemic control, measured as the change in glycated hemoglobin (HbA1c) from baseline to Week 12 (after intervention) compared to the control group. Other endpoints included comparisons of the effects of intervention on fasting plasma glucose (FPG), postprandial plasma glucose (PPG), body weight, Michigan diabetes knowledge test (MDKT), diabetes empowerment scale-short Form (DES-DSF), and summary of diabetes self-care activities (SDSCA). Changes in the primary and secondary outcomes were compared using the t-test for continuous variables with a normal distribution and χ2-test for categorical variables.ResultsThe IG showed more improvements on mean HbA1c, compared to the CG (−2.8% vs −1.8%), so did the FPG, PPG, MDKT, DES-DSF and SDSCA (all P<0.01) after the 12-week follow up. Though the final mean insulin dose in the IG was higher than the CG at the end of the study (0.32 U/kg vs 0.28 U/kg), the changes of body weight were similar between the two groups (0.46kg vs 0.40kg, P=0.246), and the proportion of patients with hypoglycemia events during the whole trial were similar (20.65% vs 17.73%, P=0.279).ConclusionDecision supporting of basal insulin glargine self-titration assisted by Diabetes Specialty Nurses is effective and safe in patients with T2DM. Decision supported telephone coaching intervention offers ongoing encouragement, guidance, and determination of relevant sources of decisional conflict, facilitating adjusting the insulin dose.

The dietary knowledge measurement instruments in diabetes: A systematic psychometric review.

To identify, critically appraise, and summarize instruments to measure dietary knowledge in patients with diabetes mellitus type 1 or 2. Psychometric systematic review. A comprehensive search was carried out during March 2020 in the followed databases: Medline, Web of Science, Open Grey, Cochrane Library, COSMIN database, and Scielo. In accordance with the most up-to-date COnsensus-based Standards for the selection of health status Measurement INstruments methodology (COSMIN) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. A systematic review of the measurement properties of the instruments that assess the level of dietary knowledge in the diabetic population was carried out. The COSMIN checklist was used to assess the measurement properties of existing patient-reported outcome measures to select the most appropriate outcome measurement instrument. The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42020186516). Nine instruments were identified. The Michigan Diabetes Knowledge Test (DKT) was the questionnaire included in the largest volume of studies. The Diabetes Knowledge Questionnaire (DKQ) was the questionnaire with the most evaluated psychometric characteristics. The Personal Diabetes Questionnaire (PDQ) was the second with the highest number of psychometric characteristics evaluated and with a better score regarding the quality of the evidence. According to the quality methodological results; DKT, DKQ and PDQ are the recommended instruments to assess dietary knowledge in people with diabetes types 1 and 2. What problem did the study address? One of the main factors that lead to greater difficulty for patients with diabetes mellitus is dietary management, and it is necessary to evaluate whether the patient has sufficient knowledge about dietetics to practice a healthy diet. What were the main findings? Nine instruments were identified that were specifically designed to assess dietary knowledge in patients with diabetes mellitus (DM) type 1 or 2. Michigan Diabetes Knowledge Test, Diabetes Knowledge Questionnaire, and Personal Diabetes Questionnaire are the recommended instruments to assess dietary knowledge in people with diabetes. Where and on whom will the research have impact? The evaluation of this construct is very useful both in clinical practice; at hospital, community and primary care levels, in patients with type 1 and / or 2 diabetes mellitus (DM), as in research.

Evaluation of home medication review for patients with type 2 diabetes mellitus by community pharmacists: a randomised controlled trial.

Background:Successful diabetes treatment requires commitment and understanding of disease management by the patients.Objective:This trial aimed to evaluate the programme effectiveness of home medication review by community pharmacists (HMR-CP) in optimising diabetes care and reducing medication wastage.Methods:A randomised controlled trial was conducted on 166 patients with Type 2 Diabetes Mellitus (T2DM) who were randomly assigned to the intervention or control groups. The intervention group received HMR-CP at 0-month, 3-month, and 6-month. The primary outcome was haemoglobin A1c (HbA1c) while clinical outcomes, anthropometric data, and humanistic outcomes were the secondary outcomes. For the intervention group, drug-related problems (DRP) were classified according to the Pharmaceutical Care Network Europe Foundation (PCNE). Medication adherence was determined based on the Pill Counting Adherence Ratio (PCAR). The cost of medication wastage was calculated based on the total missed dose by the T2DM patients multiplied by the cost of medication. General linear model and generalised estimating equations were used to compare data across the different time-points within and between the groups, respectively.Results:No significant difference was observed in the demographic and anthropometric data at baseline between the two groups except for fasting blood glucose (FBG). There was a significant reduction in the HbA1c (-0.91%) and FBG (-1.62mmol/L) over the study period (p<0.05). A similar observation was noted in diastolic blood pressure (DBP) and total cholesterol (TC) but not in high-density lipoprotein (HDL), and anthropometric parameters. Both utility value and Michigan Diabetes Knowledge Test (MDKT) scores increased significantly over time. As for the intervention group, significant changes in PCAR (p<0.001) and the number of DRP (p<0.001) were noted.Conclusions:HMR-CP significantly improved the glycaemic control, QoL, medication adherence, and knowledge of T2DM patients as well as reduced the number of DRP and cost of medication wastage. However, the impact of HMR-CP on certain clinical and anthropometric parameters remains inconclusive and further investigation is warranted.

