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Background: Type 2 diabetes mellitus (T2DM) is a common comorbidity in patients with chronic obstructive pulmonary disease (COPD) and has been associated with an increased risk of mortality in this population. Purpose: This study was designed to investigate the predictive factors of diabetes awareness (DA), including diabetes knowledge (DK), and diabetes care behaviors (DCB) among older people with both COPD and T2DM. Methods: This was a cross-sectional descriptive correlation study. One hundred thirty-three older-age patients with COPD comorbid with T2DM receiving treatment at a chest hospital were enrolled as participants. Both DK and DCB were utilized to measure DA. The Diabetes Knowledge Questionnaire was utilized to measure DK, and the Summary of Diabetes SelfCare Activities was used to evaluate DCB. Results: The average glycated hemoglobin (HbA1c) was 7.68% (SD = 1.55%), with 74 (55.6%) participants having a level > 7%. The average DA was 46.46% (SD = 13.34%), the average DK was 53.42% (SD = 18.91%), and the average DCB was 39.50% (SD = 16.66%). In terms of demographic variables, age, diabetes education, diabetes shared care, and HbA1c were all significantly associated with DA, DK, and DCB (all ps < .05). The overall variance in DA was significantly explained by diabetes education and HbA1c (all ps < .05). The overall variance in DK was significantly explained by age, diabetes education, and HbA1c. The overall variance in DCB was significantly explained by diabetes education and HbA1c (all ps < .05). Conclusions/Implications for Practice: Our study findings indicate that older adult patients with COPD comorbid with T2DM are at elevated risks of poor glycemic control and low DA. Healthcare professionals should be aware of these issues and develop appropriate DA plans to prevent poor glycemic control in this population. Providing accurate information on diabetes to older adults with COPD comorbid with T2DM is important to improving their DK and promoting better DCB. [ABSTRACT FROM AUTHOR]

Jing Li,1,&ast; Yanhong Zhao,2,&ast; Youli Jiang,3 Ying Zhang,4 Peize Zhang,1 Lingjun Shen,2 Zijiao Chen1 1Department of Pulmonary Medicine and Tuberculosis, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 2Department of Tuberculosis, the Third People’s Hospital of Kunming, Kunming, Yunnan, People’s Republic of China; 3Department of Neurology, People’s Hospital of Longhua, Shenzhen, 518109, People’s Republic of China; 4Department of Endocrinology, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zijiao Chen; Lingjun Shen, Email 785863383@qq.com; m18608770202@163.comBackground: Tuberculosis (TB) and diabetes mellitus (DM) present a dual burden to public health. The screening of DM in TB patients may aid in the early detection and management of diabetes, ultimately improving treatment outcomes for those with the comorbidity of TB-DM. We aim to examine the prevalence and identify risk factors of diabetes in individuals with active pulmonary tuberculosis (PTB) in financially affluent China cities.Methods: A cross-sectional survey was conducted in adult patients with highly suspected TB in two cities of China, spanning from May 9, 2023, to June 30, 2023. We compare the clinical characteristics, nutrition status, fasting blood glucose (FBG) level, living style, and knowledge of TB and DM at admission between patients with and without DM. Univariate and multivariate logistic regression analyses were employed to identify risk factors associated with TB-DM comorbidities.Results: Of the 322 patients diagnosed with pulmonary tuberculosis (PTB), 54 individuals (16.8%) had comorbid diabetes mellitus (DM). This included 43 males (13.4%) and 11 females (3.4%). The average age was 55.44 ± 12.36 in DM patients and 46.09 ± 16.87 in non-DM patients. A multivariate logistic regression analysis revealed that male (adjusted odds ratio [aOR]=3.29, 95% confidence interval [CI]: 1.05– 10.30), age older than 47 years (aOR = 1.04, 95% CI: 1.01– 1.07), having a family history of diabetes (aOR = 5.09, 95% CI: 1.28– 20.32), and an elevated random blood glucose level (aOR = 1.6, 95% CI: 1.38– 1.86) were risk factors for DM in patients with PTB. Furthermore, it was found that diabetes awareness (aOR = 0.07, 95% CI: 0.03– 0.21) and zero, light to moderate alcohol consumption were associated with a lower risk of diabetes.Conclusion: Diabetes is prevalent in patients with active PTB. Screening and raising awareness of DM are recommended, particularly in men after middle age with a family history of diabetes and elevated random blood glucose. Early diagnosis of diabetes and effective diabetes prevention may reduce the dual burden of TB–DM comorbidity.Keywords: tuberculosis, diabetes, risk factors, diabetes awareness, waist-to-hip ratio, alcohol consumption

