初诊2型糖尿病患者疾病态度对短期胰岛素泵强化治疗后血糖控制的影响

目的：探讨初诊2型糖尿病患者对疾病的态度对短期胰岛素泵强化治疗后血糖控制的影响。方法：118例持续皮下胰岛素输注（CSII）治疗后获得临床缓解的初诊2型糖尿病患者完成1年随访,分别于基线期、出院后3个月、6个月、1年使用密西根糖尿病管理评定量表（DCP）评价患者对糖尿病的态度（包括积极态度、消极态度、自我护理能力、自我管理重要性认识、自我管理坚持性认识）,并检测患者糖化血红蛋白水平（HbA1c）水平,采用Spearman相关分析探讨患者对疾病态度与HbA1c水平的相关性。结果：65例缓解期≥1年患者为缓解组,53例缓解期〈1年患者为治疗失效组;缓解组患者初中文化的比例明显低于治疗失效组,大学或以上文化的比例明显高于治疗失效组（P〈0.05）。经过2周CSII治疗后两组患者血糖指标均明显改善,缓解组患者CSII治疗后的空腹血糖（FPG）和餐后2 h血糖（2 hPG）低于治疗失效组,伴随胰岛素第一时相分泌（AIR）值高于治疗失效组（P〈0.05）。随访期内缓解组患者积极态度、自我护理能力、自我管理重要性认识和坚持性认识得分较基线升高,并高于同时期的治疗失效组（P〈0.05）,消极态度得分逐渐降低,并低于同时期的治疗失效组（P〈0.05）,而治疗失效组患者积极态度、自我护理能力、自我管理重要性认识和坚持性认识得分较基线下降,消极态度得分则始终维持较高的水平;Spearmen相关分析显示,除0个月外,各随访期HbA1c水平与积极态度、自我护理能力、自我管理重要性认识和坚持性认识得分呈显著负相关,与消极态度得分呈正相关。结论：糖尿病患者对疾病的态度对初诊糖尿病患者CSII后血糖控制具有重要影响,因此应重视对初诊2型糖尿病患者进行心理教育,使患者形成良好的管理疾病的态度,进而更好的控制病情,维持理想的生存质量。     

行为治疗对社区精神分裂症患者精神症状的影响

目的探讨行为治疗对缓解社区精神分裂症患者的精神症状、自知力和治疗态度方面的作用。方法将 96例非急性期的社区精神分裂症患者随机分为行为治疗组 (以下简称治疗组 ,48例 ,其中脱落 2例 )和对照组 (4 8例 )。对行为治疗组进行行为治疗共 6个月。采用阳性症状与阴性症状量表 (PANSS)、自知力与治疗态度问卷表 (ITAQ)对患者进行评估。结果行为治疗组干预后与干预前的PANSS评分、阴性量表得分、一般精神病理量表得分、自知力与治疗态度问卷表得分比较有非常显著性差异 (P <0 0 1) ;第 6个月末时点与干预前时点评分差值的比较 ,两组患者的PANSS分、阳性量表分、自知力与治疗态度问卷表分的具有显著性差异 (P <0 0 5 ) ;阴性量表分、一般精神病理量表分具有非常显著性差异 (P <0 0 1)。结论在药物治疗的基础上 ,行为治疗能改善精神分裂症患者的症状及其自知力和治疗态度。     

Rehabilitation students' attitudes toward persons with disabilities in high- and low-stakes social contexts: A conjoint analysis

Purpose. The primary objective of this research is to examine factors influencing rehabilitation services students' attitudes toward people with disabilities in two social contexts using a conjoint analysis design.

Method. Ninety-nine students in rehabilitation counselling participated in a conjoint measurement study featuring 55 stimulus cards representing varying disability types, genders, races or ethnicities, grade point averages, internship evaluations, and employment statuses for both high-stakes scenarios and low-stakes scenarios. The participants were instructed to order the stimulus cards to indicate their preferences for associating with different people with disabilities in two social contexts: A high-stakes context as a rehabilitation administrator hiring a counsellor and a low-stakes context as a mentor/companion.

Results. The results showed that age and disability type were most involved in the decision-making process in the low-stakes group, and performance-related variables were most important in the high-stakes context. Attitude was significantly affected by client characteristics unrelated to disability including age and race or ethnicity, and factors influencing attitude formation differed across the two social contexts.

