Knowledge of and Adherence to Health Advice among Adults with Diabetes in Libya

Background: Non-adherence to medical and health care advice is a common problem, though reasons for non-adherence can differ across different groups and societies as well as between individuals. Objective: to examine diabetes knowledge among people with both type1 and type2 diabetes in Libya and explore any other factors that enhance adherence to treatment and management of the condition. Methods: A cross-sectional survey design was used to collect data from adults with type1 or type2 diabetes who have been diagnosed for 12 months or more, in Benghazi Diabetes Centre, which is one of the oldest and largest diabetes registries in Libya. A total of 855 participants were asked to fill in two questionnaires; the Michigan Diabetes Knowledge Test to investigate the level of diabetes knowledge and the Confidence in diabetes Self-care Scale to assess self-efficacy. For the purpose of the study descriptive statistics and inferential statistical tests were conducted. Results: Diabetes knowledge is very poor especially among females and those classed as illiterate within the sample. The Mean HbA1c of 9.39 was higher than the recommended levels. Four variables namely knowledge about diabetes, duration of illness, family history and self-efficacy significantly predicted levels of HBA1c. Conclusion: Based on the above findings two different programmes of diabetes education would be recommended. The first programme of education would focus primarily on those with inadequate levels of knowledge about diabetes, particularly female and people with long duration diabetes. The second programme would be for both healthcare professionals and people with type 1 and type2 diabetes, which would consider the psychological factors that are involved in the process of diabetes management

When and How Can Endpoints Be Changed after Initiation of a Randomized Clinical Trial?

Contains fulltext : 52680.pdf ( ) (Open Access)OBJECTIVES: It is unclear whether insulin-like growth factor (IGF) function is involved in the pathophysiology of chronic fatigue syndrome (CFS). Unpublished data and reports in patient organization newsletters suggest that Acclydine, a food supplement, could be effective in the treatment of CFS by increasing biologically active IGF1 levels. Here we aimed to measure the IGF1 and IGF binding protein (IGFBP) 3 status of CFS patients compared to age- and gender-matched neighborhood controls, and to assess the effect of Acclydine on fatigue severity, functional impairment, and biologically active IGF1 level (IGFBP3/IGF1 ratio). DESIGN: A randomized, placebo-controlled, double-blind clinical trial. SETTING: Radboud University Nijmegen Medical Centre, The Netherlands. PARTICIPANTS: Fifty-seven adult patients who fulfilled the US Centers for Disease Control and Prevention criteria for CFS. IGF status of 22 CFS patients was compared to that of 22 healthy age- and gender-matched neighborhood control individuals. INTERVENTION: Acclydine or placebo for 14 wk. OUTCOME MEASURES: Outcomes were fatigue severity (Checklist Individual Strength, subscale fatigue severity [CIS-fatigue]), functional impairment (Sickness Impact Profile-8 [SIP-8]), and biologically active IGF1 serum concentrations. Analyses were on an intention-to-treat basis. RESULTS: There was no difference in IGF status in 22 CFS patients compared to healthy age- and gender-matched control individuals. Treatment with Acclydine did not result in significant differences compared with the placebo group on any of the outcome measures: CIS-fatigue +1.1 (95% CI -4.4 to +6.5, p = 0.70), SIP-8 +59.1 (95% CI -201.7 to +319.8, p = 0.65), and IGFBP3/IGF1 ratio -0.5 (95% CI -2.8 to +1.7, p = 0.63). CONCLUSION: We found no differences in IGF1 status in CFS patients compared to healthy matched neighborhood controls. In addition, the results of this clinical trial do not demonstrate any benefit of Acclydine over placebo in the treatment of CFS

A six-year follow-up study of smoking habits and microvascular complications in young adults with type 1 diabetes.

One hundred insulin-dependent diabetic patients (age < 45 years, 53 smokers) were followed for six years. The age, duration of diabetes and mean glycated haemoglobin levels, were comparable between the smokers and non-smokers. Microvascular complications (retinopathy and increased urine albumin excretion) were commoner and more severe in the smoking group at six years, particularly in heavy smokers. Of the 45 original smokers reviewed at six years, 12 (27%) had stopped, six of whom had developed microvascular complications. Only two of the 'heavy' initial smokers, likely to be at most risk, had stopped smoking, and three original non-smokers had started smoking