IS KNOWLEDGE OF DIABETES MELLITUS A PREREQUISITE FOR OPTIMAL SELF-CARE AND CONTROL OF THIS DISEASE?
Abstract
Diabetes mellitus (DM) is the most common endocrinological disease of the modern era of pandemic proportions. People with DM have an increased risk of premature death caused by cardiovascular and other diseases compared to the general population. Patients' knowledge about DM includes a series of beliefs about different aspects of the disease that patients have accumulated during their lifetime, before and after diagnosis. This knowledge represents a significant cognitive factor that can influence a person's adaptation to the disease, the course of the disease and its treatment. In this review, it was examined whether knowledge about DM is a prerequisite for optimal self-care and control of this disease. The literature search was conducted using the following key words: diabetes mellitus, self-management, knowledge and education in PubMed, Emabase, Scopus, SCIndex and Hrčak for the period from 2001 to 2024. The largest number of studies on DM patients' knowledge used the Diabetes Knowledge Questionnaire (DKQ) with 24 items. In patients with DM type 1 and DM type 2 who participated in these studies, ubiquitous, deficient knowledge about DM was observed, which the authors link to suboptimal blood glucose values, high morbidity and mortality of the patients. Family history of DM, younger age and college education were independent predictors of optimal knowledge of patients with DM in most studies. Routine assessment of the level of knowledge of patients with DM through standardized questionnaires, accompanying identification of vulnerable groups and their education would enable the improvement of the knowledge of patients and the acquisition of skills necessary for self-menagement.
References
Zuñiga JA, Huang YC, Bang SH, Cuevas H, Hutson T, Heitkemper EM, et al. Revision and Psychometric Evaluation of the Diabetes Knowledge Questionnaire for People with Type 2 Diabetes. Diabetes Spectr 2023; 36(4):345–353. doi: 10.2337/ds22-0079.
Szymona-Pałkowska K, Janowski K, Pedrycz A, Mucha D, Ambroży T, Siermontowski P. Knowledge of the Disease, Perceived Social Support, and Cognitive Appraisals in Women with Urinary Incontinence. BioMed Research International. 2016:3694792. doi:10.1155/2016/3694792.
Association AD. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2013;36(Supplement 1):S67-S74. doi: 10.2337/dc13-S067.
Snježana Popović-Pejičić i saradnici. Savremni stavovi u liječenju dijabetes melitusa tipa 2. Banja Luka: Medicinski fakultet Univerzitet u Banjoj Luci; 2021.
Jevremović O, Radević S, Kocić S, Radovanović S, Radovanović J, Selaković V, et al. Epidemiološke karakteristike dijabetes melitusa u srpskim sredinama na Kosovu i Metohiji. Glasnik javnog zdravlja. 2022;96(2):165- 77. doi: 10.5937/serbjph2202165J
Association AD. Professional Practice Committee; 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2022. Diabetes Care. 2022:45(Supplement_1):S17–S38. doi: 10.2337/dc22-S002
Rosenquist KJ, Fox CS. Mortality Trends in Type 2 Diabetes. In: Cowie CC, Casagrande SS, Menke A, et al., editors. Diabetes in America. 3rd edition. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018 Aug. CHAPTER 36. Available from: https://www.ncbi.nlm.nih.gov/books/NBK568010/
Požar H, Simin D. Strukturirano obrazovanje bolesnika s dijabetesom: pregled organizacijskih i metodoloških strategija i čimbenika uspjeha. Sestrinska reč. 2021; 24(83):19-25. doi: 10.5937/sestRec2183019P
Nisar N, Khan IA, Qadri MH, Sher SA. Knowledge and Risk assessment of diabetes mellitus at primary care level: A Preventive approach required combating the disease in a developing country. Pak J Med Sci 2008; 24(5):667-72. Available at: https://www.pjms.com.pk/issues/octdec108/article/article5.html
Singh KB, Nnadozie MC, Abdal M, Shrestha N, Abe RAM, Masroor A, et al. Type 2 Diabetes and Causes of Sudden Cardiac Death: A Systematic Review. Cureus. 2021;13(9):e18145. doi: 10.7759/cureus.