Conclusion. Conjoint analysis can contribute to our understanding of the formation of attitudes or preferences in multiple social contexts. Using these results, it may be possible to develop effective attitude change strategies.     

Sexuality of the aged and the attitudes and knowledge of nursing students

Sexuality of the aged is one area of particular concern to nurse educators, because students' lack of knowledge and negative attitude can have far-reaching effects on nursing care of the elderly. This study examined the relationship of the dependent variables, attitude and knowledge, to the independent variables of ethnicity, age, experience in health care, family income, religious affiliation, religiosity, living arrangements, and level of education. One hundred fifty-eight female nursing students completed White's Aging Sexuality Attitude and Knowledge Scale. The study found that higher knowledge was related to more positive attitude scores (r = .25, P less than .004). Age was also significantly related to both positive attitude (r = .44, P less than .001) and higher knowledge (r = .54, P less than .001). Older students had a more positive attitude toward the elderly and were more knowledgeable about aged sexuality than younger students in the sample. One-way analysis of variance was used to test the significance between means of the dependent and independent variables. A statistically significant difference was found between ethnicity and attitude (f = 33.09, P less than .001) and ethnicity and knowledge (f = 18.36, P less than .001). Asian students in this study had a more negative attitude and were less knowledgeable about aged sexuality than Caucasian students. The study suggests that nurse educators need to pay special attention to the age and ethnicity of students when planning gerontological learning experiences designed not only to facilitate knowledge acquisition, but to promote positive attitudes toward the elderly.     

Theory development and a science of rehabilitation: Authors' response to commentaries

Purpose. The primary objective of this research is to examine factors influencing rehabilitation services students' attitudes toward people with disabilities in two social contexts using a conjoint analysis design.

Method. Ninety-nine students in rehabilitation counselling participated in a conjoint measurement study featuring 55 stimulus cards representing varying disability types, genders, races or ethnicities, grade point averages, internship evaluations, and employment statuses for both high-stakes scenarios and low-stakes scenarios. The participants were instructed to order the stimulus cards to indicate their preferences for associating with different people with disabilities in two social contexts: A high-stakes context as a rehabilitation administrator hiring a counsellor and a low-stakes context as a mentor/companion.

Results. The results showed that age and disability type were most involved in the decision-making process in the low-stakes group, and performance-related variables were most important in the high-stakes context. Attitude was significantly affected by client characteristics unrelated to disability including age and race or ethnicity, and factors influencing attitude formation differed across the two social contexts.

Conclusion. Conjoint analysis can contribute to our understanding of the formation of attitudes or preferences in multiple social contexts. Using these results, it may be possible to develop effective attitude change strategies.     

Pharmacokinetic and Pharmacodynamic Responses of Insulin Degludec in African American,White, and Hispanic/Latino Patients With Type 2 Diabetes Mellitus

Background

Pharmacokinetic and pharmacodynamic profiles of exogenous insulin may be affected by intrinsic factors, such as age, ethnicity/race, and hepatic and renal function. Insulin degludec (IDeg) is a basal insulin with an ultralong duration of action and a flat and stable glucose-lowering effect profile.

Objective

The purpose of this study was to investigate whether the pharmacokinetic and pharmacodynamic responses to IDeg at steady state vary according to patient race/ethnicity.

Methods

This randomized, single-center, double-blind, 2-period crossover trial investigated responses to IDeg in 59 patients with type 2 diabetes mellitus from 3 groups: African American, Hispanic/Latino, and white. Patients were allocated randomly to a sequence of 2 treatment periods, separated by a 7- to 21-day washout period, with once-daily IDeg or insulin detemir dosing for 6 days at a predefined fixed dose level (0.6 U/kg). Differences in pharmacokinetic and pharmacodynamic variables among groups were analyzed using an ANOVA with treatment period, an interaction between race/ethnicity, and treatment as fixed factors, subject as a random effect, and residual variance, depending on treatment.