Introduction: This study aimed to investigate awareness of type 2 diabetes and how sociodemographic factors influence diabetes knowledge in a rural population of Tamil Nadu, India. Previous research has identified poor awareness of diabetes in several low and middle-income countries, which can lead to a high prevalence of undiagnosed diabetes. India having the second highest prevalence of diabetes globally, it is increasingly important to assess how diabetes can be addressed in rural Indian populations. Methods: Systematic random sampling was used to gather study participants in 17 villages within the Krishnagiri district of Tamil Nadu, India. Data on diabetes knowledge was collected using a validated questionnaire. Knowledge score range was 0-8; a score of zero was designated as 'low knowledge', scores 1-4 as 'moderate knowledge', and scores 5-8 as 'good knowledge'. Associations between sociodemographic factors and composite diabetes knowledge score were assessed using a multinomial logistic GLLAMM model in Stata. Results: A total of 753 individuals participated in the study. The average age of participants was 47 years and 55% were women. Overall awareness of diabetes was low, with 66% of individuals having no knowledge of diabetes. Only 16% and 17% achieved a moderate and a good knowledge score, respectively. Achieving a moderate knowledge score was significantly positively associated with education, wealth, participation in the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), and business ownership as a source of income. Achieving a good knowledge score was significantly positively associated with education, wealth, rurality, participation in MGNREGA, business ownership as a source of income, and frequency of healthcare utilization. Rurality was significantly negatively associated (relative risk ratio (95% confidence interval)) with both moderate knowledge score (0.34 (0.19-0.59)), and good knowledge score (0.43 (0.24-0.74)). The strongest predictor of having a good knowledge score was having a high-school graduate or postsecondary education (11.07 (4.44-27.61)). Enrolment in MGNREGA employment was the strongest predictor for having a moderate knowledge score (3.27 (1.93-5.54)), as well as strongly associated with having a good knowledge score (2.39 (1.31-4.36)). Conclusion: The low awareness of diabetes among participants of this study raises serious concerns for public health in India. Public health efforts must prioritize health equity to lessen the impacts of diabetes in rural populations, where individuals face systemic barriers to receiving prevention and treatment for conditions such as diabetes. [ABSTRACT FROM AUTHOR]

Abdulrahman Al-Yahya,1 Alwaleed Alsulaiman,1 Abdulrahman Almizel,1 Abdulrahman Barri,1 Fadwa Al Adel2 1College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi ArabiaCorrespondence: Fadwa Al Adel Email FFAladel@pnu.edu.saBackground: Diabetes mellitus (DM) and its complication present a major morbidity burden among Saudi population. Awareness and proper knowledge of this highly prevalent disease is crucial to enhance early detection and proper intervention. Therefore, the main aim of this study was to identify the knowledge, attitude, and practices (KAP) of diabetic patients towards diabetes and diabetic retinopathy in Riyadh, Saudi Arabia.Methods: This cross-sectional study was conducted in 50 randomly selected primary care centers and two university hospitals in Riyadh, Saudi Arabia, between May and December 2018. Diabetic patients ≥ 18 years old were enrolled in the study. A validated KAP-45 questionnaire was used to assess the KAP levels of diabetics towards diabetes and diabetic retinopathy.Results: A total of 313 participants were enrolled in the study. The majority were males 168 (59.8%). The median age was 49 ± 24, and the median duration of diabetes was 8 ± 11 years. The average knowledge score for diabetes was 10 (good). While the average knowledge score for diabetic retinopathy was 4.5 (suboptimal). The average attitude scores for both diabetes and diabetic retinopathy were 0 and 2 (suboptimal), respectively. The average practice score for diabetes was 5 (good) while it was 3 (low) for diabetic retinopathy. The most common barrier to comply with regular follow-up was inadequate knowledge about the importance of periodic eye exam 47.1% (107). Patients with low socio-economic status had a significantly poor knowledge regarding diabetes (P< 0.0001) and diabetic retinopathy (P< 0.015), respectively. However, patients with low educational level had a significantly poor knowledge (p< 0.0001) and poor practice regarding diabetes (P< 0.013), respectively.Conclusion: It is important to improve education and awareness of DM and diabetic retinopathy among diabetics, as it’s essential for controlling the disease and reducing its complications, by improving patient compliance to treatment and follow-up.Keywords: DM, diabetes mellitus, DR, diabetic retinopathy, regular eye exam, primary care, diabetes awareness, knowledge, attitude and practice

