Background: The impact of caregivers’ health literacy (HL) and patient care behaviors on glycemic control in type 2 diabetes mellitus (T2DM) is not well known. Purpose: This study examined the HL and behaviors of both patients and caregivers in relation to glycemic control among T2DM patients. Methods: A cross-sectional study in Fang district, Chiang Mai Province, involved 305 T2DM patients aged over 45 and their caregivers, selected through simple random sampling. Data were collected via questionnaires, and blood samples were analyzed for fasting blood sugar (FBS) and glycated hemoglobin (HbA1c). Results: The findings revealed that most patients and caregivers had diabetes HL scores at the functional literacy level (53.77% and 37.05%, respectively). The majority of patients scored moderately in self-care behaviors (SCB) at 76.10%, while caregivers’ patient care behaviors also scored moderately at 68.20%. Mean FBS and HbA1c levels were 129.81 mg/dl and 7.3%, respectively. Linear regression analysis showed that, after adjusting for sex, age, education level, financial status, duration of diabetes, smoking, and alcohol consumption, FBS was significantly associated with patients’ HL (Beta = − 0.161), SCB (Beta = − 0.197), caregivers’ HL (Beta = − 0.217), and caregivers’ patient care behaviors (Beta = − 0.181). Similarly, HbA1c was significantly correlated with patients’ HL (Beta = − 0.265), SCB (Beta = − 0.233), caregivers’ HL (Beta = − 0.255), and caregivers’ patient care behaviors (Beta = − 0.200). Conclusion: These results highlight the importance of enhancing health literacy (HL) and behaviors in both patients and caregivers to achieve optimal glycemic control, underscoring the need for caregivers to develop strong HL skills and improve their competencies in effectively managing T2DM.

Background/Objectives: Sleep disorders are common among older adults and have been increasingly linked to metabolic abnormalities and non-communicable diseases (NCDs). However, evidence on the relationship between sleep quality and health-related clinical outcomes and biomarkers in rural Northern Thailand remains limited. This study aimed to assess the association between sleep quality and health-related clinical outcomes and biomarkers among older adults in rural Northern Thailand. Methods: A cross-sectional study was conducted among 424 older adults in Phayao Province, rural Northern Thailand. Quota sampling was employed to ensure equal representation of participants with and without NCDs (n = 212 per group). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Physical health status was evaluated through measurements of blood pressure (BP), including systolic blood pressure (SBP) and diastolic blood pressure (DBP), and fasting blood sugar (FBS). Results: The participants’ mean PSQI score was 8.03 ± 4.86, and 29.7% had poor sleep quality (PSQI > 5). Hypertension (35.4%) and diabetes mellitus (17.5%) were the most common underlying diseases. The mean fasting blood sugar level was 116.33 ± 30.84 mg/dL, with 21.0% of participants presenting abnormal levels (≥126 mg/dL). Multivariable binary logistic regression demonstrated that each one-point increase in the overall PSQI score was significantly associated with higher odds of having an underlying disease (adjusted odds ratio [AOR] = 2.37; 95% confidence interval [CI]: 2.00–2.81), hypertension (AOR = 1.51; 95% CI: 1.37–1.66), diabetes mellitus (AOR = 1.42; 95% CI: 1.28–1.58), other non-communicable diseases (AOR = 1.94; 95% CI: 1.64–2.29), abnormal fasting blood sugar (AOR = 1.47; 95% CI: 1.33–1.63), elevated systolic blood pressure (AOR = 1.39; 95% CI: 1.28–1.51), and elevated diastolic blood pressure (AOR = 1.30; 95% CI: 1.19–1.43). Subjective sleep quality, sleep duration, and habitual sleep efficiency were also significantly associated with multiple health-related clinical outcomes and biomarkers. Although sparse data and quasi-complete separation may have influenced the precision of some regression estimates, the overall pattern of associations remained consistent and should be interpreted with appropriate caution. Conclusions: Higher overall PSQI scores were significantly associated with adverse health-related clinical outcomes and biomarkers among older adults in rural Northern Thailand. These findings highlight the clinical importance of routinely assessing sleep quality in older adults, particularly those with chronic conditions or increased cardiometabolic risk. Because of the cross-sectional design and the statistical uncertainty associated with sparse data in some regression models, the findings should be interpreted as evidence of associations rather than causal relationships. The observed associations are consistent with the likely bidirectional relationship between sleep disturbances and chronic diseases. Integrating sleep quality screening into routine health assessments, alongside comprehensive chronic disease management, may facilitate the early identification of older adults at increased cardiometabolic risk and support evidence-based health promotion strategies.

