Knowledge Attitude and Practice regarding Diabetes Mellitus among patients with Type2 Diabetes in a tertiary care teaching hospital in Kerala, India

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Dr. Manju L, Dr. Ajithkumar P V*, Dr. Divija, Dr. Susanna John, “Knowledge Attitude and Practice regarding Diabetes Mellitus among patients with Type2 Diabetes in a tertiary care teaching hospital in Kerala, India”, ijmhs, vol. 9, no. 11, pp. 665–674, Nov. 2019.
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Abstract

Diabetes mellitus (DM) is one of the major health issues in India. Prevalence
of type 2 or noninsulin dependent diabetes mellitus is high in India. Kerala, a
southern state in India has varying prevalence rate of diabetes in its different
geographical regions. Adequate knowledge, practice and attitude are the three
vital parameters of a diabetic patient. Studies are there in literature to evaluate
the knowledge, attitude and practice of diabetes patients in different settings
but very few studies have investigated the situation in Kerala. Hence the aim of
this study was to assess the current knowledge, attitude and practice to start an
educational programme.
Methods
A descriptive study was conducted in the out patient department of a tertiary
care hospital in South Kerala during the period April 2019 to September 2019.
A sample of 220 patients were studied using a pretested questionnaire.
Convenience sampling technique was adopted. Study participants were type-2
diabetic patients above 18 years and diagnosed for at least six months. Student t
test/one way ANOVA was used to identify the socio-demographic variables
associated with knowledge, attitude and practice.
Result
The mean(SD) knowledge, attitude and practice scores are 58.16(18.96),
77.83(8.77) and 59.75(14.58) respectively. Knowledge and attitude are found
to be associated with educational and occupational status (p<0.05). Family
history is associated with attitude (p=0.001). There is statistically significant
difference between the practice scores of males and females (p=0.023). Mode
of treatment is associated with knowledge (p=0.02)
Keywords: Type 2 diabetic patients, knowledge, attitude, practice.

