The relationship between the level of diabetes-related knowledge and the incidence of peripheral neuropathy in patients suffering from chronic Type-2 diabetes mellitus in Malta

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AuthorCynthia Formosa
AbstractOBJECTIVE The objective of this study is to determine the relationship between the level of diabetes-related knowledge and the incidence of peripheral neuropathy in patients with chronic Type-2 diabetes in Malta. RESEARCH DESIGN AND METHOD A single-centre case-control study was conducted at the Diabetes Out-Patients Clinic St Lukes Hospital Malta from July 2002 to September 2002. Sixty patients suffering from Type-2 diabetes for at least 10 years were randomly recruited from the outpatient clinic. The sample comprised 30 participants suffering from peripheral neuropathy and 30 participants without peripheral neuropathy, using the 10-gram Monofilament Ten Point Test to determine neuropathy status. A 24-item questionnaire (DKQ-24) was administered to them to assess knowledge about the disease state, diagnostic tests, complications and management of diabetes. Further data on medical history and care provided to patients were obtained from the annual medical records held at St Lukes Hospital. Data abstracted included number of visits to the diabetes clinic, latest HbA1c level, current medication, smoking and drinking history, marital status and educational level achieved. RESULTS The study found no significant difference (P 0.427) between the level of knowledge and the incidence of peripheral neuropathy. It did, however, find a significant difference in HbA1c level (P 0.002) and duration of Type-2 diabetes (P 0.026). The score of correct answers for the total study group was 69%, indicating that patients with Type-2 diabetes in Malta have knowledge deficit in a number of key areas in the management of diabetes. Major areas of knowledge deficit were: cause of diabetes mellitus, cause of insulin reactions, wound management in diabetes, and signs and symptoms of hypoglycemia. CONCLUSIONS No significant difference was found related to the level of knowledge in patients with Type-2 diabetes and the incidence of peripheral neuropathy. However, a significant difference in HbA1c level and duration of Type-2 Diabetes was identified between the cases and the controls. The findings have also highlighted a knowledge deficit in a number of key areas in the management of diabetes implying the need of encouraging self-monitoring and educating people living with Type-2 Diabetes in Malta about the course of the disease and its complications. Further research of high methodological quality in diverse study settings such as private clinics and private hospitals in Malta where populations may differ from the one studied here may be necessary to assess, compare and determine the effectiveness of diabetes-related knowledge on peripheral neuropathy in patients suffering from Type-2 diabetes in Malta.

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Compiled by: Dr. I. Stabile    Dr. J. Pace