Diabetes knowledge, positive attitudes, good self-management practices and adherence to medication are important in diabetes care because of the chronic nature of the disease requiring long-term maintenance treatment. This study was conducted to assess present knowledge, attitude and practices of patients in the management of type 2 diabetes. Under a cross-sectional design, one hundred and three out-patients with type 2 diabetes mellitus that have been on oral anti-diabetic medication for at least a year prior to study were assessed through a validated knowledge, attitude and practice (KAP) questionnaire.  The mean age of participants was 59.68±11and mean duration of diabetes was 7.22±4.7 More than half, 80.6% were males and 19.4% were females. 38.2% had good glycaemic control. Majority (79.6%) had poor diabetes knowledge. Years of formal education (p=0.01) and duration of illness (p=0.02) was significantly associated with diabetes knowledge, attitudes and self care practices. Treatment non-compliance among subjects was 34.9%. Respondents were more willing to practice dietary modification (57.3%) than active exercises (33.0%). Use of alternative medication was reported by 18.5% of participants. There is the need for health educational interventions to improve the knowledge, attitude and practices of patients with type 2 diabetes.

Keywords:  Diabetes mellitus, knowledge, attitude, practice, Nigeria.  

1. DF: IDF Diabetes Atlas, 6th edition, Brussels, Belgium: International Diabetes Federation, 2013. (http://www.idf.org/diabetesatlas/update-2014)
2. World Health Organization. Prevention of diabetes mellitus. Report of a WHO Study Group No. 844. Geneva: World Health Organization; 1994.
3. King H, Aubert RE, Herman WH. Global burden of Diabetes, 1995–2025. Diabetes Care. 1998;21(9):1414-1431.
4. International Diabetes Federation Diabetes Atlas (5th ed.) 2012 update. Available from: http://www.idf.org/sites/default/files/5E_IDFAtlasPoster_2012_EN.
5. Kasper L. Harrison’s principle of internal medicine, 17th ed. Graw Hill Company: 2008.
6. Roglic G, Unwin N, Bennett PH, Mathers C, Tuomilehto J, Nag S, Connolly V, King H.The burden of mortality attributable to diabetes: Realistic estimates for the year 2000. Diabetes Care. 2005;28(9):2130-2135
7. McPherson ML, Smith SW, Powers A, Zuckerman IH (2008) Association between diabetes patients’ knowledge about medications and their blood glucose control. Res Social Adm Pharm Mar; 4(1):37–45.
8. Norris SL, Engelgau MM, Narayan KM. Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. Diabetes Care 2001;24:561–87.
9. Duke SA, Colagiuri S, Colagiuri R. Individual patient education for people with type 2 diabetes mellitus. Cochrane Database Syst Rev 2009;21;(1):CD005268
10. World Health Organization. Global health risks: mortality and burden of disease attributable to selected major risks. 2009.
11. World Health Organization. Global recommendations on physical activity for health. 2010.
12. Demaio AR, Dugee O, De Courten M, Bygbjerg IC, Enkhtuya P, Meyrowitsch DW.Exploring knowledge, attitudes, and practices related to alcohol in Mongolia: anational population-based survey. BMC Public Health. 2013;13(1):178.
13. Rani P, Raman R, Subramani S, Perumal G, Kumaramanickavel G, Sharma T. Knowledge of diabetes and diabetic retinopathy among rural populationsin India, and the influence of knowledge of diabetic retinopathy on attitude and practice. Rural Remote Health. 2008;8(3):838.
14. Zaman MJ, Patel A, Jan S, Hillis GS, Raju PK, Neal B, Chow CK. Socio-economic distribution of cardiovascular risk factors and knowledge in rural India. Int J Epidemiol. 2012;41(5):1302-1314

15. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann InternMed. 2011;155(2):97-107
16. Al-Maskari F, El-Sadig M, Al-Kaabi JM, Afandi B, Nagelkerke N, Yeatts KB.Knowledge, attitude and practices of diabetic patients in the United Arab Emirates. PLoS One. 2013;8(1):e52857.
17. Department of Health 2002. National service framework for diabetes: Standards. London: Department of Health; 2002
18. American Diabetes Association. Clinical practice recommendations 2000. Diabetes Care. 2000;23(suppl 1):S1-11
19. Mukhopadhyay P, Paul B, Das D, Sengupta N, Majumder R. Perceptions and practices of type 2 diabetics: A cross-sectional study in a tertiary care hospital in Kolkata. Int J Diabetes Dev Ctries. 2010; 30: 143-9.
20. International Diabetes Federation IDF2011: Global burden of diabetes.; Diabetes Atlas. (5th edition) 2011. Available from: www.idf.org/diabetesatlas/se/the-global-burden .
21. He X, Wharrad H. Diabetes knowledge and glycemic control among Chinese people with type 2 diabetes. Int Nurs Rev. 2007;54(3):280–7.
22. Shah VN, Kamdar P, Shah N. Assessing the knowledge, attitudes and practice of type 2 diabetes among patients of Saurashtra region, Gujarat. Int J Diab Developing Countries. 2009;29(3):118.
23. Gul N. Knowledge, attitudes and practices of type 2 diabetic patients. J Ayub Med Coll Abbottabad .2010; 22: 128-31.
24. Adebisi SA, Oghagbon K, Jimoh AK, Akande T, Olarinoye JK. Quality of diabetic care in a tertiary health care facility in Ilorin, Nigeria. Diabetol Croat. 2009;31:38–2.
25. Clifford RM, Davis WA, Batty KT, Davis TME. Effect of a Pharmaceutical Care Program on Vascular Risk Factors in Type 2 Diabetes: The Fremantle Diabetes Study. Diabetes Care 2005; 28:771–6.
26. Ben Abdelaziz A, Thabet H, Soltane I, Gaha K, Gaha R, et al. Knowledge of patients with type 2 diabetes about their condition in Sousse,Tunisia. East Mediterr Health J2007; May–Jun; 13(3):505–14
27. He X, Wharrad HJ. Diabetes knowledge and glycemic control among Chinese people with type 2 diabetes. Int Nurs Rev 2007;Sep; 54(3):280–7
28. Murata GH, Shah JH, Adam KD, Wendel CS, Bokhari SU, et al. Factors affecting diabetes knowledge in Type 2 diabetic veterans. Diabetologia 2003;46:1170–8.
29. Gagliardino Juan, González Claudio, Caporale Joaquín. The diabetes-related attitudes of health care professionals and persons with diabetes in Argentina. Rev Panam Salud Publica. 2007 Nov;22(5):304-7.
30. Xie W, Zhao Y, Zhang Y. Traditional chinese medicines in treatment of patients with type 2 diabetes mellitus. Evid Based Complement Alternat Med. 2011;2011:726723
31. Hjelm K, Mufunda E. Zimbabwean diabetics’ beliefs about health and illness: an interview study. BMC Int Health Hum Rights. 2010;10:7.
32. Gbolade AA. Inventory of antidiabetic plants in selected districts of Lagos State, Nigeria. J Ethnopharmacol. 2009;121(1):135–139
33. Modak M, Dixit P, Londhe J, Ghaskadbi S, Paul ADT. Indian herbs and herbal drugs used for the treatment of diabetes. J Clin Biochem Nutr. 2007;40(3):163–173.
34. Cramer JA.A systematic review adherence with medications for diabetes. Diabetes Care 2004; 27: 1218– 1224.
35. Albert UK, Effiong JH. Medication non-adherence in type 2 diabetes: prevalence and correlates in a tertiary healthcare facility in southeast Nigeria. Int J Health Sci Res. 2015; 5(9):53-61
36. Tans AS, Yong LS, Wan S, Wong ML. “Patient education in the management of Diabetes Mellitus”. Singapore Med. J. 1997; 38 :156-60
37. Awah P.K. Diabetes and traditional medicine in Africa. Diabetes Voice 2006;51:3:24-26.

Dr Jombo Henry Effiong

Department of Psychiatry, University of Uyo, Akwa Ibom state, Nigeria