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References

1. Raman Kutty V, Joseph A, R Soman C. High prevalence of type 2 diabetes in an urban settlement in Kerala, India. Ethn Health. 1999;4(4):231–239. 2. Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. 2007;125(3):217–30. 3. Vijayakumar G, Arun R, Kutty VR. High prevalence of type 2 diabetes mellitus and other metabolic disorders in rural Central Kerala. J Assoc Physicians India. 2009 Aug;57:563–7. 4. Thankappan KR, Shah B, Mathur P, Sarma PS, Srinivas G, Mini GK, et al. Risk factor profile for chronic non-communicable diseases: results of a community-based study in Kerala, India. Indian J Med Res. 2010;131(1):53. 5. Shayeghian Z, Aguilar-Vafaie M, Besharat MA, Parvin M, Roohi Gilani K. The association between self-care and control of blood sugar and health-related quality of life in type II diabetes patients. Iran J Endocrinol Metab. 2014;15(6):545–551. 6. Knight K, Badamgarav E, Henning JM, Hasselblad V, Gano Jr AD, Ofman JJ, et al. A systematic review of diabetes disease management programs. Am J Manag Care. 2005;11(4):242–50. 7. 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]. Japi. 2005;53:283–287. 8. Nelson et al. Diabetes self-care: A community based cross sectional study from Kollam district, Kerala. Indian J Basic Appl Med Res. 2016;5(2):581–8. 9. Kurian B, Qurieshi MA, Ganesh R, Leelamoni K. A community-based study on knowledge of diabetes mellitus among adults in a rural population of Kerala. Int J Noncommunicable Dis. 2016;1(2):59. 10. 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 Clin Res Rev. 2016;10(1):S114–S119. 11. Gupta RK, Shora TN, Jan R, Raina SK, Mengi V, Khajuria V. Knowledge, attitude and practices in type 2 diabetes mellitus patients in rural Northern India. Indian J Community Health. 2015;27(3):327–333. 12. Fatema K, Hossain S, Natasha K, Chowdhury HA, Akter J, Khan T, et al. Knowledge attitude and practice regarding diabetes mellitus among Nondiabetic and diabetic study participants in Bangladesh. BMC Public Health. 2017;17(1):364. 13. Islam FMA, Chakrabarti R, Dirani M, Islam MT, Ormsby G, Wahab M, et al. Knowledge, attitudes and practice of diabetes in rural Bangladesh: the Bangladesh Population based Diabetes and Eye Study (BPDES). PLoS One. 2014;9(10):e110368. 14. Salem, et al. Knowledge, Attitude, and Practice Regarding Diabetes Mellitus among General Public and Diabetic Patients in Riyadh, Saudi Arabia. Asian J Pharm. 2018;12(1). 15. Tanuja. P.Pattankar and Shailaja. S. Patil. Knowledge, attitude and practice regarding type 2 diabetes mellitus among Diabetic patients residing in an urban field practice area of Patil medical college, Vijayapura. Int J Curr Adv Res. 2017;6(6):4190–3. 16. Nagar V, Prasad P, Mitra A, Kale S, Yadav K, Shukla M. Assessment of knowledge, attitude and practice about diabetes among diabetic patients of tertiary care centre in central India. Int J Community Med Public Health. 2018;5(9):4065–4071. 17. 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(3):379. 18. Roux M le, Walsh C, Reid M, Raubenheimer J. Diabetes-related knowledge, attitude and practices (KAP) of adult patients with type 2 diabetes mellitus in the Free State province, South Africa. South Afr J Clin Nutr. 2018;1–8. 19. Mangaiarkkarasi A, Nitya S, Ali MR, Ramaswamy S. A study to assess the knowledge, attitude and practice about diabetes among diabetic patients in Pondicherry. Res J Pharm Biol Chem Sci. 2012;3(4):1185–96. 20. Babikr WG, Aedh AI, Ahmed AM, Abdelraheem AM, Elhussein AB. Assessment of knowledge, attitude and practice of diabetic people in Najran, Kingdom of Saudi Arabia. Int J Res Med Sci. 2017;5:2150–5. 21. Baradaran H, Knill-Jones R. Assessing the knowledge, attitudes and understanding of type 2 diabetes amongst ethnic groups in Glasgow, Scotland. Pract Diabetes Int. 2004;21(4):143–8. 22. Hawal NP, Shivaswamy MS, Kambar S, Patil S, Hiremath MB. Knowledge, attitude and behaviour regarding self-care practices among type 2 diabetes mellitus patients residing in an urban area of South India. Int Multidiscip Res J. 2012;2(12). 23. Kamel NM, Badawy YA, El Zeiny NA, Merdan IA. Sociodemographic determinants of management behaviour of diabetic patients. Part II. Diabetics’ knowledge of the disease and their management behaviour. 1999; 24. Al-Adsani AMS, Moussa MAA, Al-Jasem LI, Abdella NA, Al-Hamad NM. The level and determinants of diabetes knowledge in Kuwaiti adults with type 2 diabetes. Diabetes Metab. 2009;35(2):121–8. 25. He X, Wharrad HJ. Diabetes knowledge and glycemic control among Chinese people with type 2 diabetes. Int Nurs Rev. 2007;54(3):280–287. 26. Shah VN, Kamdar PK, Shah N. Assessing the knowledge, attitudes and practice of type 2 diabetes among patients of Saurashtra region, Gujarat. Int J Diabetes Dev Ctries. 2009;29(3):118. 27. Bruce P. Knowledge attitude and practice about diabetes among patients with diabetes attending medicine OPD of tertiary care hospital at Kulasekharam. Int J Community Med Public Health. 2018;5(10):4254–4257. 28. Tejaswi P. Dhakre S, Reddy P, Goyal C. Evaluation of the knowledge, attitudes and practices of diabetic patients in a tertiary care hospital in Central India. Int J Med Res Rev. 2018;6(1):24–32. 29. Rathod S, Kumar S, Rathod GB, Parmar P. Knowledge, attitude and practice (KAP) of general population of Vadodara towards diabetes mellitus. IAIM. 2018;5(4):1–6. 30. Aldossari K, Abdelrazik M, Kamal S, Al-Zahrani J, Al-Ghamdi S, Altamimi I, et al. Assessment of Levels of knowledge, attitude and practice about diabetes mellitus (DM), its complications and self-management of diabetic patients in AlKharj city, Saudi Arabia. Int J. 2015;3(5):23–32. 31. Alanazi FK, Alotaibi JS, Paliadelis P, Alqarawi N, Alsharari A, Albagawi B. Knowledge and awareness of diabetes mellitus and its risk factors in Saudi Arabia. Saudi Med J. 2018;39(10):981. 32. Basu S, Khobragade M, Raut DK, Garg S. Knowledge of diabetes among diabetic patients in government hospitals of Delhi. Int J Noncommunicable Dis. 2017;2(1):8. 33. Al-Maskari F, El-Sadig M, Al-Kaabi JM, Afandi B, Nagelkerke N, Yeatts KB. Knowledge, attitude and practices of diabetic patients in the United Arab Emirates. PloS One. 2013;8(1):e52857. 34. Al-Naggar RA, Osman MT, Ismail N, Ismail Z, Noor NAM, Ibrahim NS, et al. Diabetes mellitus among selected Malaysian population: A cross-sectional study. Int J Med Res Health Sci. 2017;6(4):1–11. 35. El-Khawaga G, Abdel-Wahab F. Knowledge, attitudes, practice and compliance of diabetic patients in Dakahlia, Egypt. Euro J Res Med Sci. 2015;3(1). 36. Satyanarayana TB, Mahendrappa SK. A cross sectional study of knowledge, attitude and practice among patients with type 2 diabetes mellitus at a tertiary care hospital. J Evol Med Dent Sci. 2014;3:5317–21.

