Abstract
Background and Aims: Almost seven million persons in Saudi Arabia are diagnosed with Type 2 Diabetes Mellitus (T2DM). Limited knowledge among informal caregivers may adversely influence diabetes management and patient outcomes, yet structured caregiver education remains insufficient. There is a need to discover T2DM informal caregivers’ knowledge and its relation to patients’ T2DM management. This study aimed to assess the level of T2DM knowledge among informal caregivers of Saudi patients and to examine its association with patients’ glycemic control (HbA1C levels). The study was guided by Nursing theories. Methods: A quantitative, correlational design was used. Convenience sampling of 37 caregiver–patient dyads (N = 74) was conducted at primary health centers in Jeddah, Saudi Arabia. Data were collected using self-reported HbA1C values and the Brief Diabetes Knowledge Test. Pearson’s correlation and multiple linear regression analyses were performed. Results: The mean diabetes knowledge score among caregivers was low (M = 8.03), indicating average knowledge. No significant correlation was found between caregiver T2DM knowledge and patients’ HbA1C levels. Multiple regression analysis showed that caregivers aged 31–45 years and those employed as students were significant positive predictors of higher diabetes knowledge scores. Conclusion: The findings demonstrate that informal caregivers possess only moderate knowledge of T2DM management. Further research, including qualitative inquiry, is recommended to explore how caregivers acquire and apply diabetes-related knowledge and how this knowledge may influence patients’ glycemic outcomes.
Keywords: Type 2 Diabetes · HBA1C Levels · Caregivers · Saudi Arabia
References
- 1.Bukhsh A, Khan TM, Nawaz MS, Ahmed HS, Chan KG, Goh BH. Association of diabetes knowledge with of type 2 diabetes patients in Riyadh, 2016;8(3):195–202. doi:10.4103/09757406.171683 doi:10.4103/09757406.171683
- 2.Robert AA, Al Dawish MA. The Worrying Trend of Diabetes Mellitus in Saudi Arabia: An Urgent Call to Action. Curr Diabetes Rev. 2020;16(3):204–10. doi:10.2174/157339981566619053109 3735 doi:10.2174/157339981566619053109
- 3.AlMazroa M. Cost of Diabetes in Saudi Arabia. Iproceedings. 2018;4(1):e10566. doi:10.2196/10566 doi:10.2196/10566
- 4.The Ministry of Health (MHO). Statistics report 2015 [Internet]. 2015 [cited 2025 May 2]. Available from: http://www.moh.gov.sa/en/Ministry/ Statistics/book/Pages/default.aspx glycemic control and self-care practices 7. World Health Organization (WHO). among Pakistani people with type 2 Aging and health [Internet]. 2018 [cited Obes. 2019;12:1409–17. doi:10.2147/ www.who.int/news-room/fact-sheets/ diabetes mellitus. Diabetes Metab Syndr DMSO.S209711 2025 May 2]. Available from: https:// detail/ageing-and-health
- 5.Williams R, Karuranga S, Malanda 8. Ansari T, Sami W, Al-Abdulmonem B, Saeedi P, Basit A, Besançon S, A, Tawalah FF, Almutalq FS, Alwadai The Relationship Between Informal Caregivers’ Knowledge of Type 2 Diabetes Mellitus Management and Patients’ HbA1c Levels Among Older Adults in Saudi Arabia 153 Majmaah Journal of Health Sciences ,Vol. 14, Issue3, July - 2026, Muharram - 1448 HS, et al. Health-related quality of life in Saudi patients with diabetes. Rawal Disord. 2018;18(1):1-12. doi:10.1186/ s12902-018-0292-9 Med J. 2018;43(4). Available from: 14. Wojujutari AK, Alabi OT, Emmanuel http://www.rmj.org.pk/?mno=290782 IE. Psychological resilience moderates Factors Associated with Diabetes dysfunction of people living with
- 6.Khlid AA, Abbas AM, Nisha S. Risk Mellitus in a Saudi Community: A Cross-Sectional Study. Prim Health Care. 2017;7(2):1-4. doi:10.4172/21671079.1000270 doi:10.4172/21671079.1000270
- 7.Alsairafi ZK, Taylor KM, Smith FJ, Alattar AT. Patients’ management of type 2 diabetes in Middle Eastern countries: review of studies. Patient Prefer Adherence. 2016;10:1051–62. doi:10.2147/PPA.S104335 doi:10.2147/PPA.S104335
