Introduction: Patient education is integral in the management of gestational diabetes mellitus (GDM), a common pregnancy complication that may cause adverse perinatal outcomes. This study evaluated the effect of diabetes education on the knowledge and attitude among patients with GDM, comparing pre- vs post-diabetes session scores and determining pregnancy outcomes. Methodology: A one-group pre-test and post-test experimental design study was conducted on 75 patients after one- session diabetes counseling using the Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ) and the third version of the Diabetes Attitude Scale (DAS-3). Results: Of the 75 subjects, 84% exhibited adequate knowledge of diabetes. Post-education, a significant increase in the total scores was seen among those less than 35 years of age (p-value: 0.003), both employed and unemployed (p-value: 0.0.026, 0.047, respectively), with a secondary level of education (p-value: 0.014) and multigravid (p-value: 0.015). An overall median positive attitude score of 3.6 was documented. For neonatal outcomes, no adverse events existed. For maternal outcomes, 17.9% had elevated fasting blood glucose while 7.1% had elevated 2-hour post-glucose tolerance test. Conclusion Diabetes education improves patient’s knowledge but not their attitude. Hence, improvement in attitude interventions should be incorporated into the current diabetes education program.
Diabetes, Gestational ; Knowledge ; Attitude

Objectives: Gestational diabetes mellitus (GDM) is a common pregnancy complication with adverse fetal and maternal outcomes. Currently, there are only a few validated tools available that address knowledge in GDM. Recognition of the inconsistencies will provide for an effective learning program to achieve optimal results. This study aimed at validating the “Gestational Diabetes Mellitus Knowledge Questionnaire” (GDMKQ). Methodology: A cross-sectional validation study on GDMKQ among 51 GDM patients aged at least 18 years was conducted in the outpatient clinics of a tertiary hospital. Excluded were those with pre-existing diabetes. The questionnaire was submitted for peer review for translation to Filipino and back-translation. Concurrent validity, internal consistency and test-retest reliability of the questionnaire were undertaken as part of the validation process. Descriptive analysis was used for data elaboration by using SPSS v23. Results: The Filipino version of GDMKQ demonstrated sensible content and face validity. As measured, respondents obtained higher total and domain scores with better knowledge levels of GDM compared to its English version. An overall adequate knowledge was observed among those married and college subgroup as compared to single women and those with secondary level of education. The reliability of the questionnaire was calculated at 0.632 using the Kuder-Richardson 20. The test-retest scores using the Filipino-translated questionnaire has a Pearson correlation coefficient of 0.853 with moderate to good level of agreement with each other, and Cohen’s kappa of 0.564 with an intra-class correlation coefficient of 0.828. Conclusion The Filipino-translated version of GDMKQ is a valid screening tool that assesses a patient’s knowledge of gestational diabetes. Identifying the level of their understanding will enable clinicians to develop an individualized, effective learning program to improve pregnancy outcomes.
Diabetes, Gestational ; Knowledge ; Surveys and Questionnaires

Humans ; Singapore ; Self-Management ; Diabetes Mellitus, Type 2/therapy* ; Health Knowledge, Attitudes, Practice ; Hospitals

Background: A well-informed patient with Type 2 diabetes may be more compliant with treatment. This study aims to evaluate the diabetes-related knowledge and socio demographic determinants of patients seen at University of Santo Tomas Hospital through a translated and validated Filipino-DKT questionnaire.

Methods: Standard translation procedure was used to produce the Filipino version of the DKT2. A convenience sample of 112 outpatients with Type 2 diabetes was identified for six months at the University of Santo Tomas Hospital, Philippines. All data were collected using the Filipino-DKT and a demographic questionnaire.

Results: The Filipino-DKT demonstrated an acceptable Cronbach's alpha of 0.70 and an acceptable average inter-item correlation of 0.40 (p<0.001). The test-retest reliability was excellent, with a Pearson coefficient r of 1.00 (p<0.001). Our study demonstrated that of the 112 patients with diabetes who answered the general knowledge test, the majority had average knowledge of 78.64%, while 16.07% had poor knowledge. A total of 55 participants on insulin answered the second part of Filipino-DKT that measures insulin knowledge. Surprisingly, 56% of the subjects on insulin had poor knowledge, and only 7% had good knowledge. Results showed that the majority (56%) had poor knowledge. Participants who reported poor control of their diabetes (HbA1c >7%) also reported lower levels of knowledge about diabetes and insulin use. There was no association between duration of diabetes, family history of diabetes, and type of diabetes with knowledge of diabetes.

Conclusion: The Filipino diabetic knowledge of diabetes is poor and not related to age, sex, and duration of diabetes. Filipino-DKT is an acceptable, reliable, and valid measure of diabetes knowledge used in our clinical practice and research.