Results

Total exposure to IDeg during one dosing interval at steady state (AUC_IDeg,τ,SS) was similar among the racial/ethnic groups (ratio [95% CI]: African American vs white, 1.10 [0.91–1.31]; African American vs Hispanic/Latino, 1.13 [0.95–1.34]; and Hispanic/Latino vs white, 0.97 [0.82–1.16]). The total glucose-lowering effect of IDeg (AUC_GIR,τ,SS) was also similar among the groups, with no statistically significant difference in pairwise comparisons (1940, 1735, and 2286 mg/kg in African American, white, and Hispanic/Latino patients, respectively). Steady state was reached in all groups after 2 to 3 days of dosing. In all groups, both exposure and glucose-lowering effect for IDeg were evenly distributed between the first and second 12 hours of the 24-hour dosing interval at steady state (mean AUC_{IDeg,0–12h,SS}/AUC_IDeg,τ,SS = 53%–54%; AUC_{GIR,0-–12h,SS}/AUC_GIR,τ,SS = 47%–52%).

Conclusion

The similar pharmacokinetic and pharmacodynamic responses to IDeg in 3 racial/ethnic groups of patients with type 2 diabetes mellitus suggest that the flat, stable, and ultralong pharmacokinetic and pharmacodynamic profiles of IDeg are preserved irrespective of race/ethnicity. Although insulin doses must be adjusted on an individual basis, similar pharmacokinetic and pharmacodynamic responses to IDeg are observed in patients with differing race/ethnicity.     

Moderate-intensity physical activity and fasting insulin levels in women: the Cross-Cultural Activity Participation Study

OBJECTIVE: The purpose of this study was to determine the association between moderate-intensity physical activity (PA) and fasting insulin levels among African-American (n = 47), Native American (n = 46), and Caucasian women (n = 49), aged 40-83 years, enrolled in the Cross-Cultural Activity Participation Study. Associations by race/ethnicity, levels of central obesity, and cardiorespiratory fitness were also examined. RESEARCH DESIGN AND METHODS: Physical activity scores were obtained from detailed PA records that included all PA performed during two consecutive 4-day periods scheduled 1 month apart. Using MET intensity (the associated metabolic rate for a specific activity divided by a standard resting metabolic rate), PA was expressed as MET-min (the product of the minutes for each activity times the MET intensity level) per day of energy expended in moderate (3-6 METs) and moderate/vigorous (> or = 3 METs) PA. Fasting insulin levels were determined by radioimmunoassay. Data were analyzed by multiple linear regression analysis. RESULTS: After adjusting for race/ethnicity, age, educational attainment, and site, an increase of 30 min of moderate-intensity PA was associated with a 6.6% lower fasting insulin level (P < 0.05). The association was similar among races/ethnicities, centrally lean and centrally obese women, and women with low and high cardiorespiratory fitness levels. CONCLUSIONS: These findings lend support to the 1995 Centers for Disease Control and Prevention and American College of Sports Medicine recommendations for an accumulation of 30 min/day in moderate-intensity PA. They also contribute to the growing literature suggesting that moderate amounts of PA have a significant role in reducing the burden of hyperinsulinemia and diabetes among ethnic populations at highest risk for these conditions.     

Promoting foot self-care in type 2 diabetes mellitus patients receiving hemodialysis based on the information-motivation-behavioral skills model

This study develops and verifies the use of the foot self-care behavioral model in patients with type 2 diabetes mellitus (T2DM) receiving hemodialysis (HD) based on the information-motivation-behavioral skills model. Data were collected between June and August 2021 from 156 outpatients with type 2 diabetes who were receiving regular HD. A structured questionnaire and electronic medical records were used to collect demographic and disease-related data along with Foot Care Knowledge Questionnaires, third version of Diabetes Attitude Scale, Multidimensional Scale of Perceived Social Support, Foot Care Confidence Scale, and Foot Self-care Behavior Scale. Age, diabetic foot care knowledge, social support, and foot care self-efficacy had a direct effect on foot self-care behavior. Foot care self-efficacy had a mediating effect on foot care knowledge, diabetes-related attitudes, social support, and foot self-care behavior. The information-motivation-behavioral skills model was suitable as a foot self-care behavioral model for patients with T2DM receiving HD. Additionally, these findings suggest that it is crucial to improve foot self-care behavior through increased foot care knowledge, diabetes-related attitudes, and social support, which could contribute to enhancing foot care self-efficacy.     