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References

1. Raman Kutty V, Joseph A, R Soman C. High prevalence of type 2 diabetes in an urban settlement in Kerala, India. Ethn Health. 1999;4(4):231–239.
2. Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. 2007;125(3):217–30.
3. Vijayakumar G, Arun R, Kutty VR. High prevalence of type 2 diabetes mellitus and other metabolic disorders in rural Central Kerala. J Assoc Physicians India. 2009 Aug;57:563–7.
4. Thankappan KR, Shah B, Mathur P, Sarma PS, Srinivas G, Mini GK, et al. Risk factor profile for chronic non-communicable diseases: results of a community-based study in Kerala, India. Indian J Med Res. 2010;131(1):53.
5. Shayeghian Z, Aguilar-Vafaie M, Besharat MA, Parvin M, Roohi Gilani K. The association between self-care and control of blood sugar and health-related quality of life in type II diabetes patients. Iran J Endocrinol Metab. 2014;15(6):545–551.
6. Knight K, Badamgarav E, Henning JM, Hasselblad V, Gano Jr AD, Ofman JJ, et al. A systematic review of diabetes disease management programs. Am J Manag Care. 2005;11(4):242–50.
7. 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]. Japi. 2005;53:283–287.
8. Nelson et al. Diabetes self-care: A community based cross sectional study from Kollam district, Kerala. Indian J Basic Appl Med Res. 2016;5(2):581–8.
9. Kurian B, Qurieshi MA, Ganesh R, Leelamoni K. A community-based study on knowledge of diabetes mellitus among adults in a rural population of Kerala. Int J Noncommunicable Dis. 2016;1(2):59.
10. 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 Clin Res Rev. 2016;10(1):S114–S119.
11. Gupta RK, Shora TN, Jan R, Raina SK, Mengi V, Khajuria V. Knowledge, attitude and practices in type 2 diabetes mellitus patients in rural Northern India. Indian J Community Health. 2015;27(3):327–333.
12. Fatema K, Hossain S, Natasha K, Chowdhury HA, Akter J, Khan T, et al. Knowledge attitude and practice regarding diabetes mellitus among Nondiabetic and diabetic study participants in Bangladesh. BMC Public Health. 2017;17(1):364.
13. Islam FMA, Chakrabarti R, Dirani M, Islam MT, Ormsby G, Wahab M, et al. Knowledge, attitudes and practice of diabetes in rural Bangladesh: the Bangladesh Population based Diabetes and Eye Study (BPDES). PLoS One. 2014;9(10):e110368.
14. Salem, et al. Knowledge, Attitude, and Practice Regarding Diabetes Mellitus among General Public and Diabetic Patients in Riyadh, Saudi Arabia. Asian J Pharm. 2018;12(1).
15. Tanuja. P.Pattankar and Shailaja. S. Patil. Knowledge, attitude and practice regarding type 2 diabetes mellitus among Diabetic patients residing in an urban field practice area of Patil medical college, Vijayapura. Int J Curr Adv Res. 2017;6(6):4190–3.
16. Nagar V, Prasad P, Mitra A, Kale S, Yadav K, Shukla M. Assessment of knowledge, attitude and practice about diabetes among diabetic patients of tertiary care centre in central India. Int J Community Med Public Health. 2018;5(9):4065–4071.
17. 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(3):379.
18. Roux M le, Walsh C, Reid M, Raubenheimer J. Diabetes-related knowledge, attitude and practices (KAP) of adult patients with type 2 diabetes mellitus in the Free State province, South Africa. South Afr J Clin Nutr. 2018;1–8.
19. Mangaiarkkarasi A, Nitya S, Ali MR, Ramaswamy S. A study to assess the knowledge, attitude and practice about diabetes among diabetic patients in Pondicherry. Res J Pharm Biol Chem Sci. 2012;3(4):1185–96.