Introduction: This study aimed to investigate awareness of type 2 diabetes and how sociodemographic factors influence diabetes knowledge in a rural population of Tamil Nadu, India. Previous research has identified poor awareness of diabetes in several low and middle-income countries, which can lead to a high prevalence of undiagnosed diabetes. India having the second highest prevalence of diabetes globally, it is increasingly important to assess how diabetes can be addressed in rural Indian populations. Methods: Systematic random sampling was used to gather study participants in 17 villages within the Krishnagiri district of Tamil Nadu, India. Data on diabetes knowledge was collected using a validated questionnaire. Knowledge score range was 0-8; a score of zero was designated as 'low knowledge', scores 1-4 as 'moderate knowledge', and scores 5-8 as 'good knowledge'. Associations between sociodemographic factors and composite diabetes knowledge score were assessed using a multinomial logistic GLLAMM model in Stata. Results: A total of 753 individuals participated in the study. The average age of participants was 47 years and 55% were women. Overall awareness of diabetes was low, with 66% of individuals having no knowledge of diabetes. Only 16% and 17% achieved a moderate and a good knowledge score, respectively. Achieving a moderate knowledge score was significantly positively associated with education, wealth, participation in the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), and business ownership as a source of income. Achieving a good knowledge score was significantly positively associated with education, wealth, rurality, participation in MGNREGA, business ownership as a source of income, and frequency of healthcare utilization. Rurality was significantly negatively associated (relative risk ratio (95% confidence interval)) with both moderate knowledge score (0.34 (0.19-0.59)), and good knowledge score (0.43 (0.24-0.74)). The strongest predictor of having a good knowledge score was having a high-school graduate or post-secondary education (11.07 (4.44-27.61)). Enrolment in MGNREGA employment was the strongest predictor for having a moderate knowledge score (3.27 (1.93-5.54)), as well as strongly associated with having a good knowledge score (2.39 (1.31-4.36)). Conclusion: The low awareness of diabetes among participants of this study raises serious concerns for public health in India. Public health efforts must prioritize health equity to lessen the impacts of diabetes in rural populations, where individuals face systemic barriers to receiving prevention and treatment for conditions such as diabetes.

ABSTRACT INTRODUCTIONOn-the-spot blood glucose testing is a health service performed in public spaces to raise diabetes awareness and screen for elevated blood glucose levels. AIMTo describe the users of this service and the frequency of detecting elevated blood glucose. METHODSData collected at point-of-testing on a standardised form over 20 months in two regions of New Zealand were audited. Descriptive and simple inferential statistics report on population demographics and presence of elevated blood glucose (mmol/L). RESULTSData from 2156 individuals were audited. Most (1680, 78%) were female, the mean age was 52 years (standard deviation 18 years) and all major ethnic groups and socioeconomic quintiles were represented. For 53% of responders, this was their first blood glucose test. In total, 153 (7.1%) cases with elevated blood glucose were identified, including 94 who did not report a previous pre-diabetes or diabetes diagnosis. Blood glucose was not correlated with socioeconomic status (r=0.04; P=0.07), but weakly correlated with age (r=0.19; P

