Abstract
Aim and objectiveDiabetes mellitus is a chronic metabolic disorder that requires continuous self-management practices. The aim of our study is to assess the factors resulting in non-compliance with self-management practices in people with type 2 diabetes mellitus (T2DM).MethodsThis cross-sectional study was conducted at Baqai Institute of Diabetology and Endocrinology (BIDE), a tertiary care center in Karachi, Pakistan, from March 2019 to May 2019. People with T2DM diagnosed for at least six months were included. A predesigned questionnaire was used to assess various components of self-management such as the use of oral hypoglycemic agents (OHAs) and insulin, self-monitoring of blood glucose (SMBG), physical activity, and daily foot care. Certified diabetes educators conducted interviews on a one-to-one basis. Data were entered and analyzed by using SPSS (version 20; IBM Corp., Armonk, NY).ResultsBetter glycated hemoglobin (HbA1c) levels were observed in compliant persons and a statistically significant difference was noted in those who were compliant with insulin use. Good compliance with self-management was observed in people who were given diabetes education previously.A total of 205 people with T2DM were included in the study, with a mean age of 52.66 ± 11.2 years and a mean duration of diabetes of 8.9 ± 7.5 years. There were 62.9% males and 37.1% females. Oral hypoglycemic agents (OHAs) were prescribed to 62.9% while 33.9 % were on both OHAs and insulin. Non-compliance with the intake of OHAs was 33.3%, insulin injection 21%, SMBG 25.7%, physical activity 69.5%, and foot care practice 34.3%. Various reasons identified for non-compliance included forgetfulness (negligence) (88%), fear of hypoglycemia (10.6%), time constraints (48%), and lack of foot care knowledge (84.8%).ConclusionNon-compliance with T2DM self-management is multifactorial and needs continuous reinforcement of structured diabetes education sessions. The study showed that the provision of diabetes education is directly proportional to self-management compliance levels.
Highlights
Diabetes mellitus is one of the major health issues worldwide
Better glycated hemoglobin (HbA1c) levels were observed in compliant persons and a statistically significant difference was noted in those who were compliant with insulin use
Good compliance with self-management was observed in people who were given diabetes education previously
Summary
Diabetes mellitus is one of the major health issues worldwide. The prevalence of type 2 diabetes (T2DM) is increasing rapidly across the globe. According to the International Diabetes Federation (IDF), 463 million people of ages 20 to 79 years are living with diabetes, which is expected to rise to 700 million by the year 2045 [1]. Sedentary lifestyles and growing obesity among adults and children because of economic development and increasing urbanization with greater consumption of unhealthy foods are some of the contributing factors for this great pandemic [2]. The global prevalence of diabetes in urban areas is 10.8%, in rural areas, it is lower, at 7.2%. Pakistan is in the top 10 countries for an absolute increase in diabetes prevalence, which has reached 17.1% [3]
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