20. Babikr WG, Aedh AI, Ahmed AM, Abdelraheem AM, Elhussein AB. Assessment of knowledge, attitude and practice of diabetic people in Najran, Kingdom of Saudi Arabia. Int J Res Med Sci. 2017;5:2150–5.
21. Baradaran H, Knill-Jones R. Assessing the knowledge, attitudes and understanding of type 2 diabetes amongst ethnic groups in Glasgow, Scotland. Pract Diabetes Int. 2004;21(4):143–8.
22. Hawal NP, Shivaswamy MS, Kambar S, Patil S, Hiremath MB. Knowledge, attitude and behaviour regarding self-care practices among type 2 diabetes mellitus patients residing in an urban area of South India. Int Multidiscip Res J. 2012;2(12).
23. Kamel NM, Badawy YA, El Zeiny NA, Merdan IA. Sociodemographic determinants of management behaviour of diabetic patients. Part II. Diabetics’ knowledge of the disease and their management behaviour. 1999;
24. Al-Adsani AMS, Moussa MAA, Al-Jasem LI, Abdella NA, Al-Hamad NM. The level and determinants of diabetes knowledge in Kuwaiti adults with type 2 diabetes. Diabetes Metab. 2009;35(2):121–8.
25. He X, Wharrad HJ. Diabetes knowledge and glycemic control among Chinese people with type 2 diabetes. Int Nurs Rev. 2007;54(3):280–287.
26. Shah VN, Kamdar PK, Shah N. Assessing the knowledge, attitudes and practice of type 2 diabetes among patients of Saurashtra region, Gujarat. Int J Diabetes Dev Ctries. 2009;29(3):118.
27. Bruce P. Knowledge attitude and practice about diabetes among patients with diabetes attending medicine OPD of tertiary care hospital at Kulasekharam. Int J Community Med Public Health. 2018;5(10):4254–4257.
28. Tejaswi P. Dhakre S, Reddy P, Goyal C. Evaluation of the knowledge, attitudes and practices of diabetic patients in a tertiary care hospital in Central India. Int J Med Res Rev. 2018;6(1):24–32.
29. Rathod S, Kumar S, Rathod GB, Parmar P. Knowledge, attitude and practice (KAP) of general population of Vadodara towards diabetes mellitus. IAIM. 2018;5(4):1–6.
30. Aldossari K, Abdelrazik M, Kamal S, Al-Zahrani J, Al-Ghamdi S, Altamimi I, et al. Assessment of Levels of knowledge, attitude and practice about diabetes mellitus (DM), its complications and self-management of diabetic patients in AlKharj city, Saudi Arabia. Int J. 2015;3(5):23–32.
31. Alanazi FK, Alotaibi JS, Paliadelis P, Alqarawi N, Alsharari A, Albagawi B. Knowledge and awareness of diabetes mellitus and its risk factors in Saudi Arabia. Saudi Med J. 2018;39(10):981.
32. Basu S, Khobragade M, Raut DK, Garg S. Knowledge of diabetes among diabetic patients in government hospitals of Delhi. Int J Noncommunicable Dis. 2017;2(1):8.
33. Al-Maskari F, El-Sadig M, Al-Kaabi JM, Afandi B, Nagelkerke N, Yeatts KB. Knowledge, attitude and practices of diabetic patients in the United Arab Emirates. PloS One. 2013;8(1):e52857.
34. Al-Naggar RA, Osman MT, Ismail N, Ismail Z, Noor NAM, Ibrahim NS, et al. Diabetes mellitus among selected Malaysian population: A cross-sectional study. Int J Med Res Health Sci. 2017;6(4):1–11.
35. El-Khawaga G, Abdel-Wahab F. Knowledge, attitudes, practice and compliance of diabetic patients in Dakahlia, Egypt. Euro J Res Med Sci. 2015;3(1).
36. Satyanarayana TB, Mahendrappa SK. A cross sectional study of knowledge, attitude and practice among patients with type 2 diabetes mellitus at a tertiary care hospital. J Evol Med Dent Sci. 2014;3:5317–21.

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