INTRODUCTION: On-the-spot blood glucose testing is a health service performed in public spaces to raise diabetes awareness and screen for elevated blood glucose levels. AIM: To describe the users of this service and the frequency of detecting elevated blood glucose. METHODS: Data collected at point-of-testing on a standardised form over 20 months in two regions of New Zealand were audited. Descriptive and simple inferential statistics report on population demographics and presence of elevated blood glucose (mmol/L). RESULTS: Data from 2156 individuals were audited. Most (1680, 78%) were female, the mean age was 52 years (standard deviation 18 years) and all major ethnic groups and socioeconomic quintiles were represented. For 53% of responders, this was their first blood glucose test. In total, 153 (7.1%) cases with elevated blood glucose were identified, including 94 who did not report a previous pre-diabetes or diabetes diagnosis. Blood glucose was not correlated with socioeconomic status (r = 0.04; P = 0.07), but weakly correlated with age (r = 0.19; P < 0.001). Blood glucose values did not appear to differ between ethnicities (P = 0.052). Men had a higher mean value than women (P = 0.003). People with elevated blood glucose access their general practitioner more often than people with normal blood glucose, irrespective of a diabetes diagnosis (P = 0.002). DISCUSSION: On-the-spot blood glucose testing is a health service accessed by a wide range of people, although more commonly by women than men. Future interventions targeting men may better engage them in health screening. Alongside awareness raising, on-the-spot community testing identified previously unknown elevated blood glucose levels at a rate of 1-in-22, and may lead to the earlier identification and treatment of prediabetes or diabetes. [ABSTRACT FROM AUTHOR]

Objectives: To identify undiagnosed diabetes and its complications in local South East Asian communities in Aylesbury, Buckinghamshire, UK. Materials and methods: We, the public health organisation with the collaboration of Diabetes UK, organised six diabetes awareness events from May 2015 to July 2016, for the local South East Asian communities in Aylesbury, Buckinghamshire, UK. The Diabetes UK comprehensive pre-diabetes risk assessment was performed by a Diabetes UK qualified team. Results: A large number of individuals participated in these events; most of the participants were diagnosed, diabetic or pre-diabetic as new cases. Conclusion: Organizing diabetes awareness events, including pre-diabetes risk assessments, werefound to be a very useful approach to identify people with undiagnosed diabetes. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Diabetes mellitus (DM) has increased globally, with a significant increase noted in African communities. Self-care health-related behavior is determined by beliefs about health and illness which are based on the person's knowledge of diabetes. The present study aimed to assess patients' diabetes awareness and level of diabetes knowledge in Zimbabwean adults with diabetes attending an outpatient diabetes clinic at a main referral hospital. METHODS: in this cross-sectional descriptive study, the Diabetes Knowledge Test (DKT) was used to measure 96 (71 women and 25 men) patients' knowledge of diabetes and their treatment. Both descriptive and analytic statistical methods were used. RESULTS: most respondents had poor knowledge in all the three knowledge categories, total knowledge of diabetes, general knowledge of diabetes and knowledge of insulin use. Major knowledge gaps were noted related to insulin use, glycemic control and diet. Attending DM classes was significantly associated with general knowledge about diabetes (p 0.026) while the level of education was an independent determinant of Total Knowledge and Insulin use knowledge scores. CONCLUSION: the identified knowledge gaps need to be addressed to control and minimize diabetes mellitus-related complications.

Introduction: Diabetes mellitus (DM) has increased globally, with a significant increase noted in African communities. Self-care health-related behavior is determined by beliefs about health and illness which are based on the person's knowledge of diabetes. The present study aimed to assess patients' diabetes awareness and level of diabetes knowledge in Zimbabwean adults with diabetes attending an outpatient diabetes clinic at a main referral hospital. Methods: In this cross-sectional descriptive study, the Diabetes Knowledge Test (DKT) was used to measure 96 (71 women and 25 men) patients' knowledge of diabetes and their treatment. Both descriptive and analytic statistical methods were used. Results: Most respondents had poor knowledge in all the three knowledge categories, total knowledge of diabetes, general knowledge of diabetes and knowledge of insulin use. Major knowledge gaps were noted related to insulin use, glycemic control and diet. Attending DM classes was significantly associated with general knowledge about diabetes (p 0.026) while the level of education was an independent determinant of Total Knowledge and Insulin use knowledge scores. Conclusion: The identified knowledge gaps need to be addressed to control and minimize diabetes mellitus-related complications. [ABSTRACT FROM AUTHOR]

