scholarly journals Knowledge, Attitudes, and Practices of Patients with type 2 Diabetes Mellitus with Regard to their Disease: A Cross-Sectional Study Among Palestinians of the West Bank

Author(s):  
Ramzi Shawahna ◽  
Saed Samaro ◽  
Zaid Ahmad

Abstract Background: In Palestine, type 2 diabetes mellitus (T2DM) is a rapidly growing health concern. This study was conducted to evaluate current knowledge, attitudes, and practices among Palestinian patients with T2DM in the West Bank and to assess association between knowledge, attitudes, and practices with sociodemographic and clinical characteristics of the patients. Methods: This cross-sectional observational study was conducted in primary healthcare facilities frequently visited by patients with T2DM across the West Bank of Palestine. A pre-validated interviewer administered questionnaire was used to determine knowledge, attitudes and practices of patients with T2DM with regard to their disease.Results: Data were collected from 220 patients with T2DM. Patients who were younger than 55 years old (p-value = 0.002), male (p-value = 0.038), never married (p-value = 0.001), employed (p-value = 0.003), had university degree (p-value <0.001), had higher income (p-value <0.001), diagnosed less than 7 years ago (p-value = 0.009), and had usual fasting plasma glucose of less than 140 mg/dL (p-value = 0.027) tended to score more than 50% in the knowledge items. Patients who had higher income tended to have higher positive attitudes (p-value = 0.041) toward their disease. Patients who were younger than 55 years old (p-value = 0.002), employed (p-value = 0.003), had university degree (p-value <0.001), diagnosed less than 7 years ago (p-value = 0.009), had usual fasting plasma glucose of less than 140 mg/dL (p-value = 0.027), had usual postprandial plasma glucose of less than 200 mg/dL (p-value = 0.027), had usual HbA1c of less than 7% (p-value = 0.027) tended to score more than 80% in the practice items.Conclusions: The study established correlation between knowledge, attitude, and practice scores with sociodemographic and clinical characteristics of patients with T2DM in Palestine. Findings of this study highlighted the need for appropriately designed interventions to increase knowledge of T2DM and its complications, address the negative attitudes toward the disease, and promote healthy practices with regard to the disease. Future studies are still needed to assess if such interventions could be effective in improve health outcomes and quality of life of patients with T2DM in Palestine.

2020 ◽  
Author(s):  
Nouar Qutob ◽  
Faisal Awartani

Coronavirus disease 2019 (COVID19) is a highly contagious illness that spreads rapidly through human to human transmission. On March 5, the government of Palestine declared a state of emergency in order to curb the spread of the virus, a declaration that it extended for a fifth time on July 5th. The degree to which a population complies with corresponding safety measures is surely affected by the people's knowledge, attitudes and practices (KAP) towards the disease. To explore this hypothesis, we gathered data from 1,731 Palestinians between April 19th and May 1st, 2020 through a KAP questionnaire. The participant pool represented a stratified sample of Palestinians living across a number of governorates in the Gaza Strip and the West Bank, with 36.5% from Gaza and (63.5%) from the West Bank. Gender was almost equally distributed within the sample with (51%) male respondents and (49%) female respondent. The questionnaire included 17 questions about participants knowledge and awareness of COVID19, 17 questions regarding the safety measures they had taken in the wake of the outbreak and 3 questions asking them to assess the efficacy of the governments response to the pandemic. The overall correct mean of the knowledge was 79.26+-0.35. Most participants' expressed confidence that Covid19 would be successfully controlled and that Palestine could win the battle against Covid19, though 62% believed that stricter measurements must be applied. Based on the results of this study, we conclude that health education programs aimed at improving the public's understanding of COVID19 are important in helping the population maintain appropriate practices, and that findings such as those discussed in this report may provide valuable feedback to lawmakers working to stop the spread of the virus.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10691
Author(s):  
Yimeng Hu ◽  
Qinge Li ◽  
Rui Min ◽  
Yingfeng Deng ◽  
Yancheng Xu ◽  
...  