655-P: Improved Outcomes with Diabetes Devices Using Lower-Literacy Teaching Guides in a Center for Underserved Individuals with Type 1 Diabetes

Healthcare disparities exist between those in more or less affluent communities. This is particularly true for diabetes devices, where intensive training and follow-up is needed. Materials are generally written at an 11th grade reading level. Further, illustrations generally show low ethnic diversity. To reduce this educational gap, we created lower literacy, English and Spanish, multicultural guides for insulin pen and pump use. Focus groups provided input, nonbranded illustrations were created, and the text was edited by the “Clear Language Group.” Methods: The guides were implemented in our clinic for underserved, largely Hispanic, individuals in East Los Angeles. 47 adults with T1D were included. Subjects were given the low literacy guides and participated in guide driven individual and group education. Measures administered at baseline and 12 months were assessed for normality and independent sample t-tests. A 2-sided alpha of 0.05 was used. Results: Initial A1C was 9.2 +/- 1.97 (SD) with no change over the study course (12-month A1C = 9.3 +/- 1.92). However, patients showed an improved overall self-report of health (p = 0.012), improvement in diabetes knowledge (Michigan Diabetes Knowledge Test, p=.004), a reduction in symptoms of depression (PHQ8, p=.042), and diabetes distress (Diabetes Distress Scale, T1D Redeem, p = 0.0123). Though no change in rates of hypoglycemia, a reduction in fear of hypoglycemia (Hypoglycemia Fear Scale, Fear sub-scale, P=0.025) was significant. Additionally, there was a reduction in rates of DKA (0.0108). Time in range was minimal, based on blinded CGM, at baseline (22.4%) and did not change at 12 months (24.0%). CGM data was only available on 25 patients due to patient reluctance to wear the device. Conclusions: Appropriately targeted teaching guides can be used to improve a variety of outcomes in people with T1D, including rates of DKA. However, more work is needed to make a significant impact on glycemic control. Disclosure A.L. Peters: Advisory Panel; Self; Abbott, Bigfoot Biomedical, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, MannKind Corporation, Medscape, Novo Nordisk Inc., Sanofi US. Consultant; Self; Livongo Health. Research Support; Self; Dexcom, Inc., vTv Therapeutics. Other Relationship; Self; Livongo Health, Mellitus Health, Omada Health, Stability Healthcare, Whole Biome Inc. M.A. Walker: None. V.F. Ruelas: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust

Knowledge about Diabetes and Glycemic Control among Diabetic Patients in Saudi Arabia.

The prevalence of diabetes in various regions has attracted significant attention of the medical experts. The prevalence of diabetes is expected to increase in the future due to changes in lifestyle and unhealthy diets of individuals. The objective of the study is to identify the extent of knowledge related to diabetes and glycemic controls in various diabetic patients living in Saudi Arabia. A total of 435 patients were recruited using a random sampling technique, while following a cross-sectional design. Patients' knowledge was tested using the Michigan Diabetes Knowledge Test. Findings of the study illustrated that the problem was common among middle-aged male patients. A significant amount of knowledge related to the consumption of medicines, insulin, healthy diet, etc. was found among diabetic patients. Despite the fact that people have adequate knowledge, valuable attention is yet required to provide necessary counselling to people living in Saudi Arabia that may help them to control health risks and mortality.

Association of Disease Knowledge and Medication Adherence Among Out-Patients With Type 2 Diabetes Mellitus in Khobar, Saudi Arabia.

