The Role of Educational Level in Glycemic Control among Patients with Type II Diabetes Mellitus

Abstract

Abstract:Objectives: To evaluate the impact of the educational level on glycemic control among patients with type II diabetes mellitus. Methods:A disproportional systematic stratified sample of 384 patients, based on educational level, was selected from patients of type II diabetes attending the Primary Care Clinic of King Khalid University Hospital, over a period of 6 months in 2012-2013. A questionnaire sought information about socio-demographic factors, clinical characteristics, awareness of diabetic complications and self-care management behaviors. Weight and height were measured. Poor glycemic control was defined as HbA1c ≥7%. Result:The rate of patients who had poor glycemic control is 67.7%. The educational level had no impact on glycemic control, but the patients of high educational level had better awareness of the complications and a high rate of adherence to diet. About 70.5% of patients were aware of two or more diabetic complications. The factors associated with poor control included increased duration of diabetes, use of insulin and oral hypoglycemic agents combination, being obese or overweight, poor adherence to diet, poor adherence to exercise and poor compliance with follow up. This study found a high rate of poor adherence to diet (68%) and poor adherence to exercise (79.4%). Conclusion:The proportion of patients with poor glycemic control was high in this study. This study showed that educational level may not be a good predictor of better therapeutic compliance. In-spite of the significant importance of appropriate diet and exercise in the control of diabetes, there was a high rate of poor adherence to diet and to exercise, especially among females. Educational programs that emphasize adherence to treatment regimens as a whole, especially to diet, to exercise and to regular follow up are of greater benefit in glycemic control as compared to compliance of medications alone.

Glycemic Control among Patients with Type 2 Diabetes Mellitus in Countries of Arabic Gulf

“…In KSA, the rate of patients who had poor glycemic control (AIC ≥ 7%) among patients of type II DM attending the Primary Care Clinic (PCC) of King Khalid University Hospital (KKUH) in 2012was 67.7%. (13) This rate is almost similar to the study done in Al Hasa area of KSA (67.9%). (5) Nerveless, this percentage of glycemic control had improved slightly at the PCC of KKUH.…”

“…One study found a high rate of poor adherence to diet (68%) and poor adherence to exercise (79.4%). (13) Only 21% of diabetes patients perform daily physical activities. (10) These results indicate a possible continuum in the relationship between diabetes risk and physical activity levels.…”

“…diet, physical activity, medication, blood glucose monitoring) was the most commonly found barrier to managing type 2 diabetes patients in Canada. (33) Some studies showed no difference in glycemic control between male and female patients, (13) while others demonstrated better control among females. (5,15,18) The adherence to lifestyle changes appeared better among males in some studies.…”

“…(5,15,18) The adherence to lifestyle changes appeared better among males in some studies. (13) The poor adherence to exercise among female could be due to more sedentary lifestyle of women in these countries. (5,13,26) Traditional/cultural restrictions in lifestyle of women in Gulf countries are one source for more sedentary life among women.…”

“…(13) The poor adherence to exercise among female could be due to more sedentary lifestyle of women in these countries. (5,13,26) Traditional/cultural restrictions in lifestyle of women in Gulf countries are one source for more sedentary life among women. Women have usually a limited access to sports and exercise, besides there is an easy availability of migrant labor for house hold work in these countries.…”