Background: Raising the awareness of childhood diabetes symptoms can reduce the frequency of diabetic ketoacidosis (DKA) at onset of type 1 diabetes (T1D). However, data on the effectiveness of such interventions are limited. The aim of the study was to describe trends of DKA at onset of childhood T1D during 2005-2014 and assess the impact of a diabetes awareness campaign launched late 2010. Methods: Data of children < 12 years presented with DKA at diagnosis were analyzed according to age, gender and year of diagnosis. The frequency and severity of DKA before and during the 4 years campaign were compared. Results: During 2005-2014, 44.9% (243/541) of children diagnosed with T1D presented with DKA. Of these, 22.7% had pH < 7.1. In both genders DKA was higher in children < 6 years (47.8% vs. 40%; p < 0.01) and more severe in < 3 years old compared to older children (30% vs. 20%; p < 0.01). Following the awareness campaign DKA rate dropped from 48% in 2010 to 39% in 2014 and 15.8% had severe DKA compared to 26.1% in 2005-2010 (p < 0.01). This trend was observed in both genders and across age groups. In children < 3 years the reduction in DKA frequency and severity was not statistically significant (p = 0.15 and p = 0.42, respectively). Conclusions: In NWSA, the frequency and severity of DKA at onset of childhood T1D were reduced following 4 years awareness campaign; but the rate is still high. Maintaining the campaign may result in further improvement following a longer period of observation. [ABSTRACT FROM AUTHOR]

Aims: To provide up-to-date estimates of undiagnosed diabetes mellitus (UDM) prevalence - both globally, and by region/country, for the year 2021.Methods: Data sources reporting diabetes prevalence were identified through a systematic search in the peer-reviewed and grey literature. The prevalence of undiagnosed diabetes was estimated from the data from each country where data was available. For countries without in-country data, the prevalence of undiagnosed diabetes was approximated by extrapolating the average of the estimates from countries with data sources within the same International Diabetes Federation (IDF) region and World Bank income grouping. We then applied these stratified prevalence estimates of UDM from each country to the number of adults in each strata and summed the counts to generate the number of adults with UDM (aged 20-79 years) for 215 countries and territories.Results: In 2021, almost one in two adults (20-79 years old) with diabetes were unaware of their diabetes status (44.7%; 239.7 million). The highest proportions of undiagnosed diabetes (53.6%) were found in the Africa, Western Pacific (52.8%) and South-East Asia regions (51.3%), respectively. The lowest proportion of undiagnosed diabetes was observed in North America and the Caribbean (24.2%).Conclusions: Diabetes surveillance needs to be strengthened to reduce the prevalence of UDM, particularly in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Purpose: The aim was to assess awareness of diabetes mellitus and its ocular complications among Timorese aged 40 years and older. Methods: An interview-based questionnaire was administered to a subset of five urban and five rural clusters of 45 people aged 40 years and older as part of a population-based cross-sectional survey. Results: The participation rate was 96.2 per cent and data were analysed for 413 respondents. Correct nomination of at least one symptom, risk factor, prevention or treatment of diabetes was made by 6.1 per cent of participants. When explicitly asked, 6.8 per cent thought that diabetes caused problems with the body and 3.6 per cent thought diabetes caused eye problems. Conclusion: There is little awareness of diabetes and its ocular complications in Timor-Leste. Given the predicted urbanisation and economic development in the coming decades, as other health challenges are addressed and resources become available, consideration of diabetes might be prudent. Improving knowledge among the population will be an important component of any strategy developed. [ABSTRACT FROM AUTHOR]

Abstract: Background: A good knowledge about diabetes could lead to early diagnosis and improved management. Objective: To evaluate the level of diabetes awareness in Cameroonians, and to identify factors that influence this awareness. Methods: In subjects aged ≥25 years (n =1000, 93.4% of response), details regarding risk factors, symptoms, treatment and complications of type 2 diabetes were collected. One mark was attributed to each true answer and a global diabetes awareness score was computed. Influence of age, gender, educational level, occupational level, notion of a relative having a chronic condition and presence of chronic disease were analyzed. Results: Eighty percent of subjects scored more than the total mean score. The highest score obtained by participants (0.10%) was 28/30. The mean total score was higher in men (p <0.02) and in subjects with a relative having a chronic condition (p <0.001). In multivariate analyses, age classes (p <0.01), educational level (p <0.001) and relatives with a chronic condition (p <0.001) were associated to the global diabetes awareness score. Conclusions: Diabetes awareness was generally good. This may be due to the fact that the study was conducted in an area where health promotion and health education on diabetes have been intensively delivered for the past 4 years. [ABSTRACT FROM AUTHOR]