- 8.A l s h a m m a r i S, A l z a h r a n i A , Alabduljabbar K, Aldaghri A, Alhusainy Y, Khan M, et al. The burden perceived by informal caregivers of the elderly in Saudi Arabia. J Fam Community Med. influence of depression on sleep diabetes. J Diabetes Metab Disord. 2019;18(2):429–36. doi:10.1007/ s40200-019-00436-9
- 9.Abdelmoneium AO, Alharahsheh ST. Family Home Caregivers for Old Persons in the Arab Region: Perceived Challenges and Policy Implications. Open J Soc Sci. 2016;4(1):151-64. doi:10.4236/jss.2016.41019 doi:10.4236/jss.2016.41019
- 10.LaManna JB, Bushy A, Norris AE, Chase SK. Early and intermediate hospital-to-home transition outcomes of older adults diagnosed with diabetes. Diabetes Educ. 2016;42(1):72–86. doi:10.1177/0145721715620020 2017;24(3):145. doi:10.4103/jfcm. 17. Bouldin ED, Trivedi RB, Reiber GE, jfcm_117_16 Rosland AM, Silverman JB, Krieger MJ. Type 2 diabetes. Lancet. an informal caregiver, social support, doi:10.1177/0145721715620020
- 11.Chatterjee S, Khunti K, Davies 2017;389(10085):2239-51. doi:10.1016/ S0140-6736(17)30058-2
- 12.A d u - S a r k o d i e N Y. Clinical in Riyadh, Saudi Arabia: A Quantitative Study. Cureus. 2020;12(1):e6601. doi:10.7759/cureus.6601 management of diabetes mellitus in the 24. Wolde M, Berhe N, van Die I, Medhin older adult patient. Curr Diabetes Rev. G, Tsegaye A. Knowledge and practice 99812666161206151706 among diabetes mellitus family 2017;13(3):225–38. doi:10.2174/15733 doi:10.7759/cureus.6601
- 13.Mayberry LS, Piette JD, Lee AA, Aikens JE. Out-of-home informal support important for medication on prevention of diabetes mellitus members in suburban cities in Ethiopia. BMC Res Notes. 2017;10(1):551. doi:10.1186/s13104-017-2871-7 adherence, diabetes distress, hemoglobin 25. Alanazi AM, El-Fetoh NMA, A1c among adults with type 2 diabetes. Alotaibi HK, Alanazi KA, Alotaibi doi:10.1007/s10865-018-0002-0. of awareness of diabetes mellitus J Behav Med. 2019;42(3):493–501. doi:10.1186/s13104-017-2871-7
- 14.Sharif L, Basri S, Alsahafi F, Altaylouni M, Albugumi S, Banakhar M, et al. An exploration of family caregiver experiences of burden and coping BK, Alshammari SM, et al. Survey among the Arar population, Northern Border Region of Saudi Arabia. Electron Physician. 2017;9(9):5369. doi:10.19082/5369 while caring for people with mental 26. R e i f e g e r s t e D, Hartleib S. disorders in Saudi Arabia—a qualitative Hypoglycemia-related information 2020;17(17):6405. doi:10.3390/ type 2 diabetes patients: Implications study. Int J Environ Res Public Health. ijerph17176405 doi:10.19082/5369
- 15.Alanazi FK, Alotaibi JS, Paliadelis P, Alqarawi N, Alsharari A, Albagawi B. seeking among informal caregivers of for health education. J Clin Transl Endocrinol. 2016;4:7–12. doi:10.1016/j. jcte.2016.02.001 Knowledge and awareness of diabetes 27. Boykin A, Schoenhofer SO. Nursing mellitus and its risk factors in Saudi as caring: A model for transforming doi:10.15537/smj.2018.10.22938 2001. p. 1–40. Arabia. Saudi Med J. 2018;39(10):981. practice. Jones & Bartlett Learning; doi:10.1016/j
- 16.Alqahtani M, Almutairi FE, Albasseet 28. Ryan P, Sawin KJ. The individual AO, Almutairi KE. Knowledge, and family self-management theory: Mellitus Among the Saudi Population process, and outcomes. Nurs Outlook. Attitude, and Practice of Diabetes Background and perspectives on context, The Relationship Between Informal Caregivers’ Knowledge of Type 2 Diabetes Mellitus Management and Patients’ HbA1c Levels Among Older Adults in Saudi Arabia 155 Majmaah Journal of Health Sciences ,Vol. 14, Issue3, July - 2026, Muharram - 1448 2009;57(4):217-25. doi:10.1016/j. 34. Shao Y, Liang L, Shi L, Wan C, Yu outlook.2008.10.004 S. The effect of social support on GPOWER: A general power analysis 2 diabetes mellitus: the mediating doi:10.1016/j
- 17.Erdfelder E, Faul F, Buchner A. program. Behav Res Methods Instrum Comput. 1996;28(1):1–11.