Background The relationship between serum uric acid (SUA) and several diabetic complications or co-morbidities remains a matter of debate. The study aims to explore the association between SUA levels and the prevalence of non-alcoholic fatty liver disease (NAFLD), diabetic retinopathy (DR), diabetic nephropathy (DN) and diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM). Methods A total of 2,809 participants (1,784 males and 1,025 females) were included in this cross-sectional study. Clinical characteristics and the prevalence of each of the four diseases were analyzed based on gender-specific quartiles of SUA levels. The Pearson correlation analysis and linear-regression analysis were used to access the correlation between SUA levels and clinical characteristics. Furthermore, a binary logistic regression analysis was carried out to determine whether SUA was an independent risk factor for each of the four complications. Results SUA levels were positively correlated to BMI, BUN, Scr and TG, but negatively associated with eGFR, HDL, FBG, 2h-PG and HbA1c% for the patients with T2DM. The prevalence of NAFLD and DN, but not DR or DPN, were increased with SUA levels from the first to the fourth quartile. Binary logistic regression further disclosed that SUA was an independent risk factor for NAFLD (ORs Male = 1.002, ∗P = 0.0013; ORs Female = 1.002, ∗P = 0.015) and DN (ORs Male = 1.006, ∗P < 0.001; ORs Female = 1.005, ∗P < 0.001), but not for DR and DPN. After adjustment for the confounders, SUA levels were significantly associated with NAFLD within the 3rd (ORs = 1.829, P = 0.004) and 4th quartile (ORs = 2.064, P = 0.001) for women, but not independently associated with SUA for man. On the other hand, our results revealed increased prevalence of DN for SUA quartile 2 (ORs = 3.643, P = 0.039), quartile 3 (ORs = 3.967, P = 0.024) and quartile 4 (ORs = 9.133, P < 0.001) in men; however, SUA quartiles were significantly associated with DN only for quartile 4 (ORs = 4.083, P = 0.042) in women Conclusion For patients with T2DM, elevated SUA concentration is an independent risk factor for the prevalence of NAFLD and DN after adjustment for other indicators, but not DR or DPN.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041269
Author(s):  
Tullaya Sitasuwan ◽  
Raweewan Lertwattanarak

ObjectivesAbout 11%–30% of individuals with impaired fasting plasma glucose (IFG) have type 2 diabetes mellitus (T2DM), diagnosed by the 75 g oral glucose tolerance test (75 g OGTT). This study investigated (1) the prevalence and cut-off levels for fasting plasma glucose (FPG) and glycated haemoglobin A1c (HbA1c) in IFG individuals that most effectively predict the presence of T2DM diagnosed by a 75 g OGTT; (2) the predictors associated with T2DM; and (3) the pathophysiological characteristics of patients with IFG.Materials and methodsA single-centre, cross-sectional study was conducted in a primary care setting. A standard 75 g OGTT was performed on 123 subjects with IFG. Their beta-cell function and insulin resistance were calculated through plasma glucose and insulin levels monitored during the 75 g OGTT.ResultsIn the IFG subjects, the prevalence of T2DM using the 2-hour postload plasma glucose (2hPG) criterion was 28.5%. Pre-diabetes and normal glucose metabolism were found in 48.7% and 22.8%, respectively, by 75 g OGTT. An HbA1c level ≥6.0% or FPG ≥5.9 mmol/L were the optimal cut-off thresholds for the prediction of the presence of T2DM. HbA1c had a sensitivity of 76.7% and specificity of 55.7% (95% CI 57.7% to 90.1% and 95% CI 43.3% to 67.6%, respectively), while FPG had a sensitivity of 85.7% and specificity of 23.9% (95% CI 69.7% to 95.2% and 95% CI 15.4% to 34.1%, respectively). The presence of metabolic syndrome, a higher HbA1c and higher FPG levels were associated with the risk of T2DM in the Thai IFG population.ConclusionsAlmost one-third of the people with IFG had T2DM diagnosed by the 2hPG criterion. HbA1c was more effective than FPG in predicting the presence of T2DM in the IFG subjects. IFG individuals with HbA1c≥6.0% or FPG≥5.9 mmol/L should be advised to undergo a 75 g OGTT to detect T2DM earlier than otherwise.


