A Descriptive Study to Assess the Knowledge Regarding Diabetes Mellitus among the Residents of Selected Rural Community, Gurdaspur, Punjab
Mrs. Sumanpreet Kaur1, Ms. Harmanpreet Kaur2
1Lecturer Mental Health (Psychiatric) Nursing, Royal Institute of Nursing, Jaito Sarja
2Clinical Instructor, Shrimati Nirmala Devi CMC Hospital, Qadian
Corresponding Author Email: skaur201989@gmail.com, harmanpreet201991@gmail.com
ABSTRACT:
Introduction: Diabetes mellitus is the metabolic disease characterized by increased the level of glucose in the blood resulting from defect in insulin secretion, insulin action or both. Diabetes mellitus is the most prevalence disease in the world now a days. Diabetes mellitus is a silent disease and is now recognized as one of the fastest growing threats to public health in almost all countries of the world. Every 5th person who suffer from diabetes mellitus in the world today is an Indian. The world health organization health report (1998) quotes that in India diabetes directly causes approximately 38, 000 deaths per year and may contribute to as many as 300, 000 deaths annually.
Objectives: To assess the level knowledge of selected community residents regarding diabetes mellitus. To determine the association of level of knowledge of the selected community residents regarding diabetes mellitus with selected demographic variables. To prepare and distribute the pamphlets regarding prevention of diabetes mellitus. Methods: A Non-Experimental, Quantitative Research Approach And Univariant Descriptive Research design was used in present study to assess the knowledge regarding diabetes mellitus among selected rural community residents. A self structured checklist was used to assess the knowledge regarding diabetes mellitus and convenience sampling was used. Results: The result of present study revealed that out of 100 community people, 90% have average knowledge, 9% have good knowledge and only 1% have poor knowledge. The mean score of good level of knowledge was 21.77 with standard deviation ±0.56, the mean score of average knowledge was 16.97 with standard deviation ±0.35 and mean score of poor level of knowledge was 10 with standard deviation 0. The association between the level of knowledge regarding Diabetes Mellitus of residents of selected rural community with their demographic variables. The result revealed that there was a significant association found with the age, education, and occupation at the level of significance <0.05 and there was no significant association found between the level of knowledge and their Gender, Type of Family, Presence of Disease, Duration of Disease, Type of Medication and Source of Information. Interpretation And Conclusion: The analysis of the data regarding the assessment level of the knowledge regarding diabetes mellitus among the residents of community. The result of present study revealed that out of 100 community people, 90% have average knowledge, 9% have good knowledge and only 1% have poor knowledge.
KEYWORDS: Diabetes Mellitus, International Nursing Council, Gestational Diabetes Mellitus, Level Of Significance, Chisquare, World Health Organization, Community Residents.
INTRODUCTION:
Physicians of the utmost fame, were called at once, but when they came, They answered, as they took their fees, there is no cure for this disease Hilary belloc1
Diabetes mellitus is a group of metabolic disorder arising either due to relative or absolute deficiency of a digestive hormone called insulin or inability or resistance of body cells to use the available insulin. Diabetes mellitus is a silent disease and is now recognized as one of the fastest growing threats to public health in almost all countries of the world. Every 5th person who suffer from diabetes in the world today is an Indian2
Diabetes mellitus is a group of metabolic disorder characterized by elevated levels of glucose in the blood (hyperglycaemia), resulting from defects in insulin secretion, insulin action or both. American nurses association expert committee and classification of diabetes mellitus(2003).3
The main underlying causes of the disease are genetic and environmental factors, such as urbanization and industrialization, as well as increased longevity and changes in lifestyle from a traditional healthy and active life to a modern, sedentary, stressful life and over-consumption of energy-dense foods. The prevalence of diabetes mellitus varies among populations due to differences in genetic susceptibility and social risk factors such as change in diet, obesity, physical inactivity and, possibly, factors relating to intrauterine development. Migrants are especially affected.
Diabetes mellitus needs to be treated by a holistic approach through dietary adjustment, exercise, medication (if needed), education and self-care measures. Type 2 diabetes mellitus is a preventable disease. These need to focus on health promoting activities to raise awareness among healthy people of the risk factors for diabetes mellitus4.
Diabetes is one of the most frequently occurring chronic diseases in the world affecting nearly 2-4% of the population (world health organization, 1998) research studies have shown that the progress of diabetes is also associated with a high risk of developing vascular, renal, retinal and neuropathy complication leading to premature disability and death.