OBJECTIVE: The prevalence of complementary and alternative medicine (CAM) usage among patients with type 2 diabetes mellitus (T2DM) in Indonesia is high. However, to date, little is known about why Indonesian T2DM patients choose CAM therapies, how their knowledge, attitude and practice (KAP) of CAM affects their choices, or how demographics correlate with patient choices. Therefore, this study aimed to investigate the KAP and predictors of CAM usage in T2DM patients in Indonesia. METHODS: This was an observational, cross-sectional study. Patients were interviewed using a questionnaire. Chi-square tests or Fisher's exact tests were used to compare demographic and clinical data, as well as KAP assessments, between T2DM patients who use and do not use CAM. Multivariate logistic regression analyses were used to investigate predictors of CAM usage. RESULTS: A total of 628 T2DM patients were enrolled in the study. CAM therapies were used by 341 patients (54.3%). The most common therapies were herbs and spiritual healing, used by 100.0% and 68.3% of CAM-using patients, respectively. CAM therapies were frequently recommended by family members (91.5%), and CAM users had significantly more knowledge and more positive attitudes toward CAM therapies than nonusers. Among users, 66% said they would not follow their healthcare providers' instructions to not use CAM therapies, and 69.5% said they would not disclose their plan to use CAM therapies with their healthcare provider. Neither demographic nor clinical characteristics were associated with CAM use. The factors that best predicted the use of CAM therapies were their availability and low cost (odds ratio [OR] = 4.59; 95% confidence interval [CI]: 3.01-7.01), the belief that CAM therapies were safe (OR = 2.04; 95% CI: 1.40-2.95), the belief that CAM therapies could help with diabetes control (OR = 1.75; 95% CI: 1.15-2.66), and the belief that CAM therapies could help maintain physical health (OR = 1.68; 95% CI: 1.13-2.49). CONCLUSION CAM therapy users were more knowledgeable and had more positive attitudes toward CAM, but most of them chose not to disclose their CAM use to their healthcare providers. CAM use in Indonesia was associated with its accessibility, affordability, safety and effectivity, but not with any demographic or clinical characteristics. This study provided new evidence and insights for nurses and physicians in Indonesia that will help to design educational programs about the safety and efficacy of CAM therapies.
Complementary Therapies ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/therapy* ; Health Knowledge, Attitudes, Practice ; Humans ; Indonesia ; Surveys and Questionnaires

Introduction: Knowledge, attitude, and practices among diabetes patients have been heavily studied topics in different settings. Organizations catering to diabetic patients such as community clubs play pivotal role in diabetes care and management. Objectives: This research explored the knowledge, attitudes and practices among adults living with Type 2 Diabetes Mellitus in an urban community. The objective of this study was to determine the KAP of DM patients attending a community-based DM Club. Methods: Using the DAS-3 and AACE Knowledge evaluation, this study was particularly interested in knowing the KAP of the patients in the different domains such as Nutrition, Exercise, Self-monitoring, and Treatment. Type 2 DM patients attending the community-based DM club were recruited and KAP questionnaires were administered among the 89 survey respondents. Results: The level of knowledge in each domain of AACE had a mean evaluation score of 50 and above. The results also show that majority of diabetic patients strongly believe in the need for special training in teaching, counselling and behavior change techniques among health care professionals, psycho-social impact of diabetes, and patients’ autonomy. Conclusion This research also emphasizes that a community-based diabetes club may play an important role in diabetes care and management providing patient education which may lead to increased KAP.
Diabetes Mellitus ; Knowledge ; Attitude ; Residence Characteristics

To understand the current situation regarding the knowledge and demand for patients with prediabetes at different self-management levels, and to provide guide for improving their knowledge.
 Methods: A total of 312 prediabetes patients from 3 hospitals in Changsha were enrolled in this survey. The questionnaires covered diabetes self-management behavior scale and prediabetes knowledge status and demand questionnaire. Diabetes knowledge acquisition and demand were analyzed among patients with different levels of self-management.
 Results: The score of self-management behavior for patients with prediabetes was 39.1±13.9. The rate of knowledge acquisition was low and the rate of demand was high. The knowledge acquisition rate was high and the knowledge demand rate was low in patients with high levels of self-management. As for the contents of health education, the dietary collocation and method for glucose detection were highly needed by all self-management levels of patients.
 Conclusion: Prediabetes patients' self-management level are low. Health education to patients with prediabetes should be based on individualized demands.
Diabetes Mellitus ; Health Knowledge, Attitudes, Practice ; Humans ; Prediabetic State ; Self-Management ; Surveys and Questionnaires