2021 ◽  
Vol 9 (2) ◽  
pp. 140-144
Author(s):  
Andrew Thomas ◽  
Mohan T. Shenoy ◽  
K.T. Shenoy ◽  
Nirmal George

Background: The effectiveness of self-monitoring of blood glucose (SMBG) in type 2 diabetes mellitus (T2DM) patients is debated in the literature. We aimed at elucidating the association and patterns of complications between SMBG use and plasma glucose values. Methods: This cross-sectional study comprised 303 participants from outpatient departments with T2DM for over 12 months. We analyzed sociodemographic and clinical variables including: anthropometry, SMBG use, disease duration, treatment modality, complications, plasma glucose level, and glycated hemoglobin level (%). Results: The mean duration of T2DM was 93±76 months. Participants were grouped into SMBG users (n=115, 38%) and non-SMBG users (n=188, 62%). The mean fasting plasma glucose levels of SMBG and non-SMBG users were 140.7±42.7 (95% Confidence Interval [95%CI]: 132.72;148.67) mg/dl and 145.4±50 (95%CI: 138.12;152.67) mg/dl (p=0.03), respectively. The mean post-prandial plasma glucose levels of the SMBG and non-SMBG groups were 202±63.42 (95%CI: 190.23;213.76) mg/dl and 209±84.54 (95%CI: 196.56;221.43) mg/dl (p=0.002), respectively. The mean difference in HbA1c among the groups were 8.14±1.69% (95%CI: 7.59;8.68) and 8.15±1.98% (95%CI: 7.27;9.02) (p=0.4), respectively. Hypoglycemia (n=50, 43.5%) was the most common complication. The prevalence of neuropathy (n=5, 4.3%, p=0.036) and cardiovascular disease (n=21, 18.3%, p=0.042) were significantly higher in the SMBG group. Conclusion: Although plasma glucose values were significantly lower in the SMBG group, its clinical significance remains questionable. Furthermore, many participants in both the groups had shortfalls in awareness, monitoring, and glycemic control. SMBG use needs to be evaluated in a cohort of patients with T2DM with adequate health awareness.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244925
Author(s):  
Nouar Qutob ◽  
Faisal Awartani

Coronavirus disease 2019 (COVID-19) is a highly contagious illness that spreads rapidly through human-to-human transmission. On March 5, the government of Palestine declared a state of emergency in order to curb the spread of the virus, a declaration that it extended for a fifth time on July 5th. The degree to which a population complies with corresponding safety measures is surely affected by the people’s knowledge, attitudes and practices (KAP) towards the disease. To explore this hypothesis, we gathered data from 1,731 Palestinians between April 19thand May 1st, 2020 through a KAP questionnaire. The participant pool represented a stratified sample of Palestinians living across a number of governorates in the Gaza Strip and the West Bank, with 36.5% from Gaza and (63.5%) from the West Bank. Gender was almost equally distributed within the sample with (51%) men respondents and (49%) women respondent. The questionnaire included 17 questions about participants’ knowledge and awareness of COVID–19, 17 questions regarding the safety measures they had taken in the wake of the outbreak and 3 questions asking them to assess the efficacy of the government’s response to the pandemic. Our data shows that 79% of the respondents have good awareness about transmission of the virus, 55.6% were knowledgeable of the symptoms exhibited by an infected individual, 81% were aware of the preventative measures and 82% demonstrated awareness of the risk groups. Most participants complied with preventative measures (77%) and 62% the study participants agreed that stricter measures have to be enforced by the government to limit the spread of the virus. Our study revealed that younger participants and people with higher educational level demonstrated more awareness of the virus. Also, Women were reported to be more aware of preventative measures and to have complied more with good practices. We report that residents of the West Bank have complied more with the right practices when compared to residents of Gaza. Based on the results of this study, we conclude that health education programs aimed at improving the public’s understanding of COVID-19 are important in helping the population maintain appropriate practices and should be target people with lower educational level, and that findings such as those discussed in this report may provide valuable feedback to lawmakers working to stop the spread of the virus.


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