The world health organization health report (1998) quotes that in India diabetes directly causes approximately 38, 000 deaths per year and may contribute to as many as 300, 000 deaths annually, including many from heart disease and kidney failure. The number of cases is increasing approximately 6% a year, making diabetes as important and formidable health problem of India. The prevalence of diabetes has been found to be approximately 2% in the rural and 3% in urban areas with local peaks as high as 8% with urbanization, changing lifestyle and dietary habits. Thus, diabetes can have a deleterious effects on the overall health and quality of life of an individual5.
Diabetes is a chronic health problem, and it is now growing as an epidemic in both developed and developing countries. India leads the world today with the largest number of diabetes in any given country followed by china and USA6.
Diabetes is becoming more common in the world. every day, every 21st seconds someone is diagnosed with diabetes. Around 40- 70% of population is affected by foot ulcer. Many serious complications such as kidney failure or blindness, can affect individuals with diabetes7.
The pre-disposition to diabetes mellitus was thought to be hereditary. More recent theories Suggest that glucagon plays a major part in the patho physiology of diabetes mellitus and this theories regarding hereditary predisposition are being questioned8.
Obesity precedes in 85% of adult with diabetes mellitus. According to Roy’s adaptation theory obesity presents an increased demand for insulin, because the beta cells within the pancreas that secrets insulin become exhausted as a result individual develops diabetes mellitus. Diabetes mellitus is more common in women than in men, and it is thought that this may be because of the higher incident of obesity among women. It is also more common of obesity in women who have borne children or to hormonal influence related to pregnancy9.
The mother with gestational diabetes mellitus is a high risk of hypertension, preeclampsia, hydramnios, urinary tract infections, caesarian section and future diabetes mellitus, and some of the foetal complications are macrosomia, hypoglycemia, prematurity and congenital anomalies. The aim of management of gestational diabetes mellitus is to control blood glucose levels to avoid maternal and foetal complications. Components of management include diet therapy, exercise, insulin therapy and diabetic education10.
Patients with diabetes mellitus cannot be cured, but they can control it with regular exercise, diet, and drug. Regular and proper administration of drug can provide desired outcome, control diabetes, and prevent its complication. Undiagnosed or inadequately treated diabetes mellitus patients develop multiple complications leading to hospital admission. Diabetes mellitus in children adolescents and old people can be controlled by, effective teaching and awareness programme about foot care, exercise, diet, its complications early detection and prevention11.
NEED OF THE STUDY:
Knowledge is the key to healthier life, and education is powerful medicine” (K.Park)12
Diabetes is an ‘ice berg’ disease. Although it increases in both the prevalence and incidence of non insulin dependent diabetes occurred globally, they have been especially dramatic in societies, in newly industrialized countries and in developing countries. Currently the number of cases a diabetes worldwide is estimated to around 150 million. The number is predicted to be doubled by the year 2025. A prevalence rate of about 5.4% with the greatest number of cases being expected in china and India. By 2030 as much as 9% of the population would be diabetic.13
The world health organization estimates that more than 180 million people worldwide have diabetes. These numbers are likely to more than double by 2030. In 2005, as estimated 1.1 million people died from diabetes. Almost 80% of diabetes deaths occur in low and middle income countries. Almost half of diabetes deaths occur in people under the age of 70 years. 55% of diabetes deaths are in women only. Most notably, diabetes deaths are projected to increase by over 80% in upper- middle income countries between 2006 and 2015. The overall risk of dying among people with diabetes is at least double the risk of their peers without diabetes. Diabetes and its complications impose significant economic consequences on individual, families, health systems and countries14.
A study was conducted at total of 342 diabetics; 53% were men and 161 43% were women. The majority, 63% was Hindu, 26% were Christian and 11% were muslin by faith. The majority 37% of the respondents were in the age group of 61-70 year, followed by 24%, 20% and 19% in the age group of 41-50 years, 51-60 years and >70 years respectively. 37% were high school pass followed by 24% higher primary, 17% primary, 15% graduate and 7% were illiterate. 73% had a per capita monthly income of rupee 3000 or more. 56% of the respondents had adequate knowledge about the symptoms of hypoglycaemia. Men were found to be more aware than women and this difference was statistically significant. Only 15% of the respondents knew about the chronic complication of diabetes. Here also men had better knowledge than women but the difference was statistically non-significant. Respondents with per capita income of rupee two thousand or more and having ten or more years of schooling were more aware regarding the disease and its chronic complications. No difference in the awareness was observed across various religious groups15.
