Hawthorne K, Tomlinson S
Manchester Diabetes Centre, UK.
Diabet Med. 1999 Jul;16(7):591-7. doi: 10.1046/j.1464-5491.1999.00102.x.
To study factors such as sex, educational status and place of care, which might influence knowledge and self-management of diabetes, and glycaemic control in a Pakistani moslem diabetic population attending primary care general practices (GP) and secondary care clinics at the Manchester Diabetes Centre (MDC).
Patients with Type 2 diabetes mellitus took part in a one-to-one semi-structured interview and gave blood for haemoglobin A1c levels.
Two hundred and one patients entered the study. Knowledge about diabetic diets was good (average scores 72%), and patients claimed to perform regular glucose measurements (66%), but they were not good at applying their knowledge to problems in daily life. Only 24% knew how to manage persistent hyperglycaemia. Women were worse than men at this (19 vs. 31% (chi2 = 3.8, P = 0.05)), were less likely to understand why glucose levels should be monitored, and had poorer glycaemic control overall (HbA1c 8.8 vs. 8.1%, P = 0.04). Fifty-four patients were completely illiterate. They had similar knowledge scores to readers but were less able to handle problem scenarios. Forty-five of these patients were women, and multiple regression analysis showed they were more likely to have the poorest glycaemic control. No major differences were found between general practitioner and hospital attenders, or between patients with and without known complications, except that hospital attenders were more likely to have complications and poorer control.
Women who cannot read in this population are likely to have poorer glycaemic control and may be finding it more difficult to learn how to apply their knowledge to daily life. This subgroup may need more intensive, culturally appropriate, health education and support.
研究性别、教育程度和护理地点等因素，这些因素可能会影响巴基斯坦穆斯林糖尿病患者在曼彻斯特糖尿病中心（MDC）的初级保健全科诊所（GP）和二级保健诊所就诊时对糖尿病的认知、自我管理以及血糖控制情况。
2型糖尿病患者参与一对一的半结构化访谈，并采集血液检测糖化血红蛋白水平。
201名患者进入研究。患者对糖尿病饮食的认知良好（平均得分72%），且声称会定期进行血糖测量（66%），但他们不善于将知识应用于日常生活中的问题。只有24%的人知道如何处理持续性高血糖。在这方面女性比男性更差（19%对31%（卡方=3.8，P = 0.05）），理解为何应监测血糖水平的可能性更低，总体血糖控制也更差（糖化血红蛋白8.8%对8.1%，P = 0.04）。54名患者完全不识字。他们的知识得分与识字者相似，但处理问题情境的能力较差。这些患者中有45名是女性，多元回归分析显示她们血糖控制最差的可能性更大。在全科医生就诊者和医院就诊者之间，以及有和没有已知并发症的患者之间未发现重大差异，只是医院就诊者更可能有并发症且控制更差。
该人群中不识字的女性可能血糖控制更差，并且可能发现在将知识应用于日常生活方面更困难。这一亚组可能需要更强化的、符合文化背景的健康教育和支持。
