effect of literacy level on health related-quality of life, self-efficacy and self-management behaviors in diabetic patients

Illiteracy in studies on quality of life [QOL] and self-efficacy [SE] of diabetic patients has been ignored. Illiteracy and diabetes have high rates in developing countries. The aim of this study was to identify the effect of literacy level on health outcomes. To achieve this, we studied health outcomes such as SE, self-management behaviors and Health-Related Quality of Life [HRQOL] in diabetic patients. A cross-sectional study was carried out in an Iranian urban federally-funded diabetes clinic [with 1400 diabetes patients] in Bandar Abbas, a city located in south of Iran. 256 Non Insulin Dependent Diabetic Mellitus patients were chosen during June, July and August 2007. Patients were grouped as illiterates, low-literates and literates. SE and QOL were measured by standard questionnaires. HbA1C was measured by calorimetric method. Data was collected with interview. Data analysis was carried out with one way ANOVA Post Hoc, and bivariate analysis method. Literacy level among the three groups from the view points of age, physical domain, psychological domain, environmental domain and SE were significant. There was no significant difference for the level of HbA1C among three groups. Literacy level does not have any effects on glycemic control. There is a strong relationship between self-efficacy and QOL domains

Can quality of life questionnaires be used in diabetics to assess the relation between HbA1c and patients' domain aspects?

Over the past few decades, quality of life [QOL] has become an important concept in medical researches and treatments. Different meaningful reasons are given for this development. In the current research two standard questionnaires for evaluating of QOL were selected. First one, was a questionnaire from The World Health Organization [WHOQOL-BREF 26] and the second one, The Iranian Diabetics' Quality of Life [IRDQOL]. The goal of this study is to assess the relation between different domains of these questionnaires and HbA1c in diabetics. A random sample of Iranian adult outpatient diabetics [n=76] was selected and they completed the WHOQOL and IRDQOL assessment instruments. In addition HbA1c was measured in these patients by calorimetric method. Comparisons were made between scores of "questionnaires' domains" and "HbA1c". Data analysis was carried out by the use of T-test, Spearman correlation coefficient, Pearson's correlation coefficient, and non-parametric statistical methods including Spearman correlation coefficient. Data analysis shows Psychological domain score in IRDQOL is lower than in WHOQOL and it is significant [P<0.0001]. Physical domain score in IRDQOL is lower than WHOQOL and it is significant [P<0.0001]. In WHOQOL questionnaire, analysis data showed when the patient's age increased, physical and psychological domain's score decreased. There is probably no relation between questionnaire domains and HbA1c in diabetics. Based on the findings in this research, there was obviously almost no difference between the two questionnaires for checking the QOL, but in IRDQOL spiritual domain is a very unreliable domain

Stopping insulin and achieving a good metabolic control in a heavy drinker five months after stopping alcohol

In this case study, we describe a 25 year-old male who showed the symptoms of diabetes after a period of heavy drinking. [HbA1c=13%]. Treatment was started with 120 units of insulin. After stopping alcohol consumption and taking an appropriate diet, insulin was tapered down. Five months after the start of treatment, insulin was stopped [HbA1c=5%]. The results showed that he was in a good metabolic control after 18 months [HbA1c=5.9%]