Moraes NM, Souza GFP, Brito FI, Antonio Júnior ME, Cipriano AE. Knowledge and self-care in diabetes mellitus and their correlations with sociodemographic, clinical and treatment variables. Diabetes Updates. 2020; 6:1-6. DOI:10.15761/DU.1000145
Murata GH, Shah JH, Adam KD, Wendel CS, Bokhari SU, Solvas PA, et al. Factors affecting diabetes knowledge in Type 2 diabetic veterans. Diabetologia. 2003; 46:1170–1178. doi: 10.1007/s00125-003-1161-1
Ferreira PL, Morais C, Pimenta R, Ribeiro I, Amorim I, Alves SM, et al. Knowledge about type 2 diabetes: its impact for future management. Front Public Health. 2024;12:1328001. doi: 10.3389/fpubh.2024.1328001
Chen CC, Chen CL, Ko Y. The Misconceptions and Determinants of Diabetes Knowledge in Patients with Diabetes in Taiwan. J Diabetes Res. 2020;2020:2953521. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321513/
Lim PC, Rajah R, Lee CY, Wong TY, Tan SSA, Karim SA. Systematic Review and Meta-Analysis of Diabetes Knowledge among Type 2 Diabetes Patients in Southeast Asia. Rev Diabet Stud; 2021:17(2):82-89. doi: 10.1900/RDS.2021.17.82.
Ministartsvo zdravlja Republike Srbije. Uredba o nacionalnom programu prevencije i rane detekcije tipa 2 dijabetesa. Beograd: Službeni glasnik Republike Srbije, br. 17/2009.
Alsolais AM, Bajet JB, Alquwez N, Alotaibi KA, Almansour AM, Alshammari F et al. Predictors of Self-Assessed and Actual Knowledge about Diabetes among Nursing Students in Saudi Arabia. J Pers Med. 2023; 13(1):57. doi:10.3390/jpm13010057.
Fitzgerald JT, Funnell MM, Anderson RM, Nwankwo R, Stansfield RB, Piatt GA. Validation of the Revised Brief Diabetes Knowledge Test (DKT2). Diabetes Educ. 2016; 42(2):178-87. doi: 10.1177/0145721715624968.
Zowgar AM, Siddiqui MI, Alattas KM. Level of diabetes knowledge among adult patients with diabetes using diabetes knowledge test. Saudi Med J. 2018; 39(2):161-168. doi: 10.15537/smj.2017.2.21343
Alexandra A. Garcia, Evangelina T. Villagomez, Sharon A. Brown, et al. The Starr County Diabetes Education Study: Development of the Spanish-language diabetes knowledge questionnaire. Diabetes Care. 2001; 24(1):16–21. doi:10.2337/diacare.24.1.16
Hsieh MH, Chen YC, Ho CH, Lin CY. Validation of Diabetes Knowledge Questionnaire (DKQ) in the Taiwanese Population — Concurrent Validity with Diabetes-Specific Quality of Life Questionnaire Module. Diabetes Metab Syndr Obes. 2022; 15:2391-403. doi: 10.2147/DMSO.S369552.
Bustos R, Barajas A, López G, Sánchez E, Palomera R, Islas J. Conocimientos sobre diabetes mellitus en pacientes diabéticos tipo 2 tanto urbanos como rurales del occidente de México. Arch Med Fam. 2007; 9:147-155. Available at: https://www.medigraphic.com/pdfs/medfam/amf-2007/amf073e.pdf
Cántaroa K, Jaraa JA, Taboada M, Mayta-Tristánc P. Asociación entre las fuentes de información y el nivel de conocimientos sobre diabetes en pacientes diabéticos tipo 2. Endocrinología y Nutrición. 2016;63(5):202-211. doi: 10.1016/j.endonu.2016.01.005
Zakiudin A, Irianto G, Badrujamaludin A, Rumahorbo H, Susilawati S. Validation of the Diabetes Knowledge Questionnaire (DKQ) With an Indonesian Population in the 4th International Seminar on Global Health. KnE Medicine. 2022:99–108. doi: 10.18502/kme.v2i2.11072
Fenwick EK, Xie J, Rees G, Finger RP, Lamoureux EL. Factors Associated with Knowledge of Diabetes in Patients with Type 2 Diabetes Using the Diabetes Knowledge Test Validated with Rasch Analysis. Plos One. 2013; 8(12):e80593. doi: 10.1371/journal.pone.0080593.
