الفهرس 
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Abstract
Diabetes, is one of the most common non-communicable diseases in the world, is responsible for a significant amount of ill-health and premature deaths [8]. The World Health Organization (WHO) predicted that the number of diabetic patients will raised to at least 300 million by 2025, In Egypt, Diabetes Mellitus is emerging as a clinical and public health problem. By the year of 2025, 13.3% of the Egyptian population above 20 years will develop diabetes with distinct geographical differences: 5.7% in urban areas, 4.1% in rural agricultural areas, and 1.5% in rural desert areas [10].
People with diabetes were prone to short-term and long-term complications, which will increase the social and the economic burden.
The prediction that developing countries would show a significant increase in diabetes due to population growth, ageing, unhealthy diets, obesity and sedentary lifestyles.
Diabetes education has been considered an important part of the clinical management of individuals with diabetes. A large body of literature suggesting that, at least for the short-term, patient education improves diabetes knowledge and its management, as well as physiological measures such as metabolic control, body weight and blood pressure. Of equal importance, patient education improves the quality of life for people with diabetes [12] .
This study is an interventional study aimed at evaluate the effectiveness of the PPT method and the Group discussion methods of health education in improving the knowledge of diabetic patients’ type 2 in El-salaam PHC unit in Ismailia city. This study carried out through 170 diabetic patients with type 2 diabetes. Participants were randomly allocated in the study groups ( the PPT group and the Group discussion groups) with 85 patients in each group.
All participants were interviewed using a structural questionnaire included the following items:
• Personal data.
• The medical history of diabetes.
• Assessment f patients’ knowledge through a questionnaire about : diabetes nature, diabetes management, and diabetes complications.
All participants were applied to this questionnaire to assess the baseline level of knowledge of the two groups then after the intervention to evaluate the effectiveness of each health education method on diabetic patients’ knowledge.
All the participants were subjected to their specific health education intervention ( the PPT method and the Group discussion method) which included all basic knowledge of diabetes and it’s symptoms and risk factors, different regimens of diabetes management and who were suitable for each regimen, and different types of diabetes acute and chronic complications. Same materials were applied to each study groups on three separate cessions.
Data management and statistical analysis revealed the following results:
• Regarding the personal characters of the study groups, there were no statistically significant differences between both groups regarding to age, gender, educational level, occupation and marital status. With the mean of age + SD were 54.35 + 10.234 and 56.29 + 11.438 for the PPT group and the Group discussion group respectively. We noticed that most of the participants were females (64 % in the PPT group and 68 % in the Group discussion group).
• Regarding the medical history of the two study groups. We noticed that 62 % of the PPT group and 55% of the Group discussion group were diagnosed as diabetic for period between 5-10 years. Also 36 % of the patients’ in the PPT group and 20 % in the Group discussion group were on tablets and nutrition control regimen of management of diabetes. Also 69 % and 73% in the PPT group and the Group discussion group respectively were regularly follow up their disease in the PHC unit. Also more than half of the patients in both groups have other chronic diseases than diabetes, 60 (71 %) participants in PPT group and 66 ( 78 %) participants in the Group discussion group. The highest percent is the hypertension( 30.6% in PPT group and 23.5% in group discussion group), while the lowest percent is the heart diseases ( 4.7 % in PPT group and 7.1% in group discussion group).
• At the baseline level of patients’ knowledge the total mean score + SD knowledge about diabetes disease among both groups of the study was nearly the same in both groups (4.64 + 2.627 for the PPT group and 4.68 + 2.601 for the group discussion group) and the difference between both groups were statistically non-significant . But after the health education programs, the mean score increased in both groups(9.75 + 2.203 for the PPT group and 11.88 + 2.456 for the group discussion group) The difference between both groups was statistically significant after the health education programs.
• Comparing the baseline knowledge mean score with that after the health education in the PPT group and Group discussion group showed a statistically significant difference between patients’ knowledge ( p value = 0.0001).
• Before the health education the mean score of knowledge about diabetes nature among both groups of the study was nearly the same ( 1.494 + 1.315 for the PPT group and 1.441 + 1.101 for the group discussion group). The difference between both groups was statistically insignificant, while after the health education of both groups, the mean were increased in both groups (3.329 + 1.2667 for the PPT group and 4.223 + 1.442 for the group discussion group) and the difference between both groups was statistically significant (p < 0.05).
• Regarding the mean of both group knowledge about the management of diabetes, the two means were nearly the same before the intervention programs (1.294 + 1.1004 and 1.447 + 1.1903 for the PPT group and the group discussion group respectively), and the difference between both groups were statistically non-significant. But after the health education programs, the mean increased in both groups (3.329 + 1.2667 and 4.223 + 1.442 for the PT group and group discussion group respectively). The difference between both groups was statistically significant after the health education programs.
• The mean score of knowledge about the diabetes complications was nearly the same before the health education (1.82 + 1.465 for the PPT group and 1.75 + 1.353 for the group discussion group) and the difference between both groups were statistically non-significant. But after the health education programs, the mean increased in both groups (3.25 + 1.224 for the PPT group and 3.71 + 1.526 for the group discussion group) The difference between both groups was statistically significant after the health education programs.
Based on the results of this study, the following recommendations were proposed:
• Many diabetic patients in type 2 lack the basic knowledge about their disease . improving these issues through the health education through their regular routine visits will help improving diabetes control.
• Ideal programs aim to improve the diabetic patients’ knowledge about diabetes , should also directed to the patients’ knowledge and practice towards their disease.