Knowledge and self-care practice regarding diabetes among Bangladeshi type 2 diabetic subjects

Background

Diabetes mellitus (DM) being a chronic illness requires sound knowledge of self-care by patients so that they can contribute meaningfully in the management of their lives. Knowledge and practice on DM can assist in early detection of the disease and reduce the incidence of complications.
Aim

The study aimed to assess disease related knowledge and practice regarding diabetes mellitus among type 2 diabetic subjects (T2DM) attending health care centers and hospitals, run by the Diabetic Association of Bangladesh in the Capital and northern part of Bangladesh and also to determine the effects of ‘knowledge’ followed by ‘practice’ among the study subjects.

 
Method

This cross-sectional study was conducted among 11917 (age ≥18 years, 4418 male and 7499 female) T2DM subjects. A detailed interviewer-administered questionnaire was developed to collect socio-demographic data and to assess patient’s knowledge and practice regarding diabetes. Knowledge and practice were measured by predefined scores, categorized as poor (<mean-1SD), average (mean±1SD) and good (>mean+1SD). Statistical analysis used Independent samples t-test, ANOVA and Pearson’s correlation were performed to determine the association between different variables considering p-value <0.05.
Results

The mean (±SD) age (years) of the T2DM was found 50±12. Majority (54%) of them belonged to middle income group and about 48% lived in urban areas. Among the subjects 43% had positive family history of diabetes mellitus. The mean knowledge and practice differed significantly in respect of the respondents’ socio-demographic variables (age, gender, living area, education, and monthly family income), body mass index (BMI) and family history of diabetes. Particularly, middle age, male gender, urban residence, higher education level, high income, obesity and positive family history of diabetes were significantly associated with higher knowledge and practice score (p<0.05). Proportion of ‘poor’, ‘average’ and ‘good’ score for knowledge were found 34%, 51% and 15% and for practice 16%, 72% and 12% respectively. Knowledge was found significantly associated with practice (r= 0.299, p=0.001).
Discussion

The study reveals a difference between knowledge and practice related to T2DM. It was also observed that the knowledge score of the subjects gradually increased and highest at middle age, urban dwellers, higher educational background, high income, higher BMI and positive family history of DM. Strengths of this study included subjects from rural to urban under the parallel health care support and explored fairly a large representative sample size, majority of the subjects responds spontaneously. Additionally fact is that the study was conducted in the healthcare centers where DM related education may be more readily accessible to patients. It raises concerns that DM patients attending primary health care centers in the region with less access to diabetes education may have even poorer diabetes awareness and practices. A hospital-based lifestyle intervention program should be implemented in order to close the gaps between knowledge and practice to improve patients’ knowledge and practice regarding healthy lifestyle. This study highlighted the factors that we need to consider while developing health promotion activities. Further, health literacy, counseling and education program need to be developed in both clinical and community settings.
Conflict of Interest
I have no potential conflict of interest to disclose

Knowledge and self-care practice regarding diabetes among Bangladeshi type 2 diabetics subjects