Phoosuwan N, Ongarj P, Hjelm K. Knowledge on diabetes and its related factors among the people with type 2 diabetes in Thailand: a cross-sectional study. BMC Public Health.2022; 22:2365. doi: 10.1186/s12889-022-14831-0
Velázquez López L, Muñoz Torres AV, Medina Bravo PG, Escobedo de la Peña J. Inadequate diabetes knowledge is associated with poor glycemia control in patients with type 2 diabetes. Aten Primaria. 2023; 55(5):102604. doi:10.1016/j.aprim.2023.102604.
Chinnusamy M, Geddam SD, Janakiraman S. Assessment of level of awareness of diabetes mellitus and its complications in diabetic patients- A questionnaire-based study in a tertiary care centre. JMSCR. 2022; 10(12):6-14. doi: 10.18535/jmscr/v10i12.02 Available at: https://jmscr.igmpublication.org/v10-i12/2%20jmscr.pdf
Chrysi M, Vaidakis D, Gamvrouli M, Kapritsou M. Adaptation and Validation of Diabetes Knowledge Questionnaire (DKQ- 24 item) within Greek Population. Health & Research Journal. 2022;8(2):111–18. Available at: https://doi.org/10.12681/healthresj.27207
Larasati LA, Andayani TM, Kristina SA. Hubungan Tingkat Pengetahuan terhadap Outcome Klinik Pasien Diabetes Melitus Tipe 2. JMPF. 2019; 9(2):101-08. doi:10.22146/jmpf.43489 Available at: https://jurnal.ugm.ac.id/jmpf/article/view/43489/pdf
Zahedi M, Dehvan F, Albatineh AN, Gheshlagh GR. Knowledge of Type II Diabetic Patients About Their Diabetes: A Systematic Review and Meta-Analysis. Advances in Nursing & Midwifery. 2020; 29(1):36–43. Available at: https://journals.sbmu.ac.ir/en-jnm/article/view/28777
Shrestha N, Yadav SB, Joshi AM, Patel BDP, Shrestha J, Bharkher DL. Diabetes Knowledge and Associated Factors among Diabetes Patients in Central Nepal. International Journal of Collaborative Research on Internal Medicine & Public Health. 2015; 7(5):82-91. Available at: https://internalmedicine.imedpub.com/diabetes-knowledge-and-associated-factors-among-diabetes-patients-in-central-nepal.pdf
Sheleme T, Bekele F, Olika W. Diabetes Knowledge and Associated Factors among Adult Diabetic Patients in Southwest Ethiopia. Diabetes Metab Disord. 2022;9(1):100044. doi:10.24966/DMD-201X/100044
Ćačić M. Znanje i samoučinkovitost kao prediktivni čimbenici regulacije šećerne bolesti tipa 2, doktorska disertacija. Zagreb: Sveučilište u Zagrebu, Medicinski fakultet; 2022. Dostupno na: https://repozitorij.mef.unizg.hr/islandora/object/mef%3A4780/datastream/PDF/view
Bukhsh A, Khan TM, Sarfraz Nawaz M, Sajjad Ahmed H, et al. Association of diabetes knowledge with glycemic control and self-care practices among Pakistani people with type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2019; 12:1409-17. doi: 10.2147/DMSO.S209711
Eva Menino EG, Maria dos AD, Maria Clarisse CL. Validation of Diabetes Knowledge Questionnaire (DKQ) in the Portuguese Population. Diabetes Obes Int J 2017; 2(S1):000S1-002. Available at: https://medwinpublishers. com/DOIJ/DOIJ16000S1-002.php?id=3
Owusu BA, Ofori-Boateng P, Forbes A, Doku DT. Knowledge of young people living with type 1 diabetes and their caregivers about its management. Nurs Open. 2023; 10(4):2426-38. doi: 10.1002/nop2.1498.
Digkliou L, Kazakos K, Kotsa K, Goulis DG. Disease-specific knowledge and lifestyle behavior in patients with diabetes mellitus. 2003; 1(1):29–32. doi: 10.1016/j.obmed.2015.12.005