Research Article

Practice and Correlates of Diabetic Mellitus Management Among the Bayelsans

Ekanem, Christiana Dominic, Owonaro Peter A* and Eniojukan F Joshua

Faculty of Pharmacy, Dept of clinical pharmacy and pharmacy practice, Niger Delta University Amassoma, Nigeria

Submission: June 24, 2024; Published: July 05, 2024

*Corresponding author: A owonaro, Faculty of Pharmacy, Dept of clinical pharmacy and pharmacy practice, Niger Delta University Amassoma, Nigeria

How to cite this article: Ekanem, Christiana D, Owonaro Peter A, Eniojukan F J. Practice and Correlates of Diabetic Mellitus Management Among the Bayelsans. Curre Res Diabetes & Obes J 2024; 17(4): 555967.DOI: 10.19080/CRDOJ.2024.17.555967

Abstract

Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels which leads, over time, to serious damage to the end organs. This research aimed to assess the knowledge, attitude, practice, and confounding factors regarding diabetes mellitus among Bayelsans. A Stratified random sampling method was used to select four hundred (400) participants who were assessing the three randomly selected hospitals in Yenagoa and Ogbia LGAs of Bayelsa state. A questionnaire on knowledge attitude and practice (KAP) and confounding factors of diabetes mellitus was completed and data was analyzed using SPSS Version 23 software. In this study, the majority of respondents were male 221(55.3%); the majority (35.8%) were in the age group of above50 years; 20.5% were in the age group of 21-30 years, 17.8% were in the age group of 41-50 years; 22.5% were single, 51.2% were married, 25.8% were divorced or widowed; approximately 60% had formal education, while 12.5% and 15.5% had O and A Levels respectively; 55.5% were Christians, 32% were Muslims. The overall mean (standard deviation) of the knowledge, attitude, practice, and confounding factors was 2.20+0.9, 3.75+0.97, 2.26+0.99, and 2.6+0.9 respectively. Data showed poor adherence to diabetic practices. Some respondents only use herbs for treatment. Significant relationships between young and old concerning knowledge, attitude, practices, and confounding factors were demonstrated in the study. This cross-sectional descriptive study revealed an average level of knowledge of diabetes, a low level of attitude toward diabetic care, and a poor level of diabetic practices among the participants in the study. The study also demonstrated significant relationships between young and old concerning knowledge, attitude, practices, and confounding factors among diabetics. It is suggested that effective health education interventions are needed to improve diabetes knowledge, attitude, and practices, particularly regarding lifestyle modifications, weight loss, proper adherence to prescribed medications, and dietary management.

Keywords:Diabetics; Bayelsa; Knowledge; Attitude; and Practice

Abbreviation:KAP: Knowledge Attitude and Practice; DM: Diabetes Mellitus; GDM: Gestational Diabetes Mellitus; FMC: Federal Medical Centre; NDUTH: Niger Delta University Teaching Hospital; CKC: Christ the King Catholic; DKT: Diabetes Knowledge Test

Introduction

Diabetes is a chronic, metabolic disease characterized by elevated blood glucose levels (or blood sugar), which leads over time to serious damage to the end organs such as the heart, blood vessels, eyes, kidneys, and nerves [1]. To reduce morbidity and mortality of the people affected with diabetes, there is a need for proper awareness regarding diabetes mellitus and its complications. Diabetes mellitus (DM) is also seen as a chronic metabolic disorder characterized by high blood sugar resulting from defects in insulin production, insulin action, or both.

Type 1 Diabetes mellitus is characterized by the destruction of beta cells in the pancreas, typically secondary to an autoimmune process. The result is the absolute destruction of beta cells, and consequentially, insulin is absent or extremely low (Iradukunda et al, 2021). Gestational diabetes mellitus (GDM) is a serious pregnancy complication in which women without previously diagnosed diabetes mellitus develop chronic hyperglycemia during gestation. In most cases, this hyperglycemia is the result of impaired glucose tolerance due to pancreatic β-cell dysfunction on a background of chronic insulin resistance. Risk factors for GDM include being overweight, obesity, advanced maternal age, and family history or any form of diabetes [2]. The purpose of this study is therefore to assess the knowledge, attitude, practice, and confounding factors of type 1& 2 diabetes mellitus in three randomly selected hospitals in Bayelsa state.

Method

Study site: The study area for this research is Federal Medical Centre Yenagoa (FMC), Niger Delta University Teaching Hospital Amassoma (NDUTH), Christ the King Catholic Hospital Imiringi (CKC).

Study design: A hospital-based cross-sectional descriptive study of KAP was used.

Sampling technique: A Stratified random sampling method was used in this study.

Data collection: Self-structured validated “Diabetes Knowledge Test (DKT)” questionnaire was used as an instrument to collect field data. The instrument was validated and certified by the competent authority. It was created and printed in hard copies and distributed also in hard copies to collect data from patients with Diabetes mellitus in Bayelsa state.

Data analysis: IBM SPSS Version 27, GraphPad insta3.0, and Microsoft Excel were used to analyze field data. Descriptive statistics such as Frequency, mean and standard deviation were used on variables and further presented in chats.