The short-term impact of a continuing medical education program on providers' attitudes toward treating diabetes

OBJECTIVE: The objective of this study was to evaluate the short-term impact of a 7-h type 2 diabetes continuing medical education (CME) program. Outcomes included a measure of health care providers' diabetes knowledge and the Diabetes Attitude Scale (DAS), a validated measure of attitudes toward diabetes. RESEARCH DESIGN AND METHODS: A CME program on type 2 diabetes was presented by an expert panel in Chicago during November 1998. A before-after trial with pre- and postintervention measurements of diabetes knowledge and attitudes toward diabetes was administered as part of the program. A convenience sample of the 129 health care providers in attendance resulted in 91 (71%) completed pre- and postintervention surveys. RESULTS: Within-subjects analysis revealed increases in knowledge and more favorable attitudes toward diabetes after the program. Between-subjects analysis revealed that attitude changes differed for physicians as compared with allied health care providers. CONCLUSIONS: A CME program was associated with an increase in knowledge of diabetes and more favorable attitudes toward diabetes as measured by the DAS. The DAS changes were subtly different for the physician group as compared with the allied health care provider group. These results suggest that the DAS can be a useful instrument for measuring the short-term impact of educational interventions.     

Attitudes toward health care providers, collecting information about patients' race, ethnicity, and language

BACKGROUND: Experts recommend that health care providers (HCPs) collect patients' race/ethnicity and language, but we know little about public attitudes towards this. OBJECTIVES: To determine attitudes towards HCPs collecting race/ethnicity and language data. PARTICIPANTS: A telephone survey was held with 563 Californians, including 105 whites, 97 blacks, 199 Hispanics (162 Spanish-speaking), 129 Asians (73 Chinese-speaking), and 33 multiracial individuals. MEASURES: Attitudes towards HCPs asking patients their race/ethnicity and preferred language, concerns about providing their own information, reactions to statements explaining the rationale for data collection, and attitudes towards possible policies. RESULTS: Most (87.8%) somewhat or strongly agreed that HCPs should collect race/ethnicity information and use this to monitor disparities, and 73.6% supported state legislation requiring this. Support for collection of patients' preferred language was even higher. However, 17.2% were uncomfortable (score 1-4 on 10-point scale) reporting their own race/ethnicity, and 46.3% of participants were somewhat or very worried that providing information could be used to discriminate against them. In addition, 35.9% of Hispanics were uncomfortable reporting their English proficiency. All statements explaining the rationale for data collection modestly increased participants' comfort level; the statement that this would be used for staff training increased comfort the most. CONCLUSIONS: Although most surveyed believe that HCPs should collect information about race/ethnicity and language, many feel uncomfortable giving this information and worry it could be misused. Statements explaining the rationale for collecting data may assuage concerns, but community engagement and legislation to prevent misuse may be needed to gain more widespread trust and comfort.     

Changes in nursing students' stereotypic attitudes toward old people.

The twofold purpose of this study was to determine if: 1) student stereotyped attitudes toward old people would diminish during an eight-week introduction to a professional nursing course which featured laboratory and classroom components on health-illness concepts in the care of geriatric patients, and 2) changes in student attitude toward the aged were related to instructor attitude toward old people. Eighty nursing students were randomly assigned to ten faculty members for experimental treatment which consisted of nursing home laboratory experiences and within-group interaction and instruction. Students were pre- and posttested using the Attitude toward Old People Questionnaire. The same instrument was used to assess instructors' attitudes at the beginning of the course. Results revealed that students' stereotypic attitudes were decreased during the course and that the amount of change in student attitude was functionally related to faculty attitude toward the aged.     

Continuous subcutaneous insulin infusion versus multiple daily injections: the impact of baseline A1c

OBJECTIVE: Rapid-acting insulin analogs (insulin lispro and insulin aspart) have emerged as the meal insulin of choice in both multiple daily insulin injection (MDII) therapy and continuous subcutaneous insulin infusion (CSII) for type 1 diabetes. Thus, a comparison of efficacy between CSII and MDII should be undertaken only in studies that used rapid-acting analogs for both intensive regimens. RESEARCH DESIGN AND METHODS: We performed a pooled analysis of the randomized controlled trials that compared CSII and optimized MDII therapy using rapid-acting analogs in adults with type 1 diabetes. RESULTS: The three studies that met inclusion criteria provided data on 139 patients, representing 596 patient-months for CSII and 529 patient-months for MDII. Mean age was 38.5 years, with duration of diabetes of 18.0 years. The studies differed significantly in mean baseline A1c (7.95, 8.20, and 9.27%). The pooled estimate of treatment effect comparing the percentage reduction in A1c by CSII with that by MDII (CSII - MDII) was 0.35% (95% CI -0.10 to 0.80, P = 0.08) using a random effect to account for heterogeneity between studies. Importantly, the interaction between baseline A1c and treatment modality emerged as an independent predictor of treatment effect (CSII - MDII) (P = 0.002). The relative benefit of CSII over MDII was found to increase with higher baseline A1c. A model derived from these data predicts that in a patient with a baseline A1c of 10%, CSII would reduce the A1c by an additional 0.65% compared with MDII. Conversely, there would be no A1c benefit of CSII compared with MDII if baseline A1c were 6.5%. There was no significant difference between CSII and MDII in the rate of hypoglycemic events. CONCLUSIONS: When using rapid-acting insulin analogs in CSII and MDII regimens in adult patients with type 1 diabetes, insulin pump therapy is associated with better glycemic control, particularly in those individuals with higher baseline A1c. Thus, CSII emerges as an important modality for implementing intensive therapy and may be uniquely advantageous in patients with poor glycemic control.     

