Diabetes Education, Knowledge Improvement, Attitudes and Self-Care Activities Among Patients With Type 2 Diabetes in Bangladesh

Abstract

Background: Diabetes education provided by physicians in Bangladesh has some limitations, and its impacts on self-management are unclear. These prompted the Diabetic Association of Bangladesh (BADAS) to train 100 diabetes educators to improve the diabetes self-care activities of patients and to pilot the effects of the education. Objectives: In this context, the current study aimed to assess the impact of diabetes education to improve knowledge on and attitudes towards diabetes and self-care activities in patients with type 2 diabetes mellitus (T2DM). Methods: The pretest-posttest study recruited 500 newly-diagnosed patients with T2DM by convenience method from 19 healthcare centers of BADAS. They received a one-hour diabetes education only once at the time of registration to the hospital. A four-part interviewer-administered questionnaire was used to assess the knowledge, attitudes, and self-care activities in the patients with diabetes. The observed changes were compared after 18 months of the intervention and psychological support, in knowledge, attitudes and self-care activities among 458 (91.6%) patients with the mean age of 52.3 ± 11.4 years. Results: After the intervention, the mean score of knowledge (8.5 ± 2.6 vs. 5.5 ± 2.9) and attitudes (85.7 ± 6.1 vs. 79.9 ± 6.5) of the patients improved significantly (P = 0.0001). About 67.7%, 85.2%, 82.8% and 92.1% of the patients were monitored for blood glucose, doing exercises, taking foot care and smoking withdrawal whereas the rates were 8.3%, 69.2%, 25.8% and 86.7%, respectively before the intervention; a significant difference was observed between the measures. Consumption of betel nuts increased at the posttest compared to that of the pretest (73.4% vs. 70.7%). About 25.5% followed the dietary advice given by dietitians whereas it was only 5.2% at the pretest; there were significant changes between the pretest and posttest measures in this regard (P = 0.0001). One-third of the subjects took meals at a certain time; the number slightly decreased compared to the pretest. Around 36% of the patients weighted food before eating compared to 37.6% at the pretest. There was a significant difference regarding the certain time and weighting food before eating between pretest and posttest measures (P = 0.001). Conclusions: Diabetes education enhances the knowledge of patients and changes their attitudes towards all aspects of DM. It also helps them to improve some aspects of diabetes self-care activities.