Baseline disease knowledge assessment in patients with type 2 diabetes in a rural area of Pakistan

[1] To assess baseline disease related knowledge in patients with type 2 diabetes about their disease, its risk factors, signs/symptoms, related complications and suitabte diet and [2] Is there an association between gender, duration of disease and age at diagnosis of diabetes and the above dependent variables.A 20-item interview-based structured knowledge questionnaire was used to collect information. A total of 82, diabetic patients, mean age 55.2 [11.4 S.D.] years, ranging from 35-80 years, were interviewed. Statistically significant association was found between age at diagnosis aJ1d better understanding of risk factors, [OR = 1.20, P=0.012 with 95% CI 0.85- 0.98]. Statistically significant association was found between gender and better understanding of word "diabetes" or "sugar" OR= 1.15, P=0.051 with 95% Confidence interval 0.96-1.29]. Statistically significant associations were found between gender and patients' better understanding of disease signs/symptoms [OR = 1.35, P=0.005 with 95% CI 0.40-0.56]. No significant associations were found between gender, duration of diabetes, age at diagnosis and patients' better understanding of disease related.Priority needs to be given by WHO education programmes for the development of diabetes education program in rural areas to give patients a better knowledge of their disease, to prevent premature morbidity and mortality associated with diabetes

Survival after myocardial infarction in patients with type 2 diabetes

To determine prospectively the survival of previously known diabetic patients admitted to coronary care unit with confirmed myocardial infarction [MI] over a one-year period and to assess the effects of gender, age, diabetes duration, hyperglycemia, hypertension, and anti-diabetic treatment on survival. In this prospective cohort study, we followed 59 patients hospitalized with a confirmed myocardial infarction at 3 coronary care units, Peshawar [Pakistan], between May 1, 2000 and April 30, 2001, We analyzed survival using univariate and multivariate Cox Proportional hazards regression models to control for potentially confounding factors. A total of 17 [28.8%] subjects [7 male and 10 female] died. Survival was significantly associated with previous history of hypertension and duration of diabetes [HR = 3-40, 95% CI = 1,33-9.22, P = 0,001, and HR = 1,24, 95% CI = 1,05-1.45, P = 0.009, by Univariate Cox model, respectively]. In multivariate analysis duration of diabetes was significantly associated with survival and Metformin treatment only, and Sulphonylurea and Metformin treatment together [P = 0.003, and 0-026, Multivariate Cox model, respectively]. Our results suggested that diabetes is associated with markedly increased mortality in the presence of hypertension after acute myocardial infarction and support for aggressive treatment of coronary risk factors among diabetic patients