老年2型糖尿病患者负性情绪和态度与糖代谢调控的关系

目的探讨老年2型糖尿病患者抑郁情绪和负性态度与糖代谢指标之间的相互关系。方法采用老年抑郁量表和自行编制的老年生活观量表,评价370例老年2型糖尿病患者的抑郁情绪和负性态度;同时测量患者的空腹血糖和糖化血红蛋白。结果多元回归分析结果显示,女性、并发症数目增多、糖代谢紊乱、长期治疗和消极生活态度对抑郁情绪有促进作用,糖代谢控制不良可形成抑郁情绪和消极生活态度;负性情绪、态度和生活事件（丧偶、离异）又可加重糖代谢紊乱。结论抑郁情绪和负性态度与糖代谢指标之间互为因果．力口重关系。     

The effects of a well older adult clinical experience on students' knowledge and attitudes

Is a planned learning experience with well older adults a positive influence on a nursing student's attitude, level of gerontological knowledge, and willingness to work with older adults after graduation? Students in a baccalaureate program were divided into treatment or control groups based on their attitudes on the Kogan's Attitude Toward Old People Scale. Knowledge was measured by the Palmore's Facts on Aging Quiz (Palmore, 1977). Half of the students were given experiences with well elderly while the other group had no experience with this population. Differences in pre- and post-test scores were compared by analysis of variance. All students, regardless of planned experience with older adults, increased their knowledge. Students who initially had negative attitudes significantly improved their attitudes regardless of the type of clinical experience. The investigation failed to support the idea that experiences with well elderly would make a difference on attitude and knowledge base. This project suggests knowledge and attitude changes are not dependent upon a particular type of clinical learning activity.     

Evaluating the effect of a human values seminar series on ethical attitudes toward resuscitation among pediatric residents

A human values seminar series was designed to provide training in medical ethics for residents in pediatrics. Attitudes of residents toward resuscitation of children were surveyed before and after the seminar series. Nonpediatric residents rotating through pediatrics served as control subjects. Although both groups of residents demonstrated a significant change in attitude on six scales at the end of 1 year of training, pediatricians and nonpediatricians differed from each other with respect to only one of these scales. After the seminar series, pediatric residents expressed decreased willingness to resuscitate certain critically ill infants in the emergency room, whereas nonpediatricians expressed more willingness (P less than 0.009). Attitude change in decision making among pediatricians was significantly correlated with the consideration given to societal needs, sanctity of life, and anticipated poor morbidity (P less than 0.05). Among nonpediatricians, attitude change was significantly correlated with poor prognosis for survival (P less than 0.05), morbidity (P less than 0.05), or anticipated poor intellectual outcome (P less than 0.01). Attitude differences between the two groups of residents were unrelated to differences in preexisting attitudes or demographic factors. These findings show that attitudes about ethical decisions are influenced by both "maturation," or progression through a training program, and formal instruction. The finding that clinical attitudes change rapidly as residents progress through training confirms our previous findings and suggests that residency training programs should provide support and formal instruction in ethics during this time of change. The small change caused by this current method of instruction indicates that preliminary studies are needed to delineate the goals and the structure of future ethics courses.     