Ethical consideration: Approval and permission were obtained from Research and Ethics Committee Federal Medical Centre Yenagoa, Niger Delta University Teaching Hospital Amassoma, and Christ the King Catholic Hospital Imiringi, all in Bayelsa state.

Results

In this study, the majority were male; 221(55.3%) and female were 179(44.8%), the socio-demographic characteristics of the study group are as follows: 10.5% of the diabetics are in the age group category of 10-20 years, 20.5% of diabetics are in the age group category of 21-30 years, 15.5% of diabetics are in the age group category of 31-40 years, 17.8% of the diabetics are in the age group category of 41-50years and 35.8% of the diabetics are in the age group category of above 50 years and were the most affected age group, which shows that age plays a vital role in diabetes mellitus. In terms of marital status, 51.2% were married, 22.5% were single, and 25.8% were divorced or widowed. Approximately 60% of the participants had formal education, while 12.5% and 15.5% had O and A Levels respectively. Men 55.3% of diabetics were most affected in the study, which seems to be the same across the globe. 55.5% were Christians, 32% were Islam and 10% were traditional worshippers.

Table 1 below shows the socio-demographic characteristics of the study group indicated by the frequency and percentage of scores by the participants.

Table 2 below shows the level of diabetic practices among various age groupings regarding diabetes mellitus indicated by the percentage of scores by the participants.

Table 3 below shows the level of diabetic practices regarding diabetes mellitus indicated by the frequency and percentage of scores by the respondents.

The overall level of diabetic practices of the respondents was sub-optimal as only a few of them were found to demonstrate a good level of diabetic practice. Findings revealed that a greater percentage of the Participants demonstrated a poor level of diabetic practices regarding various aspects of diabetes specifically shown in the data. 21.8%were addicted to smoking, 22.5% were addicted to alcohol, and 14.8% were diagnosed with obesity.

Regarding diabetic practices, a little less than half (49%) could check their blood glucose regularly, less than one-tenth (8.0%), one-fifth (20.8%), respectively had regular checks of their, Blood Pressure, and eye, about 3.0%, and 1.5% respectively had a regular check of body weight and BMI. This is corroborated by the findings of [3,4]. They reported that more than half of the study subjects never had their blood sugar checked, over 50% of the study subjects were not involved with any preventive measures, about 65% used to take refined sugar liberally, and a large majority (80%) had no regular exercise activity. This study is also similar to findings from Eberechukwu et al, (2016) which revealed that only 31.1% had their eye examined regularly the rest had not been to an eye clinic due to lack of funds, time, no ocular problems and not having been referred to an eye doctor.

Findings also showed that; 5.0%, 3.5%, 15.5%m 6.0%, and 2.5%, respectively had ever participated in health education programs, outreaches, engaged in aerobic exercise, being diagnosed with hypoglycemia, and had wounds that refused to heal despite all medical interventions. Data also showed that 68.3% and 72.3% were addicted to fried or fatty foods and latenight meals

Discussion

The characteristic descriptors of the participants considered in the study include age, gender, education, marital status, and religion. From the study above, male participants were more than female participants. The study further cuts across several age groupings in which the highest participants in this study were within the age category of 51 years and above who formed about 35.8% of the participants. The age category of (21 to 30 years) was next to them, forming about 20.5% of the total participants while the least participating group was the adolescents (10 to 20 years).

The study for the assessment of practice and correlates of diabetes mellitus management among the Bayelsans showed that 24% of the participants who had an average level of diabetic practices were in the age category of 51 years and above, 8.0% and 16.0% of the participants within that age group constantly experienced numbness of the limbs and constipation respectively. This data is in line with studies carried out by [5-7], in which age, poor dietary habits, physical inactivity, positive family history, and educational status were significantly associated with Type 2 Diabetes mellitus in both sexes.

The overall level of diabetic practices of the respondents was sub-optimal as only a few of them were found to demonstrate a good level of diabetic practices. Findings also revealed that a greater percentage of the Participants demonstrated a poor level of diabetic practices regarding various aspects of diabetes mellitus specifically shown in the data. 21.8% were addicted to smoking, 22.5% were addicted to alcohol, and 14.8% were diagnosed with obesity. This data corroborates the findings of Iradukunda et al, (2021), Rendall et al, [8-10] in which the majority of the participants were addicted to smoking, alcohol consumption, and diagnosed with obesity.

