KNOWLEDGE OF THE DISEASE AMONG TYPE 2 DIABETES PATIENTS IN A TERTIARY CARE HOSPITAL IN MUMBAI, INDIA

Authors

  • Vimal Pahuja Consultant Metabolic Physician and Program Supervisor, Obesity and Diabetes Center of Excellence, Dr. L.H. Hiranandani Hospital, Mumbai, Maharashtra, India,
  • Genevie Fernandes Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland,
  • Nilesh Chatterjee Behavioral Science Consultant, Kalyani Media Group, Chembur, Mumbai, Maharashtra, India.

DOI:

https://doi.org/10.22159/ajpcr.2018.v11i12.28126

Keywords:

Diabetes mellitus, Diabetes knowledge, Diabetes education, Urban, India

Abstract

Objective: An estimated 72 million in India live with diabetes; the country faces an impending health-care crisis with prevalence and complications of diabetes forecasted to multiply in the next decade. Improving patients' knowledge about diabetes to manage the disease better is an urgent and important public health goal.

Methods: Knowledge about diabetes, its complications, and management was surveyed using a structured questionnaire among 167 Type 2 diabetes patients attending a tertiary care hospital in Mumbai, India.

Results: None of the participants had ever received any formal diabetes self-management education previously. Respondents' mean and median correct knowledge scores were 20 of 32 test items. Although majority answered statements about blood sugar levels and complications, there was lack of knowledge about the causes and management of diabetes. Around 82% stated that medication was more important than dietary intake and physical activity in managing diabetes. A multiple regression model showed that postgraduate or graduate level education, not being married, having two or less children, and visiting a doctor 1–3 times a year (as compared to more than three visits) was independently associated with higher diabetes knowledge scores (*p<0.05) in this sample.

Conclusion: An information disparity exists between patients who have higher levels of education versus those with lesser education. Future research will have to examine the mechanisms by which higher education contributes to better knowledge, and facilitate the design of diabetes education programs that bridge information gaps and improve required competencies in patients to better manage their condition.

Downloads

Download data is not yet available.

Author Biography

Vimal Pahuja, Consultant Metabolic Physician and Program Supervisor, Obesity and Diabetes Center of Excellence, Dr. L.H. Hiranandani Hospital, Mumbai, Maharashtra, India,

Behavioural Science Consultant, Kalyani Media Group

References

International Diabetes Federation (IDF). IDF Atlas. 8th ed. Brussels: IDF; 2017.

Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004;27:1047-53.

Indian Council of Medical Research (ICMR). Public Health Foundation of India (PHFI), and Institute for Health Metrics and Evaluation (IHME). India: Health of the Nation’s States – The India State Level Disease Burden Initiative. New Delhi: ICMR, PHFI, IHME; 2017.

Anjana RM, Deepa M, Pradeepa R, Mahanta J, Narain K, Das HK, et al. Prevalence of diabetes and prediabetes in 15 states of India: Results from the ICMR–INDIAB population-based cross-sectional study. Lancet Diabetes Endocrinol 2017;5:585-96.

World Health Organization. Global Report on Diabetes. Geneva: World Health Organization; 2016.

Bommer C, Sagalova V, Heeseman E, Manne-Goehler J, Atun R, Bärnighausen T, et al. Global economic burden of diabetes in adults: Projections from 2015 to 2030. Diabetes Care 2018;41:963-70.

Seuring T, Archangelidi O, Suhrcke M. The economic costs of Type 2 diabetes: A global systematic review. Pharmacoeconomics 2015;33:811-31.

Dey S. Yearly Spend on diabetes is Rs 1.5 lakh cr, rising by 30% pa. The Times of India. 2016. Available from: http://www.epaperbeta.timesofindia.com/Article.aspx?eid=31808&articlexml=Yearly-spend-on-diabetes-is-Rs-15-lakh-09022016018024. [Last cited on 2018 Jun 05].

Ramachandran A, Ramachandran S, Snehalata C, Augustine C, Murugesan N, Viswanathan V, et al. Increasing expenditure on health care incurred by diabetic subjects in a developing country: A study from India. Diabetes Care 2007;30:252-6.

Kapur A. Economic analysis of diabetes care. Indian J Med Res 2007;125:473-82.

Wilkinson A, Whitehead L, Ritchie L. Factors influencing the ability to self-manage diabetes for adults living with Type 1 or 2 diabetes. Int J Nurs Stud 2014;51:111-22.

Nam S, Chesla C, Stotts NA, Kroon L, Janson SL. Barriers to diabetes management: Patient and provider factors. Diabetes Res Clin Pract 2011;93:1-9.

Pace AE, Ochoa-Vigo K, Caliri MH, Fernandes AP. Knowledge on diabetes mellitus in the self-care process. Rev Lat Am Enfermagem 2006;14:728-34.