Racial and ethnic differences in health care access and health outcomes for adults with type 2 diabetes

OBJECTIVE: To evaluate health care access and utilization and health status and outcomes for type 2 diabetic patients according to race and ethnicity and to determine whether health status is influenced by health care access and utilization. RESEARCH DESIGN AND METHODS: National samples of Caucasians, African-Americans, and Mexican-Americans were studied in the third National Health and Nutrition Examination Survey. Information on medical history and treatment of diabetes, health care access and utilization, and health status and outcomes was obtained by structured questionnaires and by clinical and laboratory assessments. RESULTS: Almost all patients in each race and ethnic group had one primary source of ambulatory medical care (92-97%), saw one physician at this source (83-92%), and had at least semiannual physician visits (83-90%). Almost all patients > or = 65 years of age had health insurance (99-100%), and for those patients < 65 years of age, Caucasians (91%) and African-Americans (89%) had higher rates of coverage than Mexican-Americans (66%). Rates of treatment with insulin or oral agents (71-78%), eye examination in the previous year (61-70%), blood pressure check in the previous 6 months (83-89%), and the proportion of hypertension that was diagnosed (84-91%) were similar for each race and ethnic group. Lower proportions of African-Americans and Mexican-Americans self-monitored their blood glucose (insulin-treated, 27 vs. 44% of Caucasians), had their cholesterol checked (62-68 vs. 81%), and had their dyslipidemia diagnosed (45 vs. 58%). African-American and Mexican-American patients had a somewhat higher proportion than Caucasian patients, with HbA1c > or = 7% (58-66 vs. 55%), blood pressure > or = 140/90 mmHg among those with diagnosed hypertension (60-65 vs. 55%), and clinical proteinuria (11-14 vs. 5%). In contrast, they had better levels of total cholesterol (> or = 240 mg/dl) (28 -30 vs. 34%) and HDL cholesterol (> or = 45 mg/dl) (46 -59 vs. 38%), and African-American and Mexican-American men were less overweight than Caucasian men (BMI > or = 30) (34-37 vs. 44%), although the opposite was true for women. LDL cholesterol levels and the proportion of patients who smoked cigarettes or were hospitalized in the past year were similar among all three groups. In logistic regression analysis, there was little evidence that levels of blood glucose, blood pressure, lipids, or albuminuria were associated with access to or utilization of health care or with socioeconomic status. CONCLUSIONS: There are some differences by race and ethnicity in health care access and utilization and in health status and outcomes for adults with type 2 diabetes. However, the magnitude of these differences pale in comparison with the suboptimal health status of all three race and ethnic groups relative to established treatment goals. Health status does not appear to be influenced by access to health care.     

Cross-cultural differences in psychiatric nurses' attitudes to inpatient aggression

Little is currently known about the attitudes of psychiatric nurses toward patient aggression, particularly from an international perspective. Attitudes toward patient aggression of psychiatric nurses from five European countries were investigated using a recently developed and tested attitude scale. Data were collected from a convenience sample of 1,769 student nurses and psychiatric nurses. Regression analysis was performed to identify personal and occupational characteristics of the respondents able to predict their attitude toward aggression. Analysis of variance was used to identify significant differences in attitudes between and among countries. Attitude was predicted by sex, contractual status (full vs. part time), and the type of ward on which subjects worked. With one exception (communicative attitude), attitudes differed across countries. More research on attitude formation is needed to determine which factors account for these differences.     

Pharmacists' attitudes toward diabetes and their involvement in diabetes education

OBJECTIVE: To determine the relationship between pharmacists' attitudes toward diabetes and their involvement in diabetes patient education in the community setting. METHODS: Registered pharmacists in Arizona were mailed surveys regarding their attitudes toward diabetes and their involvement in diabetes patient education. Attitudes were measured using the Diabetes Attitude Scale (DAS); the types of educational skills evaluated were based on those recommended by the American Diabetes Association's Standards of Medical Care. RESULTS: Pharmacists' attitudes were significantly positive toward the need for special training for diabetes care, the importance of tight glycemic control, the team approach to care, and the preference for diabetes education in an outpatient setting (p < 0.001). The majority of the time, pharmacists provided basic patient education (52%) rather than intermediate or advanced patient education (26% and 27%, respectively). There was a negative correlation between the attitude that diabetes is a difficult disease to treat and pharmacists' involvement in diabetes patient education (p < 0.05). This indicates that, although pharmacists believe that diabetes is a treatable disease, they infrequently provide diabetes patient education. CONCLUSIONS: Overall, pharmacists had positive attitudes toward diabetes. These attitudes did not correlate with the degree of their involvement in diabetes patent education. More diabetes patient education through community pharmacists is needed.