Status of diabetes control and knowledge about diabetes in patients

Factors Influencing the Control of Diabetes Measured via Glycated Hemoglobin Concentrations in Adults with Type 1 Diabetes

Numerous complications of type 1 diabetes (T1D) may be prevented through suitable glycemic control. Glycated hemoglobin (HbA1c) may be one of the markers for the early detection of the metabolic imbalance characteristic of the disease. However, optimal control of diabetes is not achieved in a large group of patients. It was demonstrated that numerous factors (sociodemographic, psychological, and clinical) contributed to this condition. The aim of the study was to identify factors influencing the control of diabetes measured via glycated hemoglobin concentrations in people with T1D. Independent factors influencing better diabetes control measured via HbA1c in the study group included higher disease acceptance, higher nutritional adherence, lower BMI, and a lower risk of eating disorders. Describing the determinants will allow for the improvement of the system of care provided to people with T1D and for it to comprise important psychological variables related to self-care and acceptance of the disease.

External validation of the risk prediction model for early diabetic kidney disease in Taiwan population: a retrospective cohort study

OBJECTIVES

This study aims to independently and externally validate the Risk Prediction Model for Diabetic Kidney Disease (RPM-DKD) in patients with type 2 diabetes mellitus (T2DM).

DESIGN

This is a retrospective cohort study.

SETTING

Outpatient clinics at Lee's United Clinics, Taiwan, China.

PARTICIPANTS

A total of 2504 patients (average age 55.44 years, SD, 7.49 years) and 4455 patients (average age 57.88 years, SD, 8.80 years) were included for analysis in the DKD prediction and progression prediction cohorts, respectively.

EXPOSURE

The predicted risk for DKD and DKD progression for each patient were all calculated using the RPM-DKD.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measure was overall incidence of DKD. Secondary outcomes included DKD progression. The discrimination, calibration and precision of the RPM-DKD score were assessed.

RESULTS

The DKD prediction cohort and progression prediction cohort consisted of patients with 2504 and 4455 T2DM, respectively. The RPM-DKD examined in this study showed moderately discriminative ability with area under the curve ranged from 0.636 to 0.681 for the occurrence of DKD and 0.620 to 0.654 for the progression of DKD. The Hosmer-Lemeshow χ² test indicted the RPM-DKD was not well calibrated for predicting the occurrence of DKD and overestimated the progression of DKD. The precision for predicting the occurrence and progression of DKD were 43.2% and 42.2%, respectively.

CONCLUSIONS

On external validation, the RPM-DKD cannot accurately predict the risk of DKD occurrence and progression in patients with T2DM.

Optical-fibre characteristics based on Fano resonances and sensor application in blood glucose detection

We propose an optical-fibre metal-insulator-metal (MIM) plasmonic sensor based on the Fano resonances of surface plasmon polaritons (SPPs). Its structure consists of a coupling fibre that connects C-shaped and rectangular cavities and a main fibre that contains a semi-circular resonator. When incident light passes through the main fibre, it excites SPPs along the interface between the metal and medium. The SPPs at the resonator induce Fano resonances, owing to the coupling effect. The results show that the designed optical-fibre MIM plasmonic sensor could flexibly tune the number of Fano resonances by adjusting the structure and geometric parameters to optimise the sensing performance. The full width at half maximum of the Lorentzian resonance spectra formed by the electric and magnetic fields reached 23 nm and 24 nm, respectively. The wavelength of the Fano resonance shifted as the refractive index changed; thus, the proposed sensor could realise the application of sensing and detection. The highest sensitivity achieved by the sensor was 1770 nm/RIU. Finally, we simulated the designed sensor to human blood-glucose-level detection, and observed that the resonance wavelength would increase with the increase of glucose concentration. Our study shows that optical fibres have broad application prospects in the field of electromagnetic switching and sensing.

Validation of Diabetes Knowledge Questionnaire (DKQ) in the Taiwanese Population - Concurrent Validity with Diabetes-Specific Quality of Life Questionnaire Module

PURPOSE

Diabetes knowledge is important for people with type 2 diabetes mellitus (DM) to improve their health. Therefore, it is important to validate an instrument for assessing diabetes knowledge. The present study aimed to validate the 24-item Diabetes Knowledge Questionnaire (DKQ).

PATIENTS AND METHODS

The 24-item DKQ and Diabetes-specific Quality of Life Module (DMQoL) were administered to 425 patients (mean±SD age=58.4±11.6) with type 2 DM.

RESULTS

The 24-item DKQ was first examined for its factor structure using exploratory factor analysis (EFA). Items with low factors loadings were removed and 18 items were retained to make a DKQ-18. In DKQ-18, five factors were identified, which were named as diabetes etiology and symptoms (F1), intermediate nursing (F2), complications (F3), diet and treatment (F4), and elementary nursing (F5). The DKQ-18 had satisfactory internal consistency (Cronbach's α= 0.732 and McDonald's ω=0.748), good known-group validity (participants with a higher level of education showed better score in DKQ-18; participants with HbA1c ≤7 had better score in DKQ-18 compared to group of HbA1c level >8.5), acceptable test-retest reliability (r=0.69), adequate responsiveness (DKQ-18 can detect knowledge change), and concurrent validity with DMQoL.

CONCLUSION

The DKQ-18 is a valid measure for assessing diabetes knowledge. The DKQ-18 could evaluate participants' diabetes knowledge and improve their diabetes knowledge and self-care through a diabetes team and serve as a tool to evaluate the knowledge of participants with type 2 DM.