All the respondents were aware regarding diet control but only 43% followed the recommended diet schedules. It was observed that more women 52% than men 32% followed the recommended diet schedules. Eighty two percent of the respondents were aware that regular physical exercise is helpful but only nine percent of the men and four percent of the women followed this advice. 41% and 36% of the total respondents had the knowledge that alcohol and cigarette smoking are harmful for diabetics but only 19% of the alcohol drinkers and 14% of the smokers stopped using these products on the advice of their doctor after being diagnosed as diabetics16.
There is a deep need for an increase in the awareness of diabetes management and its complications in the primary healthcare sector. Continuing education on diabetes mellitus and its complications for primary healthcare providers is crucial and this should be accompanied by a regular assessment of their diabetic knowledge. Screening for diabetes is important, but equally crucial is patient education and counseling. It is evident from this study that patients are not sufficiently equipped with the knowledge to comprehensively manage their disease. Knowledge of diabetes is therefore essential for primary healthcare and other diabetic patients in order to prevent co-morbidities, which may compromise their lifestyles as well as increase the burden on public health care17.
An important area of focus in future studies should be the physical observation of nurses counseling diabetic patients. The inclusion of this parameter in a study will highlight the possible barriers to patient counseling and will also be an important tool in measuring the efficacy of counseling in terms of the use of appropriate language and techniques with the different patient groups, more aggressive counseling for elderly patients, more focus on counseling rural dwellers beyond the urban hub, and the efficacy of post-plasma glucose test counseling. The evaluation of the actual and perceived level of nursing knowledge regarding diabetes mellitus and its co-morbidities is also an area of importance and it would be interesting if a correlation is done between this and patient knowledge, and the prevalence of diabetes-related co-morbidities at the particular clinic. A study of youth awareness of diabetes mellitus in rural settings is also a viable study area, as education will be the key to prevention and disease management in later years. The key to unraveling the knots in rural diabetic patient management thus lies in empowering the patient and the healthcare provider with the essential18.
The researcher has observed the complications of diabetic patients during her working experience. The individuals who carry most of their weight and longer period uncontrolled diabetes tend to have a higher risk of diabetes foot. So these factors instigated the researcher to perform a study to assess the knowledge and attitude regarding diabetic foot care among diabetic patients19.
REVIEW OF LITERATURE:
Literature review is defined as a broad, comprehensive, in depth, systematic and critical review of scholarly publication, unpublished printed or audio visual material and personal communications.20
Review of literature for the present study has been organized under the following headings.
1. Studies Related To Diabetes Mellitus and Nutritional Management
2. Studies Related To Exercise and Gestational Diabetes Mellitus
3. Studies Related To Medications Or Insulin Administration
4. Studies Related To Care Of Women With Gestational Diabetes Mellitus To Reduce Long term Risk.
5. Studies Related To Foot Care
1. Studies related to diabetes mellitus and nutritional management:
Identification of risk factors for the development of type 2 diabetes mellitus is a necessary step in planning prevention programmes for diabetes mellitus. Socio-demographic data, family history of diabetes, and data on work related physical activity were recorded. Height, weight and waist-hip measurement were calculated. About 50% of the respondents were inactive. 52.7% were currently taking alcohol. 3.5% of the subjects admitted to parental history of diabetes mellitus. 21.4% were either overweight or obese. 32% of males and 86% of females had abnormal waist circumferences. 23.8% males and 74.9% females had abnormal waist-hip measurement. Inactivity alcohol usage and excess weight appear to be dominant risk factors for development of type 2 DM in this group21.
This descriptive study was conducted in an Arab-Muslim town to assess the level of knowledge, beliefs, and concerns about diabetes care. More than a third of respondents report not receiving any counselling on issues such as foot care or the effects of smoking on diabetes, misconceptions attributable to social norms are common, and more than a third forgo taking medications because of financial reasons. There is a need for interventions focused on overcoming these barriers to improve diabetes treatment and self-care in this population22.