Berikai P, Meyer P, Kazlauskaite R, Savoy B, Kozik K, Fogelfeld L. Gain in Patients’ knowledge of diabetes management targets is associated with better glycemic control. Diabetes Care 2007;30:1587-9.

Funnell M, Tang T, Anderson R. From DSME to DSMS: Developing empowerment-based diabetes self-management support. Diabetes Spectr 2007;20:221-6.

Kent D, Melkus GD, Stuart PM, McKoy JM, Urbanski P, Boren SA, et al. Reducing the risks of diabetes complications through diabetes self-management education and support. Popul Health Manag 2013;16:74- 81.

Strine TW, Okoro CA, Chapman DP, Beckles GL, Balluz L, Mokdad AH. The impact of formal diabetes education on the preventive health practices and behaviors of persons with Type 2 diabetes. Prev Med 2005;41:79-84.

Dussa KN, Sahay RK, Sundarajan P, Vishnuvardhanarao M. Adaptation of diabetes knowledge questionnaire for South Asian countries context. Int J Pharm Pharm Sci 2017;9:252-6.

Mohan D, Raj D, Shanthirani CS, Datta M, Unwin NC, Kapur A, et al. Awareness and knowledge of diabetes in Chennai--the Chennai Urban rural epidemiology study [CURES-9]. J Assoc Physicians India 2005;53:283-7.

Deepa M, Bhansali A, Anjana RM, Pradeepa R, Joshi SR, Joshi PP, et al. Knowledge and awareness of diabetes in urban and rural India: The Indian council of medical research India diabetes study (phase I): Indian council of medical research India diabetes 4. Indian J Endocrinol Metab 2014;18:379-85.

Mehta N, Trivedi M, Maldonado LE, Saxena D, Humphries DL. Diabetes knowledge and self-efficacy among rural women in Gujarat, India. Rural Remote Health 2016;16:3629.

Kazi N, Bote M, Raikar K. Knowledge, attitude and practices about diabetes mellitus and its complications in T2DM patients attending the UHC in Mumbai. Int J Community Med Public Health 2017;4:2793-7.

Dussa K, Parimalakrishnan S, Sahay R. Assessment of diabetes knowledge using diabetes knowledge questionnaire among people with Type 2 diabetes mellitus. Asian J Pharm Clin Res 2015;8:254-6.

Press Trust India. With Total Wealth Worth $950 Billion, Mumbai is 12th Richest City Globally. The Times of India. 2018. Available from: http://www.indianexpress.com/article/india/with-total-wealth-worth-950-billion-mumbai-is-12th-richest-city-globally-5059348/. [Last cited on 2018 Jun 05].

Directorate of Census Operations, Maharashtra. Mumbai District Census Handbook. Mumbai: Government of India; 2011.

Municipal Corporation of Greater Mumbai (MCGM). Mumbai Human Development Report 2009. Mumbai: MCGM; 2010. Available from: http://www.indiaenvironmentportal.org.in/files/Mumbai%20HDR%20Complete.pdf. [Last cited on 2018 Jun 05].

Salve P. Mumbai has the Best Healthcare. It Isn’t Enough. India Spend; 2014. Available from: http://www.indiaspend.com/cover-story/mumbai-has-indias-best-healthcare-it-isnt-enough-69529. [Last cited on 2018 Jun 06].

Garcia A, Villagomez ET, Brown SA, Kouzekanani K, Hanis CL. The Starr county diabetes education study development of the Spanish-language diabetes knowledge questionnaire. Diabetes Care 2001;24:16 21.

Hashim MJ, Mustafa H, Ali H. Knowledge of diabetes among patients in the United Arab Emirates and trends since 2001: A study using the Michigan diabetes knowledge test. East Mediterr Health J 2017;22:742 8.

Dos Santos PF, dos Santos PR, Ferrari GS, Fonseca GA, Ferrari CK. Knowledge of diabetes mellitus: Does gender make a difference? Osong Public Health Res Perspect 2014;5:199-203.

Perera DP, De Silva RE, Perera WL. Knowledge of diabetes among Type 2 diabetes patients attending a primary health care clinic in Sri Lanka. East Mediterr Health J 2013;19:644-8.

Rankin D, Heller S, Lawton J. Understanding information and education gaps among people with Type 1 diabetes: A qualitative investigation. Patient Educ Couns 2011;83:87-91.

Khapre MP, Mude A, Goyal RC, Wagh V. Low awareness of diabetes affecting the clinical outcome of patient: A cross-sectional study conducted in rural tertiary care hospital. Int J Biol Med Res 2011;2:627 30.

Deepali BS, Subramanian M, Soumya G, Nagashree N. Knowledge of diabetes, its complications and treatment adherence among diabetic patients. Int J Community Med Public Health 2017;4:2428-34.

