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It should be noted that the results obtained for the BMI contradict the answers of
respondents when faced with the question relative to the risk factor of obesity.
In relation to the associated pathology that most respondents answered they have,
we found that 52.9% of the respondents had hypertension. The results of these
responses are congruent with the values obtained by evaluating the blood pressure. In
fact, the way to prevent and control diabetes and hypertension are similar, implying
the adoption of similar lifestyles. Some researchers have been recommending the
implementation of therapeutic education programs with evaluation, namely through
randomized studies, as fundamental to the appropriate control and prevention of the
complications of chronic diseases, such as diabetes [19]. Regarding the existence of
complications, 48.9% of respondents indicated they suffer one or more complications,
retinopathy being the one with higher expression (28.5%). The concern with this type
of complication is evident in the efforts made in recent years in identifying patients to
treat. In 2010, 3,425 diabetic people have been identified for treatment, in 2013 this
number raised to 8,110 (corresponding to an increase of 137%) and may still be
underrepresented due to delays in reading the tests [2].
In relation to the compliance with the diet, only 33.2% of respondents continuously
followed the indications referring to food, thwarting one of the premises in the
treatment of diabetes. There are several successful clinical trials that demonstrate that
preventing, or at least delaying the onset of type 2 diabetes is a feasible task, through
weight loss, increased physical exercise and adequate food, thus reducing the
incidence of the disease by 60% [20].
As regards the instruments used, and more particularly DES-SF, we note that all
items had very similar scores, with the exception of question number 6, referring to the
6th dimension "support request", which had the highest average score: 4.34 with a
standard deviation of 0.830. We found an average score for this instrument of 3.67 with
a standard deviation of 0.69. The values found indicate a relatively positive perception
vis-à-vis
diabetes control, which is not translated, as one would expect, in an effective
control, as we can verify, in particular by the high HbA1c values, BMI, and risk factors,
in particular obesity. It should be noted that other studies point to a lack of consistency
in the evidence concerning health literacy or numeracy and clinical results of the type
we analyzed [19]. However, other studies also confirm the fact that individuals with
positive attitudes regarding the management and control of their diabetes may be more
likely to change their behavior, thus obtaining a better control of blood sugar levels,
when compared to individuals who exhibit negative attitudes [21].
DKT presented values of correct answers for non-insulin treated individuals,
assessing the general average knowledge in 63.37±12.28% and, for insulin-treated
individuals evaluating the global average knowledge in 65.74±12.42% of correct
answers. We can see a relatively poor diabetes knowledge, with a slight increase in
the overall knowledge, i.e. in the insulin-treated respondents. When reviewing the
questions with greater frequency of wrong answers, we note that the knowledge
related to food is very low, the ignorance of HbA1c analytical parameter very high,
thus demonstrating a poor general knowledge in aspects that are fundamental to
enable the person to act as an effective partner in the disease control. But the
questions addressed only to the insulin-treated also reveal lack of knowledge, namely
a deep ignorance about ketoacidosis and on the peak of intermediate insulin action.
Poor knowledge about diabetes in type 2 diabetic people is evidenced by several
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