A study was conducted at a Veterans Administration Hospital to evaluate patient capability for self-management found that over 35 per cent of the patients interviewed lacked any formal training. Seventeen patients had been placed on insulin without formal instruction. Almost one half the patients who claimed to have attended training programs could not demonstrate adequate knowledge or skills in any of the major areas of self-care: insulin administration, urine testing, diet, foot care, and management of hypoglycaemia and hyperglycemias. While patients with training were more knowledgeable than patients without training, the difference was slight. The results indicate the need for systematic analysis of patient knowledge and the evaluation of training programs23.
The study was developed to explore the psychological and behavioural factors that may influence both the incidence of chronic wounds and their progression. They found that patients may find it difficult understanding the rationale underlying prevention and treatment of foot ulcers; ulcerated patients may find it difficult to engage in the management of their foot ulcer outside consultations. Patient and practitioner factors may contribute to the effective implementation of clinical guidelines regarding education, partnership building and shared decision-making24.
A Review of nutritional management of gestational Diabetes Mellitus was conducted in U.K. The aim of the review was to examine the scientific evidence of the optimal nutritional management of gestational diabetes mellitus. Medline search of all English papers published between 1995 and 2005 was cross referenced, gestational diabetes mellitus with diet was undertaken. Overall current evidence points to the effectiveness of dietary advice as a means of improving maternal hyperglycemias and reducing the risk of accelerated foetal growth 25.
An article in medical nutrition therapy addresses that excellent glucose control is as foundational as appropriate weight gain and adequate nutrient intake in a pregnancy complicated by gestational diabetes mellitus. If a balance between nutrient needs and glucose cannot be achieved, the concurrent medication therapy is needed to assist in reducing insulin resistance. Medical nutrition therapy is a self management therapy. Education, support and follow up are required to assist the women to make life style changes essential to successful nutrition therapy 26.
2. Studies related to exercise and gestational diabetes mellitus
An evidence based guidelines indicate that regular prenatal exercise is an important component of a healthy pregnancy. In addition to monitoring physical fitness exercise may be beneficial in preventing or treating maternal foetal disease. Women who are the most physically active have lowest prevalence of gestational diabetes and prevention of gestational diabetes mellitus may decreases the incidence of obesity and type 2 diabetes in both mother and offspring 27.
An article on gestational diabetes and exercise addresses that pregnancy is a diabetogenic event which could develop into gestational diabetes mellitus up to 12% of pregnant women. Gestational diabetes mellitus is a carbohydrate intolerance of variable severity with onset or first recognition during pregnancy, involves a relative resistance to insulin. Exercise becomes a logical intervention, only recently offered as an adjunctive therapy to pregnant diabetes. This articles reviews out current understanding of the role of exercise in the management of gestational diabetes mellitus.28
A Study was conducted among randomly assigned 32 gestational diabetes mellitus mothers to examine the effects of circuit type resistance training on the need for insulin. Group-I Was treated with diet alone and group-II was treated with diet plus resistance exercise. The number of women whose condition required insulin therapy was the same regardless of treatment. Women in the diet plus exercise group were prescribed less insulin and should a longer delay from diagnosis to the initiation of insulin therapy. This study revealed that resistance training may helps to avoid insulin therapy for women with gestational diabetes mellitus 29.
3. Studies related to medications or insulin administration
A review of use of insulin pump in pregnancy complicated by gestational diabetes mellitus was conducted in a single hospital at South Auckland and diabetes cases were reviewed from 1991 through 1994. This study revealed that insulin pump therapy was safe and effective for maintaining glycolic control in pregnancies complicated by gestational diabetes mellitus and type 2 diabetes.30
4. Studies related to care of women with gestational diabetes mellitus to reduce long term risk.
An article on improving the care of women with gestational diabetes mellitus addresses that gestational diabetes mellitus affects approximately 7% of all pregnant women’s. Women are considered at high risk for gestational diabetes if they are markedly obese, have a personal history of gestational diabetes, have a strong family history of diabetes or have glycosuria. Risk assessment is essential in determining whether a women should be screened or tested for gestational diabetes. Women who have had gestational diabetes should have comprehensive preconception care prior to a subsequent pregnancy to ascertain appropriate weight, nutrition, exercise and signs of gestational diabetes mellitus. 31
An article on post partum management to reduce long term risks addresses that women with gestational diabetes mellitus are at increased risk for developing overt diabetes later in life. In addition their offspring exposed to the diabetes environment in utero are also at increased risk for developing obesity, glucose intolerance and type 2 diabetes later in life This article reviews the roles of medical nutrition therapy, physical activity and pharmacotherapy in preventing type – 2 diabetes in women with a gestational diabetes mellitus history.32
5. Studies related to diabetic foot care
A study was to assess the knowledge and practices among the diabetic patients regarding foot care. About 29.3% respondents had good knowledge, 40% had satisfactory knowledge and 30.7% had poor knowledge about foot care. Whereas only 14% respondents had good practices for foot care, 54% had satisfactory practices and 32% had poor practices. About one third of diabetic patients had poor knowledge about foot care and only very few patients had good practices for foot care. Literacy has significant association with the knowledge and practices related to foot care in diabetic patients33.