Hussain R, Giridhar R, Gopalakrishnan M, Gopalakrishnan M, Sadasivan S, James J, et al. Knowledge and awareness about diabetes mellitus and diabetic retinopathy in suburban population of a South Indian state and its practice among the patients with diabetes mellitus: A population-based study. Indian J Ophthalmol 2016;64:272-6.

Kurian B, Qurieshi MA, Ganesh R, Kamalamma L. A community-based study on knowledge of diabetes mellitus among adults in a rural population of Kerala. Int J Noncommun Diseases 2016;1:59-64.

Shrestha S, Thapa P, Saleh F, Thapa N, Stray BP, Khanom K. Knowledge of diabetes mellitus among pregnant women in three districts of Nepal. J Nepal Health Res Counc 2013;11:259-63.

Cantaro K, Jara J, Taobada M, Mayta-Tristan P. Association between information sources and level of knowledge about diabetes in patients with Type 2 diabetes. Endocrinol Nutr 2016;63:202-11.

Bukhsh A, Lee S, Pusparajah P, Khan AH, Khan TM. Psychometric properties of the Urdu version of diabetes knowledge questionnaire. Front Public Health 2017;5:139.

Formosa C, Muscat R. Improving diabetes knowledge and self-care practices. J Am Podiatr Med Assoc 2016;106:352-6.

Odili V, Isiboge P, Eregie A. Patients’ knowledge of diabetes mellitus in a Nigerian city. Trop J Pharm Res 2011;10:637-42.

Gunay T, Ulusel B, Velipasaoglu S, Unal B, Ucku R, Ozgener N. Factors affecting adult knowledge of diabetes in Narlidere health district, Turkey. Acta Diabetol 2000;43:142-7.

Mufunda E, Ernerssson A, Hjelm K. Limited knowledge of diabetes in patients attending an outpatient diabetes clinic at a referral hospital in Zimbabwe: A cross-sectional study. Pan Afr Med J 2018;29:144.

Zainudin SB, Ang DY, Soh AW. Knowledge of diabetes mellitus and safe practices during Ramadan fasting among Muslim patients with diabetes mellitus in Singapore. Singapore Med J 2017;58:246-52.

Niroomand M, Ghasemi SN, Karimi-Sari H, Kazempour-Ardebili S, Amiri P, Khosravi MH. Diabetes knowledge, attitude and practice (KAP) study among Iranian in-patients with Type-2 diabetes: A cross-sectional study. Diabetes Metab. Syndr 2016;10:S114-9.

Long P, Long K, Kedia A, Gren LH, Smith A, Biswas J. A cross-sectional study of diabetic knowledge in West Bengal, India: An analysis based on access to health care. Int J Diabetes Dev Ctries 2015;35:614-9.

Fenwick E, Xie J, Rees G, Finger RP, Lamoureux EL. Factors associated with knowledge of diabetes in patients with Type 2 diabetes using the diabetes knowledge test validated with Rasch analysis. PLoS One 2013;8:e80593.

Yun LS, Hassan Y, Aziz NA, Awaisu A, Ghazali R. A comparison of knowledge of diabetes mellitus between patients with diabetes and healthy adults: A survey from north Malaysia. Patient Educ Couns 2007;69:47-54.

Thomas SM, Gajjar SN, Reddy UK, Devi H. A prospective study: Knowledge assessment and patient care of diabetic foot ulcer patients in tertiary care hospital. Int J Pharm Pharm Sci 2017;9:104-10.

Murata G, Shah J, Adam K, Wendel CS, Bokhari SU, Solvas PA, et al. Factors affecting diabetes knowledge in Type 2 diabetic veterans. Diabetologia 2003;46:1170-8.

Larme AC, Pugh JA. Evidence-based guidelines meet the real world: The case of diabetes care. Diabetes Care 2001;24:1728-33.

Walker RJ, Smalls BL, Egede LE. Social determinants of health in adults with Type 2 diabetes-contribution of mutable and immutable factors. Diabetes Res Clin Pract 2015;110:193-201.

Van Den Arend IJ, Stolk RP, Rutten GE, Schrijvers GP. Education integrated into structured general practice care for Type 2 diabetic patients results in sustained improvement of disease knowledge and self-care. Diabet Med 2000;17:190-7.

Published

07-12-2018

How to Cite

Pahuja, V., G. Fernandes, and N. Chatterjee. “KNOWLEDGE OF THE DISEASE AMONG TYPE 2 DIABETES PATIENTS IN A TERTIARY CARE HOSPITAL IN MUMBAI, INDIA”. Asian Journal of Pharmaceutical and Clinical Research, vol. 11, no. 12, Dec. 2018, pp. 234-40, doi:10.22159/ajpcr.2018.v11i12.28126.

Issue

Section

Original Article(s)