Marques João O, Bandeira Andreia, Parreira Roberta B, Ferreira Adriana M, Roteia Catarina C
Esporões Family Health Unit, Braga Local Health Unit, Braga, PRT.
Gualtar Family Health Unit, Braga Local Health Unit, Braga, PRT.
Cureus. 2024 Dec 10;16(12):e75439. doi: 10.7759/cureus.75439. eCollection 2024 Dec.
Diabetes mellitus is a prevalent disease in the Portuguese population and is associated with significant morbidity and mortality. Its proper therapeutic management is multifactorial, with lifestyle habits having a major impact. Studies show that poorer metabolic control is associated with deficient knowledge related to diabetes, lower self-efficacy, and limited patient empowerment. The aim of this study was to characterize diabetic patients' knowledge about their disease using the Diabetes Knowledge Test (DKT) and to assess the potential correlation between disease knowledge and metabolic control.
A cross-sectional study was conducted involving a convenience sample of diabetics followed in four primary care units in Braga, Portugal. The sample was divided into two groups: insulin-treated (IT) and non-insulin-treated (NT).
Each participant was given the DKT. Frequency measures were used to describe the sociodemographic characteristics and clinical parameters. For association between categorical variables, the Fisher's test and chi-square test were used. To compare the distribution of the response variable (metabolic control represented by glycated hemoglobin (HbA1C) values) between IT and NT, the Mann-Whitney test was used. For association between nominal qualitative variables, the chi-square test was employed. The statistical significance level used in the tests was 5% (p<0.05).
A total of 99 responses were obtained, with an average age of 65.5 years. Most of the respondents were male, had a low education level, were overweight, and had type 2 diabetes diagnosed 10 or more years ago, with an average HbA1C value of 6.83%. The average performance obtained by the DKT scale revealed medium levels of knowledge (IT and NT). Both groups displayed a medium level of knowledge (59% for NT and 62.5% for IT), without statistically significant difference. There was a statistical difference in metabolic control between IT and NT (Mann-Whitney test, p<0.05). Regarding the degree of knowledge of the disease (by DKT results), there was no statistically significant association, using the Fisher's test (p=0.20), between the two groups. In NT, there was no statistically significant association between metabolic control and the degree of knowledge (Fisher's test, p=0.69). There was an association between metabolic control and the duration of the disease (Fisher's test, p=0.029, odds ratio 3.83) in NT, as in IT (p=0.025). However, there was not a proven association between metabolic control and the degree of knowledge in IT (Fisher's test, p=0.62).
This study provides a comprehensive analysis of the characteristics of patients with diabetes and the factors affecting both metabolic control and disease knowledge. Although general knowledge of diabetes was "medium" for most patients, this level of knowledge may not be sufficient to ensure good self-care, especially in IT and those with a longer duration of disease. A longer duration of diagnosis was associated with poorer metabolic control, which may be related to the natural progression of diabetes and the challenges in maintaining adequate control over time. This finding highlights the need for continuous and personalized strategies for managing the disease as it progresses. Furthermore, these results emphasize the need for public health policies that promote enhanced diabetes education, aiming to empower patients to manage their condition more effectively.
糖尿病是葡萄牙人群中的一种常见疾病，与显著的发病率和死亡率相关。其恰当的治疗管理是多因素的，生活方式习惯有重大影响。研究表明，较差的代谢控制与糖尿病相关知识不足、自我效能较低以及患者赋权有限有关。本研究的目的是使用糖尿病知识测试（DKT）来描述糖尿病患者对其疾病的了解情况，并评估疾病知识与代谢控制之间的潜在相关性。
进行了一项横断面研究，涉及在葡萄牙布拉加的四个初级保健单位接受随访的糖尿病患者便利样本。样本分为两组：胰岛素治疗组（IT）和非胰岛素治疗组（NT）。
为每位参与者进行DKT测试。使用频率测量来描述社会人口学特征和临床参数。对于分类变量之间的关联，使用费舍尔检验和卡方检验。为比较IT组和NT组之间反应变量（以糖化血红蛋白（HbA1C）值表示的代谢控制）的分布，使用曼 - 惠特尼检验。对于名义定性变量之间的关联，采用卡方检验。测试中使用的统计显著性水平为5%（p<0.05）。
共获得99份回复，平均年龄为65.5岁。大多数受访者为男性，教育水平低，超重，且在10年或更早以前被诊断为2型糖尿病，平均HbA1C值为6.83%。DKT量表获得的平均成绩显示知识水平中等（IT组和NT组）。两组均显示知识水平中等（NT组为59%，IT组为62.5%），无统计学显著差异。IT组和NT组之间在代谢控制方面存在统计学差异（曼 - 惠特尼检验，p<0.05）。关于疾病知识程度（根据DKT结果），使用费舍尔检验（p = 0.20），两组之间无统计学显著关联。在NT组中，代谢控制与知识程度之间无统计学显著关联（费舍尔检验，p = 0.69）。与IT组一样（p = 0.025），NT组中代谢控制与疾病持续时间之间存在关联（费舍尔检验，p = 0.029，优势比3.83）。然而，IT组中代谢控制与知识程度之间未证实存在关联（费舍尔检验，p = 0.62）。
本研究对糖尿病患者的特征以及影响代谢控制和疾病知识的因素进行了全面分析。尽管大多数患者对糖尿病总体知识为“中等”，但该知识水平可能不足以确保良好的自我护理，特别是在IT组和疾病持续时间较长的患者中。诊断时间较长与较差的代谢控制相关，这可能与糖尿病的自然进展以及随着时间维持充分控制的挑战有关。这一发现凸显了随着疾病进展进行持续和个性化疾病管理策略的必要性。此外，这些结果强调了促进加强糖尿病教育的公共卫生政策的必要性，旨在使患者更有效地管理自己的病情。
