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Patient and health care provider knowledge of diabetes and diabetic microvascular complications: a comprehensive literature review

Elafros, M. A., Callaghan, B. C., Skolarus, L. E. , Vileikyte, L., Lawrenson, J. ORCID: 0000-0002-2031-6390 & Feldman, E. L. (2022). Patient and health care provider knowledge of diabetes and diabetic microvascular complications: a comprehensive literature review. Reviews in Endocrine and Metabolic Disorders, 24(2), pp. 221-239. doi: 10.1007/s11154-022-09754-5


Diabetic retinopathy, neuropathy, and nephropathy occur in more than 50% of people with diabetes, contributing substantially to morbidity and mortality. Patient understanding of these microvascular complications is essential to ensure early recognition and treatment of these sequalae as well as associated symptoms, yet little is known about patient knowledge of microvascular sequalae. In this comprehensive literature review, we provide an overview of existing knowledge regarding patient knowledge of diabetes, retinopathy, neuropathy, and nephropathy. We also discuss health care provider's knowledge of these sequalae given that patients and providers must work together to achieve optimal care. We evaluated 281 articles on patient and provider knowledge of diabetic retinopathy, neuropathy, and nephropathy as well as predictors of improved knowledge and screening practices. Results demonstrated that patient and provider knowledge of microvascular sequalae varied widely between studies, which may reflect sociocultural or methodologic differences. Knowledge assessment instruments varied between studies with limited validation data and few studies controlled for confounding. Generally, improved patient knowledge was associated with greater formal education, longer diabetes duration, and higher socioeconomic status. Fewer studies examined provider knowledge of sequalae, yet these studies identified multiple misconceptions regarding appropriate screening practices for microvascular complications and the need to screen patients who are asymptomatic. Further investigations are needed that use well validated measures, control for confounding, and include diverse populations. Such studies will allow identification of patients and providers who would benefit from interventions to improve knowledge of microvascular complications and, ultimately, improve patient outcomes.

Publication Type: Article
Additional Information: This version of the article has been accepted for publication, after peer review and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at:
Subjects: R Medicine > RC Internal medicine
Departments: School of Health & Psychological Sciences > Optometry & Visual Sciences
SWORD Depositor:
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