Assessment of Knowledge, Attitude and Practice Regarding Insulin Use and its Adverse Effects in Adult Diabetic Population in a Tertiary Care Hospital

Abstract

Background and Aims: A proper assessment and understanding of knowledge, attitude and practice factors among patients is helpful in diabetes, for which prevention and control necessitate a lifelong adoption of healthy lifestyles. This study aims to assess the knowledge, attitude and practice regarding insulin use and its adverse effects among the diabetic population. Methods: A cross-sectional, observational, questionnaire-based study was conducted over a period of three months on patients of both type 1 and type 2 diabetes mellitus on insulin therapy for more than three months and attending medicine/diabetes outpatient department in a tertiary care hospital. A pretested structured questionnaire comprising of 27 items was administered through a face-to-face interview. Results: Responses from 295 subjects were analyzed. Most of the subjects were unaware of different types of insulin (65.8%), believed that insulin could be stopped once blood glucose levels normalize (63.1%) and did not keep a readily available source of blood glucose when went out (53.9%). Males were more knowledgeable regarding insulin use and adverse effects compared to female (p ≤0.0063). Higher education was associated with good practice regarding insulin use (p≤0.0287). Longer duration of diabetes was associated with better knowledge (p≤0.0004). Longer duration of insulin use was associated with better knowledge (p≤0.0001) and practice (p≤0.0155). Conclusions: A proper educational intervention is needed that may create awareness among insulin users on the aspect of knowledge that would rather improve their attitude and practice.

References

1. 1.Powers AC. Diabetes mellitus. In: Kasper DL, Fauci AS, Longo DL, Ameson JL, Loscalzo J, Hauser SL, et al., editors. Harrison’s Principles of Internal Medicine. 18th Edition. New York: The McGraw-Hill Companies, Inc.; 2012.
2. 2.ChoNH,ShawJE,KarurangaS,Huang Y, Da Rocha Fernandes JD, Ohlrogge AW, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017andprojectionsfor2045.Diabetes Res Clin Pract. 2018 Apr;138:271-81.
3. 3.International Diabetes Federation. IDF diabetes atlas: 9th ed. 2019 [document ontheinternet].Availablefrom:https:// www.diabetesatlas.org/upload/resources/material/20200302_133351_IDFA- TLAS9e-final-web.pdf [Last accessed on 2022 Jul 27]
4. 4.Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R, et al. Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy: A consensus statement of the American Diabetes Association and the EuropeanAssociation for the Study of Diabetes. Diabetes Care. 2009 Jan;32(1):193-203.
5. 5.United States Centers for Disease Control and Prevention. Diabetes data and trends: Age-adjusted percentage of adults with diabetes using diabetes medication, by type of medication, United States, 1997- 2011 [document on the internet] 2013. [Last accessed on 2013 Nov 20]. Available from: http://www.cdc.gov/diabetes/statistics/ meduse/fig2.htm .
6. 6.Kapur A, Shishoo S, Ahuja MMS, Sen V, Mankame K. Diabetes care in India-Patient’s Perceptions,Attitudes and Practices. Int J Diabetes Dev Ctries. 1997;17:5–14.
7. 7.Alberti G. The Diabetes Attitudes, Wishes, and Needs (DAWN) study. Prac Diabetes Int 2002 Jan;19:22-4.
8. 8.Peyrot M, Rubin RR, Lauritzen T, Skovlund SE, Snoek FJ, Matthews DR, et al. Resistance to insulin therapy among patients and providers: Results ofthecross-nationalDiabetesAttitudes, Wishes, and Needs (DAWN) study. Diabetes Care. 2005 Nov;28(11):2673-9.
9. 9.Ramachandran A, Jali MV, Mohan V, Snehalatha C, Vishwanathan M. High prevalence of diabetes in an urban population in south India. BMJ. 1988 Majmaah Journal of Health Sciences ,Vol. 11, Issue 2, April - 2023, Ramadan - 1444 103 Assessment of Knowledge,Attitude and Practice Regarding Insulin UseAnd ItsAdverse Effects InAdult Diabetic Population InATertiary Care Hospital Sep;297(6648):587–90.
10. 10.Mishra A, Pandey RM, Devi JR, Sharma R, Vikram NK, Khanna N. High prevalence of diabetes, obesity and dyslipidemia in urban slum population in northern India. Int J Obes Relat Metab Disord. 2001 Nov;25(11):1722–9.
11. 11.Madhu SV, Rao PV. Epidemiology of diabetes mellitus in India. In: Tripathi BB, Chandalia HB, editors. RSSDI Textbook of Diabetes Mellitus. 2nd ed. Hyderabad: Research Society for study of diabetes in India; 2008. p. 209–26.
12. 12.RamachandranA, Snehalatha C, Kapur A, Vijay V, Mohan V, Das AK, et al. High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia. 2001 Sep;44(9):1094–101.
13. 13.ShahVN,KamdarPK,ShahN.Assessing the knowledge, attitudes and practiceoftype2diabetesamongpatientsof Saurashtra region, Gujarat. Int J Diabetes Dev Ctries. 2009 Jul;29(3):118–22.
14. 14.Priyanka Raj CK, Angadi MM. Hospital-based KAP study on diabetes in Bijapur, Karnataka. Indian J Med Spec. 2010;1(2):80–3.
15. 15.Malathy R, Narmadha MP, Ramesh S, Alvin JM, Dinesh BN. Effect of a diabetescounselingprogrammeonknowledge, attitude and practice among diabetic patients in Erode district of South India. J Young Pharm. 2011 Jan- Mar;3(1):65–72.
16. 16.Nivethitha T, Manickavasagam S, Paramasivam M, Sai Thaejasvi G. Knowledge, attitude and practice of insulin use and its adverse effects in adult diabetic population. International Journal of Basic & Clinical Pharmacology. 2017 Nov;6(11):2651-7.
17. 17.Tripathy JP, Thakur JS, Jeet G, Chawla S, Jain S, Pal A, et al. Prevalence andrisk factors of diabetes in a large community based study in North India: results from a STEPS survey in Punjab, India. Diabetol Metab Syndr. 2017 Jan;9:1-8.
18. 18.Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al.Prevalenceofdiabetesandprediabetes(impairedfastingglucoseand/orimpaired glucose tolerance) in urban and rural India: phase I results of the Indian Council of Medical Research–India DIABetes (ICMR–INDIAB) study. Diabetologia. 2011 Dec;54(12):3022-7.
19. 19.Behera SK, Behera RR, Thakur H. A study of knowledge and practices inprevention of type 2 diabetes mellitus among Bhilai steel plant employees. Indian J Med Spec. 2012;3:143-8. 104 Majmaah Journal of Health Sciences ,Vol. 11, Issue 2, April - 2023, Ramadan - 1444 Assessment of Knowledge,Attitude and Practice Regarding Insulin UseAnd ItsAdverse Effects InAdult Diabetic Population InATertiary Care Hospital
20. 20.Choudhury SD, Das SK, HazraA. Survey of knowledge-attitude-practice concerning insulin use in adult diabetic patients in eastern India. Indian J Pharmacol. 2014; 46(4): 425–9.