BackgroundAchieving good glycaemic control is important in diabetes management. However, poor glycaemic control is widely reported. This article assessed the prevalence of uncontrolled and poor glycaemic control among Libyans with type 2 diabetes and examined the relative contribution of diabetes coping behaviours to their glycaemic control status.MethodsA cross-sectional study was undertaken in 2013 in a large diabetes centre in Tripoli. The study included 523 respondents. Diabetes coping behaviours were measured using the revised version of the Summary of Diabetes Self-Care Activities measure (SDSCA) and the eight-item Morisky Medication Adherence Scale (MMAS-8©), while glycaemic control status was based on the HbA1c level.ResultsMean HbA1c was 8.9 (±2.1), and of the 523 patients, only 114 (21.8%) attained the glycaemic control target of HbAc1 of less than 7.0%. Females (OR=1.74, 95% CI=1.03–2.91), patients on insulin and oral hypoglycaemic agents (OR=1.92, 95% CI=1.05–3.54), patients on insulin (OR=3.14, 95% CI=1.66–6.03), and low-medication adherents (OR=2.25, 95% CI=1.36–3.73) were more likely to have uncontrolled and poor glycaemic control, while exercise contributed to glycaemic control status as a protective factor (OR=0.85, 95% CI=0.77–0.94).ConclusionThe findings from this study showed the considerable burden of uncontrolled and poor glycaemic control in one of the largest diabetes care settings in Libya. Medication adherence as well as exercise promotion programs would help in reducing the magnitude of poor glycaemic control.

BackgroundThe surrounding environment influences the constitution of illness perceptions. Therefore, local research is needed to examine how Libyan diabetes patients perceive diabetes and how their perceptions influence their medication adherence.MethodsA cross-sectional study was conducted at the National Centre for Diabetes and Endocrinology in Tripoli, Libya, between October and December 2013. A total of 523 patients with type 2 diabetes participated in this study. A self-administered questionnaire was used for data collection; this included the Revised Illness Perception Questionnaire and the eight-item Morisky Medication Adherence Scale.ResultsThe respondents showed moderately high personal control and treatment control perceptions and a moderate consequences perception. They reported a high perception of diabetes timeline as chronic and a moderate perception of the diabetes course as unstable. The most commonly perceived cause of diabetes was Allah's will. The prevalence of low medication adherence was 36.1%. The identified significant predictors of low medication adherence were the low treatment control perception (p=0.044), high diabetes identity perception (p=0.008), being male (p=0.026), and employed (p=0.008).ConclusionDiabetes illness perceptions of type 2 diabetic Libyans play a role in guiding the medication adherence and could be considered in the development of medication adherence promotion plans.

No validation study has previously been made for the Arabic version of the 8-item Morisky Medication Adherence Scale (MMAS-8 © ) as a measure for medication adherence in diabetes. This study in 2013 tested the reliability and validity of the Arabic MMAS-8 for type 2 diabetes mellitus patients attending a referral centre in Tripoli, Libya. A convenience sample of 103 patients self-completed the questionnaire. Reliability was tested using Cronbach alpha, average inter-item correlation and Spearman-Brown coefficient. Known-group validity was tested by comparing MMAS-8 scores of patients grouped by glycaemic control. The Arabic version showed adequate internal consistency (α = 0.70) and moderate split-half reliability (r = 0.65). Known-group validity was supported as a significant association was found between medication adherence and glycaemic control, with a moderate effect size (ϕc = 0.34). The Arabic version displayed good psychometric properties and could support diabetes research and practice in Arab countries. visant à mesurer l'adhésion au traitement du diabète. La présente étude menée en 2013 a testé la fiabilité et la validité de la version en langue arabe de l'échelle MMAS-8 chez des patients atteints de diabète de type 2 consultant dans une clinique de recours à Tripoli (Libye). Dans un échantillon de proximité, 103 patients ont rempli l'autoquestionnaire. La fiabilité a été testée à l'aide de l'alpha de Cronbach, de la corrélation moyenne entre item et du coefficient de Spearman-Brown. La validité par groupe connu a été testée en comparant les scores MMAS-8 des patients regroupés par contrôle glycémique. La version en langue arabe a révélé une cohérence interne adéquate (α = 0,70) et une fiabilité fractionnée modérée (r = 0,65). La validité par groupe connu a été confirmée par une association significative observée entre l'adhésion au traitement et le contrôle de la glycémie, avec une taille d'effet modérée (ϕc = 0,34). La version en langue arabe avait des propriétés psychométriques satisfaisantes et pourrait être utile pour la recherche sur le diabète et la pratique y afférente dans les pays arabes. ‫ـكري‬ ‫السـ‬ ‫ـرىض‬ ‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫العرشون‬ ‫و‬ ‫احلادي‬ ‫املجلد‬ ‫العارش‬ ‫العدد‬ 723

The use of traditional medicines is common among patients with chronic illnesses and this practice might pose health risks. The use among Libyan patients with diabetes is unknown. Therefore, this study aimed to estimate the prevalence of traditional medicine use in the previous year among Libyans with type 2 diabetes and to examine the association between its use and sociodemographic and clinical characteristics of the patients. A cross-sectional study was conducted at a large diabetes centre in Tripoli. A self-reported questionnaire was used for data collection. Of the 523 respondents, 28.9% used traditional remedies. Sex was the only variable significantly associated with traditional medicine use; more women used traditional medicines (P = 0.01). A total of 77 traditional medicine items were reported to be used, of which herbs were the most common. The use of traditional medicine for diabetes is prevalent and some of the reported items could pose health risks. Health education programmes are suggested to raise the awareness of the health risks of this practice. RÉSUMÉ L'utilisation à la médecine traditionnelle est courante parmi les patients souffrant de maladies chroniques et cette pratique peut entraîner des risques pour la santé. On ignore dans quelle mesure les patients diabétiques libyens y ont recours. La présente étude avait pour objectif d'estimer la prévalence de l'utilisation de la médecine traditionnelle au cours de l'année précédente chez des patients libyens atteints de diabète de type 2, ainsi que d'examiner l'association entre cette utilisation et les caractéristiques socio-démographiques et cliniques des patients. Une étude transversale a été conduite dans un grand centre de traitement du diabète à Tripoli. Un questionnaire auto-déclaré a été utilisé pour la collecte de données. Sur les 523 répondants, 28,9 % prenaient des remèdes traditionnels. Le sexe des individus était la seule variable associée de façon significative à l'utilisation de la médecine traditionnelle, un plus grand nombre de femmes y ayant recours (p = 0,01). Un total de 77 produits de médecine traditionnelle ont été déclarés, les plus courants étant les plantes. L'utilisation de la médecine traditionnelle pour traiter le diabète est prévalente, et certains des produits rapportés peuvent constituer des risques pour la santé. Il est suggéré de mettre au point des programmes d'éducation sanitaire afin de sensibiliser la population aux risques que cette pratique représente pour la santé. ‫الثاين‬

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