The data also revealed a little less than half (49%), less than one-tenth (8.0%), one-fifth (20.8%), 3.0%, and 1.5% respectively had regular checks of their blood glucose, Blood Pressure, eye, body weight, and BMI. This study is similar to findings from [11,12], and Eberechukwu et al, (2016) which revealed that only very few respondents had their blood pressure and blood glucose regularly checked and only31.1% had their eye examined regularly the rest had not been to an eye clinic due to lack of funds, time, no ocular problems and not having been referred to an eye doctor. Findings also showed that; 5.0%, 3.5%, 15.5% 6.0%, and 2.5%, respectively had ever participated in health education programs, and outreaches, engaged in aerobic exercise, diagnosed with hypoglycemia, and had wounds that refused to heal despite all medical interventions. Data also showed that 68.3% and 72.3% were addicted to fried / fatty foods and late-night meals. This is also in line with studies carried out by [4,13]. Even though the level of education was significantly and positively associated with knowledge, the association of gender, age, and attitude with knowledge was not significant. Herath also reported that the attitude towards diabetes was poor in the majority (90%) and the level of education had no significant effect on attitude. Also, more than a half of the study subjects never had their blood sugar checked. About half of the study subjects were not involved with any preventive measures and, about 65% used to take refined sugar liberally and a large majority (80%) had no regular exercise activity.

In the study, the overall mean (standard deviation) of the knowledge, attitude, practice and confounding factors was 2.20 +0.9, 3.75 +0.97, 2.26 +0.99 and 2.6 +0.9 respectively. Data also showed poor adherence to diabetic practices. Some respondents 26.3% only use herbs for treatment and only 20.5% were compliant with their prescribed medications. Significant relationships between young and old concerning knowledge, attitude, practices, and confounding factors were demonstrated in the study. The majority had either moderate knowledge of diabetes mellitus or above moderate knowledge of diabetes mellitus and even though level of education is significantly and positively associated with knowledge of diabetes mellitus, their level of education has no significant effect on attitude towards diabetic care and practices. This is in line with the findings of [4,5,14] in which the majority demonstrated either moderate or above moderate knowledge of diabetes, yet the respondents had poor attitude of diabetic care and their high level of education had no significant effect on attitude towards diabetic care.

With the analyzed clinical data of the participants in the study, 44.0%, 42.9%, 23.3%, 25.0%, and 16.7%, of the participants were sometimes involved in alcohol intake, smoking, diagnosed with obesity, have had wounds that refused to heal and had been treated for diabetic complications respectively. This study is similar to the findings of [13,15], and [2]. Also, the majority of the participants had co-morbidities: 85.5%, 7.8%, 8.3%, 38%, 56.3%, 33.8% and 1.00% had, Hypertension, congestive heart failure, liver disease, HIV/AIDS, high cholesterol level tuberculosis and kidney disease respectively. This study is also in line with the findings by [2], and Iradukunda et al, (2021) work on the assessment of diabetic complications and associated factors in a Tertiary Hospital in Rwanda, using A 5-Year Facility- based Cross-sectional study with Retrospective charts review of 246 participants.

Iradukunda reports 48.5%, 24.2%, 52.4%, and 56.3%, of alcohol intake, smoking, obesity, and family history respectively as recorded diabetes mellitus risk factors. Also, in this study, analyzed data showed that a fifth (20%), about a third (29.0%) of the respondents. had been diagnosed with diabetes; less than a year, and less than five years ago respectively. Also, about a third (30.5%), about one-fifth (17.0%), a fifth (20.3%), and one-tenth (12.0%) had been diagnosed with diabetes less than ten years ago, more than ten years ago, during pregnancy, and diagnosed as a child respectively. A study by Eberechukwu et al, (2016) revealed that 68.9% of respondents had been diabetic for 5 years or less. Eberechukwu et al 2016 also reported that only 31.1% had had their eyes examined; the rest had not been to an eye clinic due to lack of funds, time, no ocular problems and not having been referred to an eye doctor.

Conclusion

This cross-sectional descriptive study revealed an average level of knowledge of diabetes, a low level of attitude toward diabetic care, and a poor level of diabetic practices among the participants in the study. The study also demonstrated significant relationships between young and old concerning knowledge, attitude, practices, and confounding factors among diabetics [16- 50].

Study Limitation

This cross-sectional descriptive study has been able to detail the level of knowledge, attitude, practice, and confounding factors of diabetes among diabetics in Bayelsa state. Areas of strength and lapses have been noted and identified; the top most is that there is an average level of knowledge of diabetes among the participants.

Weaknesses identified were seen in the negative attitude towards diabetic care and poor diabetic practices among them. There are some misconceptions in attitude toward diabetic care; some use herbs only for treatment. The study also demonstrated significant relationships between young and old concerning knowledge, attitude, practices, and confounding factors among diabetics in Bayelsa state. However, their high level of education had no significant effect on their attitude towards diabetic care and practices.

Recommendation

The study suggested that effective health education interventions are needed to improve diabetic practices, particularly regarding lifestyle modifications, weight loss, proper adherence to prescribed medications, and dietary management. Health professionals must step up in the awareness campaign strategy.

Contribution to Knowledge

This study helps to identify gaps in knowledge and misconceptions, allowing for targeted educational interventions to improve understanding and awareness of diabetes and its complications. The study also provides information on the effectiveness of current practices and interventions, by identifying areas for improvement.

Acknowledgment

There was no conflict of interest among the authors. The researchers appreciated the participants, statistician, and the researcher for the time.

Conflict of Interest

There was no conflict of interest among the Researchers.

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