ObjectiveThe study aimed to evaluate the association between disease knowledge and medication adherence in patients with type 2 diabetes mellitus.MethodsA cross-sectional study was conducted for three months, in patients with type 2 diabetes who visited three community pharmacies located in Khobar, Saudi Arabia. Patients’ disease knowledge and their adherence to medications were documented using Arabic versions of the Michigan Diabetes Knowledge Test and the General Medication Adherence Scale respectively. Data were analyzed through SPSS version 23. Chi-square test was used to report association of demographics with adherence. Spearman’s rank correlation was employed to report the relationship among HbA1c values, disease knowledge and adherence. Logistic regression model was utilized to report the determinants of medication adherence and their corresponding adjusted odds ratio. Study was approved by concerned ethical committee (IRB-UGS-2019-05-001).ResultsA total of 318 patients consented to participate in the study. Mean HbA1c value was 8.1%. A third of patients (N = 105, 33%) had high adherence and half of patients (N = 162, 50.9%) had disease knowledge between 51% - 75%. A significantly weak-to-moderate and positive correlation (ρ = 0.221, p < 0.01) between medication adherence and disease knowledge was reported. Patients with >50% correct answers in the diabetes knowledge test questionnaire were more likely to be adherent to their medications (AOR 4.46, p < 0.01).ConclusionDisease knowledge in most patients was average and half of patients had high-to-good adherence. Patients with better knowledge were 4 to 5 times more likely to have high adherence. This highlights the importance of patient education and awareness regarding medication adherence in managing diabetes.

Relationship Between Diabetes Knowledge, Glycemic Control, and Associated Health Conditions.

Objective.The purpose of this study was to identify any existing relationship between diabetes knowledge and glycemic control, as well as possible associations with patient health, among patients with type 2 diabetes.Design and Methods.This qualitative study used a validated multiple-choice test (the Michigan Diabetes Knowledge Test) to assess diabetes knowledge among 17 hospital patients between the ages of 18 and 75 years with type 2 diabetes and a recent (within 3 months) A1C laboratory value. Participants also provided information about their diabetes self-care habits, previous diabetes education, and diabetes-related secondary health conditions.Results.The average diabetes knowledge score was 8.4 of 14 (60%), and the average A1C was 9.3%. Thirteen participants had previously received diabetes education, whereas four participants had never received diabetes education. The participants who had not received education scored 15.3% lower on the diabetes knowledge test and had an average A1C 0.89% higher than those who had received previous education. Although this difference was not statistically significant, it is clinically relevant. There was a significant association between diabetes knowledge and presence of retinopathy (P = 0.03).Conclusion.Diabetes self-management education and support is a crucial component of diabetes care. There is a considerable need for diabetes education strategies to improve self-management of diabetes and thereby improve outcomes and decrease the costs of diabetes-related care. There is also a need for efforts to ensure regular vision screenings for individuals with type 2 diabetes.

Psychosocial factors and glycemic control in insulin-naïve and insulin-experienced people with type 2 diabetes: a path analysis model

The purpose of this study was to compare the status of psychosocial factors and glycemic control in insulin-naive and insulin-experienced people with type 2 diabetes (T2D). In this observational study on people with T2D, demographic, self-care behavior, resources, and affective variables as well as health-related quality of life were assessed and compared in insulin-naive and insulin-experienced considering the number of oral glucose-lowering drugs (OGLDs). Measured variable path analysis was used to test the association among variables and their effect on HbA1c in both groups. In total, 215 insulin-naive and 165 insulin-experienced patients were recruited in this study. The mean duration of diabetes was 11.7 ± 7.0 years in insulin-experienced and 6.8 ± 5.4 years in insulin-naive (p < 0.001). The mean hemoglobin A1c (HbA1c) was significantly higher in insulin-experienced subjects irrespective of the number of OGLDs [68 ± 20 mmol/mol (8.4 ± 1.8%) vs. 56 ± 16 mmol/mol (7.3 ± 1.4%); p < 0.001]. Moreover, insulin-experienced subjects had significantly higher level of diabetes-related distress (2.2 ± 0.9 vs. 1.9 ± 0.8), depression (9.5 ± 5.5 vs. 8.1 ± 5.1), anxiety (18.3 ± 12.0 vs. 15.1 ± 10.5), and lower knowledge of insulin use considering the results of 9-item insulin-use subscale of Michigan diabetes knowledge test (mean 3.9 ± 1.8) compared to insulin-naive subjects (p < 0.05). Higher levels of distress, depression, and anxiety are found in insulin-experienced people with T2D. Therefore, one should be aware that, at the time of insulin need/initiation, people with T2D have reached a more vulnerable state and this should be taken into consideration when implementing a complex insulin initiation plan.