- 18.Fitzgerald JT, Funnell MM, Hess GE, glycemic control in patients with type roles of self-efficacy and adherence. J Diabetes Res. 2017;2017:2804178. doi:10.1155/2017/2804178 Barr PA, Anderson RM, Hiss RG, et 35. Field A. Discovering statistics using al. The reliability and validity of a brief IBM SPSS statistics. Sage; 2013. Care. 1998;21(5):706-10. doi:10.2337/ R. Assessment of diabetes knowledge doi:10.1155/2017/2804178
- 19.Fitzgerald JT, Funnell MM, Anderson among people with type 2 diabetes diabetes knowledge test. Diabetes 36. Dussa K, Parimalakrishnan S, Sahay diacare.21.5.706 RM, Nwankwo R, Stansfield RB, Piatt GA. Validation of the revised using diabetes knowledge questionnaire mellitus. Asian J Pharm Clin Res. 2015;8(2):254–6. brief diabetes knowledge test (DKT2). 37. Al-Maskari F, El-Sadig M, Al-Kaabi Diabetes Educ. 2016;42(2):178-87. JM, Afandi B, Nagelkerke N, Yeatts
- 20.Alhaiti AH, Alotaibi AR, Jones LK, of diabetic patients in the United Arab doi:10.1177/0145721715624968 DaCosta C, Lenon GB. Psychometric evaluation of the revised Michigan KB. Knowledge, attitude and practices Emirates. PLoS One. 2013;8(1):e52857. doi:10.1371/journal.pone.0052857 Diabetes Knowledge Test (V.2016) 38. Appil R, Sjattar EL, Yusuf S, Kadir in Arabic: translation and validation. K. Effect of Family Empowerment on doi:10.1155/2016/9643714 Foot Ulcers. Int J Low Extrem Wounds. J Diabetes Res. 2016;2016:9643714. doi:10.1177/0145721715624968
- 21.Haghighatpanah M, Nejad ASM, HbA1C Levels and Healing of Diabetic 2020. doi:10.1177/1534734620930120 Haghighatpanah M, Thunga G, 39. Aljofan M, Altebainawi A, Alrashidi Mallayasamy S. Factors that correlate MN. Public knowledge, attitude and 2 diabetes mellitus patients with region, Saudi Arabia. Int J Gen Med. with poor glycemic control in type complications. Osong Public Health Res Perspect. 2018;9(4):167–74. doi:10.24171/j.phrp.2018.9.4.05 156 practice toward diabetes mellitus in Hail 2019;12:255–62. doi:10.2147/IJGM. S214441 doi:10.1177/1534734620930120
- 22.Alsous M, Abdel Jalil M, Odeh The Relationship Between Informal Caregivers’ Knowledge of Type 2 Diabetes Mellitus Management and Patients’ HbA1c Levels Among Older Adults in Saudi Arabia Majmaah Journal of Health Sciences ,Vol. 14, Issue3, July - 2026, Muharram - 1448 M, Al Kurdi R, Alnan M. Public doi:10.1155/2020/5151604 toward diabetes mellitus: A cross- Ferrari GSL, Fonseca GAA, Ferrari 2019;14(3):e0214479. doi:10.1371/ does gender make a difference?. knowledge, attitudes and practices 45. Dos Santos PFL, Dos Santos PR, sectional study from Jordan. PLoS One. journal.pone.0214479 doi:10.1155/2020/5151604
- 23.Arora S, Marzec K, Gates C, Menchine M. Diabetes knowledge in CKB. Knowledge of diabetes mellitus: Osong Public Health Res Perspect. 2014;5(4):199-203. doi:10.1016/j. phrp.2014.06.004 predominantly Latino patients and 46. Chinnappan S, Sivanandy P, Sagaran family caregivers in an urban emergency R, Molugulu N. Assessment of Available from: https://www.jstor.org/ urban areas of Klang district, Malaysia. department. Ethn Dis. 2011;21(1):1-6. stable/48717847 doi:10.1016/j
- 24.Mayberry LS, Osborn CY. Family knowledge of diabetes mellitus in the Pharmacy. 2017;5(1):11. doi:10.3390/ pharmacy5010011 support, medication adherence, 47. Herath HMM, Weerasinghe NP, and glycemic control among adults Dias H, Weerarathna TP. Knowledge, 2012;35(6):1239-43. doi:10.2337/dc11- mellitus among the general public in with type 2 diabetes. Diabetes Care. 2103 doi:10.2337/dc11-
- 25.Nguyen TD, Bygbjerg IC, Meyrowitsch DW, Gammeltoft T, Le CD, Nguyen AT, et al. Perceived knowledge on type-2 diabetes of informal caregivers in rural attitude and practice related to diabetes Galle District, Southern Sri Lanka: a pilot study. BMC Public Health. 2017;17(1):7. doi:10.1186/s12889-0174459-5 communities of Thai Binh, Vietnam: Implications for health education. Public Health Pract. 2021;2:100210. doi:10.1016/j.puhip.2021.100210 doi:10.1186/s12889-0174459-5
- 26.AlHaidar AM, AlS hehri NA, AlHussaini MA. Family Support and Its Association with Glycemic Control in Adolescents with Type 1 Diabetes Mellitus in Riyadh, Saudi Arabia. J Diabetes Res. 2020;2020:5151604. The Relationship Between Informal Caregivers’ Knowledge of Type 2 Diabetes Mellitus Management and Patients’ HbA1c Levels Among Older Adults in Saudi Arabia 157
Peer review
Peer reviewed by 2 reviewers, who chose to remain anonymous.