Background/Objectives: Knowledge of emergency medical services (EMS) and awareness of emergency contact numbers are important for emergency preparedness among older patients with non-communicable diseases (NCDs) and their caregivers. This study aimed to assess self-reported EMS knowledge, awareness of Thailand’s emergency number 1669, previous EMS utilization, prior EMS training, and associated factors among both groups in rural Northern Thailand. Methods: A cross-sectional study included 828 participants comprising independently recruited older patients with chronic diseases (n = 414) and caregivers (n = 414). Data were collected using structured questionnaires and clinical assessments. Associations with self-reported EMS knowledge and awareness of the emergency number 1669 were examined using multivariable binary logistic regression separately for each group. Results: Among older patients, 60.1% reported familiarity with EMS, 57.7% were aware of the emergency number 1669, 11.8% had previously used EMS, and 8.0% had received EMS training. The corresponding proportions among caregivers were 48.3%, 39.6%, 9.4%, and 17.6%, respectively. Among patients, educational attainment, receipt of NCD-related information, and HbA1c levels were associated with self-reported EMS knowledge, while educational attainment and NCD-related information were associated with awareness of 1669. Among caregivers, age, occupation, and underlying medical conditions were associated with self-reported EMS knowledge, while age, occupation, underlying medical conditions, and poster exposure were associated with awareness of 1669. Conclusions: Self-reported EMS knowledge and awareness of the emergency number 1669 varied between older patients with chronic diseases and caregivers. These findings highlight the importance of targeted community-based educational initiatives to improve EMS-related knowledge and emergency number awareness in rural communities.

Zanthoxylum rhetsa (Roxb.) DC. (Ma-Khwaen) is an economically important medicinal plant traditionally used for pain and inflammatory disorders. This study explored its phytochemical composition, biological activities, and potential for nano-spray product development. Methods: Ethanolic fruit extracts collected from five provinces in Northern Thailand were evaluated for extraction yield, total phenolic content (TPC), total flavonoid content (TFC), antioxidant activity, and anti-inflammatory activity. Extracts from Nan Province were further selected for DPPH radical scavenging, GC–MS characterization, nitric oxide (NO) inhibition assay in LPS stimulated RAW 264.7 macrophages, nano-spray formulation development, and stability assessment. Results: Considerable phytochemical variation was observed among geographical origins, with TPC and TFC ranging from 19.47 to 103.09 mg GAE/g extract and 28.57 to 400.72 mg QE/g extract, respectively. The Nan whole-fruit extract exhibited the highest extraction yield (20.81%), whereas the pericarp extract showed the strongest antioxidant activity (IC₅₀ = 111.78 μg/mL). GC–MS analysis revealed anti-inflammatory phytochemicals, predominantly α-terpineol, geranyl acetate, n-hexadecanoic acid, oleic acid, and linalool. The selected extract demonstrated potent anti-inflammatory activity (IC₅₀ = 6.95 ± 0.44 μg/mL), exceeding that of prednisolone, and was successfully incorporated into a physically stable nano-spray formulation with 60-day storage stability. Conclusions: These findings provide scientific validation for the traditional use of Ma-Khwaen and support its development as a stable nano-spray formulation for muscle pain relief and inflammation alleviation.