A study was done to assess the disease knowledge in patients attending a diabetic foot clinic. All diabetic patients attended the clinics because of their high-risk status for the development of diabetic foot infection or ulcers. All received ongoing foot-specific patient education. Only approximately 80% were able to respond appropriately to simple questions related to the care of their "at-risk" feet. This simple quality initiative reinforces the nation that patients with diabetes who are at risk for the development of diabetic foot ulcers should receive ongoing foot-specific patient education34.
A study was done to determine knowledge and practice of foot care in people with diabetes. The mean knowledge score was 6.5 out of a possible 11. There was a positive correlation between the score and received advice on foot care. Deficiencies in knowledge included the inability to sense minor injury to the feet (47.3%), proneness to ulceration (52.4%) and effect of smoking on the circulation (44.5%). 24.6% (20.1-29.2) never visited a chiropodist, 18.5% (14.2-22.7) failed to inspect their feet and 83% (79.1-86.9) did not have their feet measured when they last purchased shoes. The results highlight areas where efforts to improve knowledge and practice may contribute to the prevention of foot ulcers and amputation35.
The study was to evaluate an intensive diabetes foot care education program at high risk for foot ulcer. The patients who attended both education sessions improved their foot care knowledge over the course of the program. After the second session, the mean improvement over baseline was 14%. These patients also reported improved satisfaction with foot care; mean improvement was 33%.Intensive education program improved the foot care knowledge and behaviour of high-risk patients36.
The study was conducted to assess the knowledge and practices regarding foot care. Only one-third of the patients had received diabetic education. The average score in the educated group was 42 +/- 0.4 versus 23 +/- 7 in the non-educated group (p = 0.0001). The best results were obtained in educated and younger patients. Our findings demonstrate that elderly diabetics can benefit from an education program and prove a real insufficiency in current education of elderly diabetics37.
The study was conducted to assessed the knowledge of the diabetic patient on foot care research was to evaluate how much the clients that frequently went to the Diabetes Ambulatory, knew about their own ill, and the feet care. So the conclusion that could be taken is that the clients knew about the care that they must have with their feet to don't have complications, but the "own care" is not well done. To insert it in the rightly on their day-by-day they must have access to the information about diabetes, participation of the family, motivation and their own ability38.
A study was conducted to assess the effectiveness of patient education on the prevention of foot ulcers in patients with diabetes mellitus. Two reviewers undertook data extraction and assessment of study quality independently. Four trials compared the effect of intensive with brief educational interventions; two of these reported clinical endpoints. One study involving high-risk patients reported a reduction in ulcer incidence and amputation rate. Weak evidence suggests that patient education may reduce foot ulceration and amputations, especially in high-risk patients39.
ASSUMPTIONS:
-Residents of the selected rural community have some knowledge regarding diabetes mellitus.
-Socio-Demographic variables may have some influence on the level of knowledge regarding diabetes mellitus among residents of selected rural community.
MATERIALS AND METHODS:
A Non-Experimental, Quantitative Research Approach and Univariant Descriptive Research design was used in present study to assess the knowledge regarding diabetes mellitus among selected rural community residents i.e. village Talwandi Lal Singh situated 8 km away from Batala, Gurdaspur. The population for this study comprises of residents of selected rural community. Total population of village at time of data collection was 1165. Population above 18 year age i.e. accessible population fulfilling inclusion criteria was 853. The sample size for the present study consists of 100 residents of selected rural community selected by convenience sampling.
A self structured checklist was used to assess the knowledge regarding diabetes mellitus comprised of Selected socio demographic variables are Age, Gender, Type of family, Education, Occupation, Presence of disease, Duration of disease, Type of medicine and Source of information. Research tool comprises of following: PART 1- Selected Socio demographic variables. PART 2- Self structured checklist to assess the knowledge regarding Diabetes Mellitus. It consists of checklist to assess the knowledge regarding diabetes mellitus. The checklist consists of 30 statement.
