Diabetic health literacy and its association with glycemic control among adult patients with type 2 diabetes mellitus attending the outpatient clinic of a university hospital in Ethiopia

Aim: In this study, we aimed to assess the level of good glycemic control, to determine association between adherence to antidiabetic medications and glycosylated hemoglobin (HbA1c) and to examine factors influencing good glycemic control. Materials and methods: A cross-sectional design was employed among 369 patients with type 2 diabetes mellitus (T2DM) from four Ministry of Health health centers in 2016. A sample of 3 ml blood was taken to measure the HbA1c, and patients were asked to fill out a pretested questionnaire. Univariate and multivariate logistic regressions, to identify independent factors associated with good glycemic control, were conducted using SPSS software version 22 (IBM Corp, Armonk, NY, USA). Results: Mean [±standard deviation (SD)] of HbA1c was 8.97 (2.02) and one fifth of patients had good glycemic control (HbA1c ⩽ 7%). Factors associated with good glycemic control were: older age [odds ratio (OR) = 0.96, 95% confidence interval (CI): 0.933–0.988), high medication adherence (OR: 2.757, 95% CI: 1.308–4.693), and better health literacy (OR= 2.124, 95% CI: 1.917–4.921). Duration of diabetes mellitus (DM > 7 years) was inversely related to good glycemic control (OR = 2.255, 95% CI: 1.189–4.276). Conclusion: Our study showed that glycemic control was suboptimal, and factors associated with that were: older age, high medication adherence, and better health literacy. Knowledge of these factors could be an entry toward helping patients and targeting interventions to improve glycemic control and prevent diabetes-related complications.

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Association of Health Literacy and Nutritional Status Assessment with Glycemic Control in Adults with Type 2 Diabetes Mellitus

Nutrients ◽

10.3390/nu12103152 ◽

2020 ◽

Vol 12 (10) ◽

pp. 3152

Author(s):

Saman Agad Hashim ◽

Mohd Yusof Barakatun-Nisak ◽

Hazizi Abu Saad ◽

Suriani Ismail ◽

Osama Hamdy ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Health Literacy ◽

Glycemic Control ◽

Nutritional Status ◽

Poor Glycemic Control ◽

Antidiabetic Therapy ◽

Oral Agents

While the role of medical and nutrition factors on glycemic control among adults with type 2 diabetes mellitus (T2DM) has been well-established, the association between health literacy (H.L.) and glycemic control is inconsistent. This study aims to determine the association of H.L. and nutritional status assessments with glycemic control in adults with type 2 diabetes mellitus. A total of 280 T2DM respondents (mean (SD) age = 49.7 (10.3) years, Glycated hemoglobin (HbA1c) = 9.9 (2.6) %, and Body Mass Index = 32.7 (15.1) kg/m2) were included in this study. A short-form Test of Functional Health Literacy in Adults (S-TOFHLA) assessed the H.L. levels. Nutritional status assessments included client history, glycemic control, anthropometric, and biochemical data. The mean (S.D.) H.L. score was 45.7 (24.6), with 56% of the respondents had inadequate H.L. Inadequate H.L. was more common among those females; housewives, low education, received oral antidiabetic therapy, and shorter diabetes duration. Respondents with inadequate H.L. were significantly older and had higher HbA1c than those with marginal and adequate H.L. Meanwhile, respondents with inadequate and marginal H.L. levels had significantly higher total cholesterol, LDL-cholesterol, and systolic blood pressure than the respondents with adequate H.L. Low H.L. scores, self-employment status, received dual antidiabetic therapy (insulin with oral agents), received insulin alone, and had higher fasting blood glucose explained about 21% of the total variation in HbA1c (adjusted R2 = 0.21; p < 0.001). Respondents with inadequate H.L. had poor glycemic control. The H.L. scores, together with nutritional status assessments, were the factors that predicted poor glycemic control among adults with T2DM.

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Trace elements in type 2 diabetes mellitus and their association with glycemic control

African Health Sciences ◽

10.4314/ahs.v20i1.34 ◽

2020 ◽

Vol 20 (1) ◽

pp. 287-293

Author(s):

Rana MW Hasanato

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Trace Elements ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Inductively Coupled Plasma ◽

Serum Levels ◽

University Hospital ◽

Inductively Coupled

Background: Alterations in serum levels of trace elements reported in type 2 diabetes mellitus (T2DM) have been linked with induction of T2DM and associated complications. Objectives: To assess serum levels of copper (Cu), zinc (Zn) and selenium (Se) in T2DM patients with adequate and poor gly- cemic control. Patients and methods: This study was performed at King Khalid University Hospital, Riyadh. A total of 100 consenting T2DM patients comprising of 50 patients with glycated hemoglobin (HbA1c) less than 6.5% and 50 patients with HbA1c more than 6.5% along with a group of 50 normal healthy individuals were included in the study. Serum levels of Cu, Zn and Se were measured by inductively coupled plasma-mass spectrometry (ICP-MS) instrument. Results: Among T2DM patients with HbA1c <6.5%, mean serum Cu levels (13.4+4.3μmol/L) were not different from the controls (14.5+1.92μmol/L) whereas Zn (9.9+2.7μmol/Lvs15+3.2μmol/L;p<0.0001) and Se levels (1+0.2μmol/ Lvs1.62+0.2μmol/L; p<0.0004) were lower than the controls. Among T2DM patients with HbA1c >6.5% mean serum Cu (18.1+4.1μmol/Lvs14.5+1.9μmol/L; p<0.0001), Zn (15+3.2μmol/Lvs13.5+1.9μmol/L; p<0.009) and Se (1.62+0.2μmol/ Lvs1.17+0.16μmol/L;p<0.0001) were significantly higher than the controls. HbA1c% negatively correlated with HbA1c >6.5% (r = -0.302; p<0.03). Conclusion: Cu, Zn and Se homeostasis was altered in T2DM patients and varied with glycemic control. Keywords: Copper; Zinc; Selenium; trace elements; diabetes mellitus.

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