Objective: To analyze the rates on prevalence, awareness, status on treatment and control of type 2 diabetes mellitus among Chinese premenopausal women aged 18-49, in 2013. Methods: Data on China Chronic and Non-Communicable Disease Surveillance in year 2013 was used for analysis. Source of data covered 302 surveillance points which were selected by Multi-stage cluster random sampling method that including 176 534 adults over 18 years of age, with 46 674 premenopausal women aged 18-49. Plasma glucose and hemoglobin A1c levels were determined after a 10-hour overnight fast for all the participants, before a 2-hour oral glucose tolerance test was conducted among participants without a self-reported history of diagnosed diabetes. Diabetes was defined according to the 1999 WHO diagnostic criteria-fasting blood glucose level as ≥7.0 mmol/L and/or 2 hours oral glucose tolerance test (OGTT-2 h) level as ≥11.1 mmol/L. After being weighed, according to complex sampling scheme and post-stratification, the sample was used to estimate the rates of prevalence, awareness, treatment and control of type 2 diabetes mellitus by age, education, urban and rural areas, and geographic locations. Results: The overall prevalence of type 2 diabetes mellitus was 5.6% among the Chinese premenopausal women aged 18-49. No statistical difference on the prevalence rates (5.7% and 5.4%, respectively) was seen, between participants from the rural or the urban areas. Prevalence rates in the eastern, central or western geographic areas were 5.8%, 6.2% and 4.4% respectively. The rates of awareness, treatment and control of diabetes appeared as 29.3%, 27.9% and 29.4% in childbearing women aged 18-49. The rate of treatment was 95.4% among those who knew their diabetic situation in childbearing women aged 18-49 years. The control rate of diabetes was 38.9% among those who had taken measures to control glucose, in 18-49-year-old childbearing women. The rate of awareness on diabetes in childbearing women aged 18-49 years in urban areas was higher than that in the rural areas. There were significantly statistical differences on the treatment rates among groups of different education levels but not in the trend test. Conclusion: The prevalence of type 2 diabetes mellitus in childbearing women aged 18-49 appeared high, but with low rates on awareness, treatment and control. However, statistical difference was seen on awareness, between urban and rural areas.
Adult ; Aged ; Asian People/statistics & numerical data* ; Awareness ; China/epidemiology* ; Diabetes Mellitus, Type 2/therapy* ; Female ; Glucose Tolerance Test ; Health Knowledge, Attitudes, Practice ; Humans ; Middle Aged ; Premenopause ; Prevalence ; Residence Characteristics ; Rural Population ; Urban Population

Objective: The objective of this study is to measure the level of knowledge and practice of diabetic foot self-care and determine the factors that affect the level and knowledge and practice of diabetic foot self-care among diabetic patients. Methodology: Three hundred thirty adult diabetic patients at the outpatient clinics were given self-administered questionnaires on knowledge and practice of diabetic foot self-care. The scores were computed based on their answers. A score of >70% was gauged as good, 50 to 70% as satisfactory and <50% as poor. Results: Of the subjects, 82.7% had good foot care knowledge, 22.4% had good foot self-care practice, and 71% had satisfactory practice score. Patients who received diabetes education were twice as likely to have a good knowledge score (OR 2.41, 95% CI, 1.09 to 5.32; p=0.03). Compared to patients who received diabetes care in private clinics, those who attended the charity outpatient clinic were nearly three times as likely to have a good knowledge score (OR 2.8, 95% CI, 1.32 to 5.96; p=0.007). Patients with known diabetes for more than ten years and those with a family history of diabetes were 50% less likely to have good practice scores (OR 0.50, 95% CI, 0.28 to 0.90; p=0.021 and OR 0.49, 95% CI, 0.29 to 0.83; p=0.008, respectively). Conclusion The current state of foot care knowledge in Filipino diabetic respondents is good but the level of foot self-care practice is only satisfactory.
Diabetic Foot ; Diabetes Mellitus ; Knowledge ; Self Care

Introduction: With the increasing prevalence of diabetes mellitus (DM) in the Philippines, Diabetes Self-Management Education (DSME) remains to play a vital role in diabetes care. It is important in optimizing metabolic control, preventing and managing complications, and maximizing quality of life in a cost-effective manner. This study aimed to determine the effect of diabetes education on the knowledge and attitudes of type 2 DM patients. It also aimed to determine the topics that needed more emphasis during education. Methods: A prospective study, which included 75 patients: 38 patients in the education group and 37 patients in the noneducation group, was conducted. A single session diabetes education was given to the patients in the education group. Baseline and follow-up knowledge and attitude scores by using the modified, validated, Filipino versions of American Association of Clinical Endocrinologists (AACE) Knowledge Evaluation Form and Diabetes Attitude Scale–3 (DAS–3), respectively, were compared between the education and non-education groups. The changes in weight and body mass index (BMI) for both groups were also compared. Results: Results showed that on follow-up, there was a significant increase in the mean percentage scores for knowledge in the education group. There was no significant increase in mean frequency of correct answers for questions on precautions prior to exercise, monitoring, nutrition and medication adjustment during ill days. Questions on psychosocial impact, and value of tight glucose control showed significant improvement in the education group, while one question on seriousness of diabetes did not improve significantly. Conclusion Diabetes education generally improved the knowledge and attitudes of patients towards their disease.
Knowledge ; Attitude ; Diabetes Mellitus, Type 2