Introduction Diabetes is a well-known global public health challenge affecting millions globally. The aims of this study are to examine the community diabetes knowledge, perceptions, and awareness among the public in Qatar regarding (1) disease symptoms, risk factors, complications, prevention, and associated behaviors, and (2) local diabetes campaigns and available services or resources. Methods This study involved a total of 501 respondents selected through purposive sampling from major public malls and public places in Doha, Qatar between February and May 2015. Data were gathered by face-to-face interview utilizing a semi-structured questionnaire. Results were analyzed using count, percentage, median, chi-square test, z-test on proportion and logistic regression. The analysis was carried out at 5% level of significance using SPSS version 22 (IBM Corporation, Chicago, IL, USA). Results About 92% of participants knew at least one type of diabetes. Over 43.9% were physically active for 1-3 days per week. Highest proportion of the population perceived blindness (86%) as the top complication; frequent urination (58%) and excessive thirst (41%) as primary symptoms; hereditary factors (74%) and obesity (74%) as the top risk factors; and exercise (77%) and diet (72%) as among the preventive measures. Demographic overview of diabetes and lifestyle factors showed that the odds of obtaining screening tests were higher among females (OR=1.7, P=0.003), age 35-45 (OR=2.2, P=0.003), age ≥55 (OR=4.1, P<0.001) and married (OR=3.0, CI=2.0-4.6, P<0.001) compared with their respective counterpart groups. Conclusions The general population in Qatar require more awareness and education about diabetes prevention and associated risk factors. This could be achieved by implementation of more public health campaigns to encourage healthier lifestyles., Competing Interests: The authors have declared that no competing interests exist.

The study reported here investigated the effectiveness of the LSU AgCenter Help a Friend, Help Yourself youth diabetes education curriculum to increase knowledge and awareness of diabetes and its symptoms in low-income middle school students participating in the Boys and Girls Club after-school program. The curriculum includes four lessons with multimedia presentations, art projects, and demonstrations designed to teach children about diabetes, with a specific focus on the signs and symptoms. Results indicated that students' knowledge of diabetes and its symptoms increased following participation in the four-session series. [ABSTRACT FROM AUTHOR]

Objective: To compare racial/ethnic differences in diabetes awareness, treatment, and glycemic control between non-Hispanic white, non-Hispanic black, and Hispanic Americans. We also determined the impact of abdominal obesity on racial/ethnic differences in diabetes awareness, treatment, and glycemic control between these population groups.Research Methods and Procedures: Third National Health and Nutrition Examination Survey (NHANES III) data were utilized for this study. Diabetes awareness was defined as acknowledging diabetic status. Diabetes treatment was defined as current use of anti-diabetic medications, good glycemic control as HbA1c <8%, and abdominal obesity as waist circumference larger than expected. The impacts of abdominal obesity on racial/ethnic differences in diabetes awareness, treatment, and glycemic control were assessed using logistic regression analyses. Adjustments were made for age, education, smoking, alcohol intake, and health insurance. Results: Rates of diabetes awareness in whites, blacks, and Hispanics suffering from abdominal obesity were ∼74%, 30%, and 21% in men and 77%, 32%, and 19% in women, respectively. Rates of diabetes treatment were 70%, 23%, and 14% in men and 57%, 45%, and 23% in women, respectively. In men, rates of glycemic control were 64%, 40%, and 30%, and in women, they were 62%, 51%, and 27%, respectively. Abdominal obesity was associated with decreased diabetes awareness and glycemic control in women.Discussion: Subjects with abdominal obesity were found to have poorer glycemic controls compared to those without abdominal obesity. Because diabetes prevalences were partially explained by racial/ethnic differences in diabetes awareness, treatment, and glycemic control, there is a need to craft diabetes awareness, treatment, and control programs along racial/ethnic origins. [Copyright &y& Elsevier]