Self-awareness of HbA1c and its association with glycemic control among patients with type 2 diabetes: A multicenter study.

OBJECTIVES: To measure the self-awareness of hemoglobin A1c (HbA1c) prevalence among type 2 diabetic Saudi patients and its association with glycemic control, thereby identifying those factors that might affect their glycemic control. METHODS: This multicenter study was carried out in outpatients' diabetes clinics in tertiary hospitals in Riyadh, Qassim, and Jeddah, Saudi Arabia. The data was collected using questionnaires. The subject's self-awareness on the HbA1c test was assessed based on the combined score of 4 questions. The latest HbA1c result before the time of data collection was obtained from medical records. Data was analyzed using bivariate and multivariate statistical methods. RESULTS: The prevalence of HbA1c self-awareness was approximately 44.5%. A total of 4 participants characteristics (glycemic control, education level, monthly income and number of follow-up visits) were associated with awareness of HbA1c. Whereas for better glycemic control; type of treatment, duration of diabetes, and self-awareness of HbA1c were independently statistically significantly associated. CONCLUSION: There is a positive association between HbA1c self-awareness and glycemic control. Glycemic control was good among those who were educated on the meaning of the test, their levels, and their target goal. Awareness among health care providers regarding the role of the patient's education regarding their condition might help in providing the patient with optimal care. Further studies with different experimental designs are needed to study this association, which will contribute to the development of a structured educational program.

The association between diabetes numeracy and diabetes self-management among Saudi adults with insulin-treated diabetes.

OBJECTIVES: To describe the association between diabetes numeracy and diabetes self-management among Saudi adults with insulin-treated diabetes. METHODS: From August 2018 to January 2019, a cross-sectional study was conducted in 3 diabetes centers in Riyadh, Buraydah, and Jeddah, Saudi Arabia. Systematic random sampling was used to include 290 Saudi adults with insulin-treated diabetes. The levels of diabetes numeracy and diabetes self-management were measured by using the Diabetes Numeracy Test tool (DNT-15) and Diabetes Self-Management Questionnaire tool (DSMQ). RESULTS: The final analysis included 279 completed surveys. The mean total score of DSMQ was 6.47. The total DSMQ score was higher among patients who had a lower level of education (p=0.02), and patients who had a higher level of diabetes knowledge (p=0.01). The mean total score of DNT-15 was 41.3%. Patients who had lower diabetes numeracy scores tended to be younger, married, have fewer years of education, have a lower monthly income(p<0.001), use insulin only, and have type 1 diabetes. Patients who achieved a total score of 82%, and higher in DNT-15 have also achieved the highest score in DSMQ (p=0.17). A linear regression analysis adjusted for level of education, diabetes knowledge, and other variables found a modest association between low diabetes numeracy and low diabetes self-management (p=0.08). CONCLUSION: Lower level of diabetes numeracy was associated with lower level of diabetes self-management.

Safe driving practices and factors associated with motor-vehicle collisions among people with insulin-treated diabetes mellitus: Results from the Diabetes and Driving (DAD) study.

INTRODUCTION: The aim of this study was to assess the prevalence of people with insulin-treated diabetes mellitus (ITDM) who have discussed issues related to diabetes and driving with their health care providers (HCPs). We also sought to determine the safe driving practices that are currently employed by this group. Finally, we investigated the factors that might increase the risk of motor-vehicle collisions (MVCs) among this group in Saudi Arabia. METHOD: This cross-sectional study surveyed a representative sample of 429 current male drivers with ITDM using a structured questionnaire in Saudi Arabia. RESULTS: Most of the participants (76.5%) never discussed topics regarding diabetes and driving with their HCPs. The majority of the participants (61.8%) reported at least never doing one of the following: (a) carrying a blood glucose testing kit while driving, (b) testing their blood glucose level before driving or during a journey, or (c) having thought of a specific threshold of blood glucose level that would preclude driving. Three factors were associated with a higher risk of MVCs among participants with ITDM: (a) being on a basal/boluses regimen, (b) never having a discussion regarding diabetes and driving with their HCPs, and (c) having experienced hypoglycemia during driving. CONCLUSIONS: The majority of people with ITDM had not had a discussion regarding diabetes and driving with their HCPs, which was reflected by a lack of safe driving practices. People with ITDM should be encouraged to take precautions while driving in order to prevent future MVCs. PRACTICAL APPLICATIONS: This research highlights the importance of investing more effort in educating drivers who have diabetes about safe driving practices by their health care providers. Also, it will attracts the attention of policymakers for an urgent need to establish clear policies and procedures for dealing with drivers who have diabetes.