ETHICAL CONSIDERATION:
Informed Consent obtained from study sample after discussing with each of them the purpose of the study and all related matters for the research purpose. Study participants were informed that obtained data is confidential and will be used only for research purpose.
RESULTS:
Major findings related to demographic variables
According to Age:
finding revealed that age group 18-29 yr have a average level of knowledge is 21% and the age group 30-41 yr have a average level of knowledge is 44%and the under age group 42- 54 yr have a average level of knowledge 17% and the under age of 42-54yr have a good knowledge is 5% and under the age group 18- 29 yr only 1% have a poor level of knowledge.
According to Gender:
Finding revealed that female have a average knowledge is 53% where as male have 37% level of knowledge and the female have good level of knowledge is 8% where as male have only 1% level of good knowledge.
According To Type Of Family:
Finding revealed that small family have a adequate level of knowledge is 54% where as joint family have a 32% and extended family have 4% level of knowledge and small family have a good level of knowledge is 8% and poor level of knowledge is 1%.
According To Education:
Finding revealed that 33% have a average level of knowledge had their primary education whereas 27% had their secondary education and the 5% people have good level of knowledge had a primary education where as 2% had a graduation education.
According To Occupation:
Finding revealed that people belongs to agriculture occupation have a average level of knowledge is 20% whereas labour have a 15% and housewife have a average level of knowledge 31%where as people belongs to labour have a good knowledge is 5% and people belongs to private job and housewife have a only 2% level of good knowledge.
According To Presence of Disease:
Finding revealed that 65% have a average level of knowledge having a no disease whereas 25% have a average level of knowledge having a disease and 6% people have a good level of knowledge having no disease.
According To Duration of Disease:
Finding revealed that 65% people have average level of knowledge having a no disease and the duration 0-1 yr and 2- 3yr duration have a average knowledge is 11% and people having no disease have a good knowledge is 6%.
According to Type of Medication:
Finding revealed that 65%people have a average level of knowledge having no disease and 14% taking allopathy medication. And 10% taking ayurvedic medication and 6% have a good level of knowledge having no disease whereas 2% people have a good level of knowledge taking ayurvedic medication.
According to Source of Information:
Finding revealed that people got knowledge from television have a average level of knowledge is 58% and from newspaper have a 18% level of knowledge and people have a good knowledge is 8% got information from television.
Major findings related to association of level of knowledge and demographic variable:
The association between the level of knowledge of residents of selected rural community with their demographic variables. The result revealed that there was a significant association found with the age, education, and occupation at the level of significance < 0.05 level.
Figure 2(j): knowledge among selected community about diabetes mellitus of Gurdaspur.
DISCUSSION:
1: To assess the level knowledge of selected community residents regarding diabetes mellitus:
A cross-sectional study was conducted in a Diabetic clinic at turkey to determine the level of knowledge on Diabetes in 524 rural adults with the age over 30 years using a questionnaire. The result showed that mean Diabetic knowledge score was 30.2+3.46. The result indicated that Diabetes knowledge was mild, moderate level knowledge in participants with Diabetes.40 In the present research study the knowledge score reveals that out of 100 community residents, 90% have average knowledge, 9% have good knowledge and only 1% have poor knowledge
2: To determine the association of level of knowledge of the selected community residents regarding diabetes mellitus with selected demographic variables:
The demographic variables analyzed in the were Age,
Gender, Type of Family, Education, Occupation, Presence of Disease, Duration of
Disease, Type of Medicine, Source of Information. The association between the
knowledge score and demographic variables was computed by using Chi-Square (
)
test. There was significant association found between the level of knowledge
and their Age, Education, Occupation and there was no significant association
found between the level of knowledge and their Gender, Type of Family, Presence
of Disease, Duration of Disease, Type of Medication and Source of Information
The study was conducted to assess the knowledge on diabetes mellitus of a
participants in terms of different charteristics. 45.6% participants had good
knowledge, 37. 7 participants had moderate and 16.7% participants had poor
knowledge. Knowledge was better among males than females was statistical
significant (p<0.001). Knowledge was higher among those with higher
education the difference was statistical significant. There was no significant
association with duration of disease.41
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