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

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..
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)..
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..
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)..
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..