Prevalence of sexual dysfunction in saudi women with Type 2 diabetes: Is it affected by age, glycemic control or obesity?

OBJECTIVE: Sexual dysfunction (SD), as a diabetes mellitus (DM)-related complication, is common among patients having diabetes. This study aimed to ascertain the prevalence of SD in Saudi women with type 2 DM and to determine whether age, glycemic control, and obesity are associated with SD or not. METHODS: A total of 275 Saudi women with type 2 diabetes took part in this cross-sectional study and filled out the Female Sexual Function Index through a fill-coded questionnaire in primary care clinics in King Khalid University Hospital, Riyadh, in the period between January 2013 and May 2013. The level of glycosylated hemoglobin and the body mass index were assessed to evaluate the DM control status and obesity among the patients. RESULTS: SD was reported by 88.7% of the Saudi women with type 2 diabetes. The results showed a significant association between the presence of SD and the increase in age of patients at 92% in the age group above 50 years. Glycemic control did not show a significant association with SD. The obesity factor showed a slight increase in SD by weight, but it was not statistically significant. CONCLUSION: The prevalence of SD among the Saudi women having type 2 diabetes is high and increases with age. No association was found between SD and glycemic control.

The bacterial contamination rate of glucose meter test strips in the hospital setting.

OBJECTIVES: To assess the rate of bacterial contamination of the multi-use vial and single-use packed glucose meter strips, and to identify the type and frequency of various bacterial contamination in different hospital wards. METHODS: This prospective observational study was conducted by a team from the Strategic Center for Diabetes Research in 7 general hospitals in the Central region of Saudi Arabia during the period from August to September 2014 to assess the bacterial contamination rate of the unused strips. A total of 10,447 strips were cultured using proper agar media and incubated both aerobically and anaerobically.  RESULTS: The total bacterial contamination rate for the multi-use vials glucose strips was 31.7%, while single-use packed strips were not contaminated at all. Ministry of Health hospitals had the highest contamination rates compared with other hospitals. Critical, obstetric, and surgical wards had the highest bacterial isolates number, where most were in the risk group 3 according to the National Institute of Health guidelines. Staphylococcus species were the most common bacteria found. CONCLUSION: Glucose meter strips should be recognized as a source of bacterial contamination that could be behind serious hospital acquired infections. The hospital infection control team should adopt proper measures to implement protocols for glucose meter cleaning and glucose strips handling.

Appraisal of the communication skills of residents in the Family Medicine Program in Central Saudi Arabia.

OBJECTIVES: To assess patients' perceptions of the communication skills of family medicine residents.   METHODS: This is a cross-sectional study. Data were collected from patients, seeing 23 residents from 4 family medicine residency programs in Riyadh, Kingdom of Saudi Arabia namely, King Khalid University Hospital, Riyadh Military Hospital, Security Forces Hospital, and King Abdul-Aziz Medical City. The translated version of the Communication Assessment Tool (CAT) was used. Data were collected during January and February 2013.  RESULTS: A total of 350 patients completed the CAT, with an 87.5% response rate. Patients rated each resident differently, but the mean percentage of items, which residents rated as excellent was 71%. In general, male residents were rated higher 72.8 ± 27.2 than female residents 67.8 ± 32.2 with a significant difference; (p less than .005). Also, significant differences were found based on the gender of the residents, when each item of the CAT was compared. Comparing training centers, there were no significant differences found in the overall percentage of items rated as excellent or among items of the CAT.   CONCLUSION: The study identified areas of strength and weaknesses that need to be addressed to improve communication skills of physicians.