Key findings:

Key findings from this study on knowledge about diabetes mellitus (DM) risk and preventive factors among primary care center attendees in Dhanot, District Kangra, Himachal Pradesh, include: low awareness levels with 47.25% recognizing aging as a risk factor, 58.75% identifying family history, and 75.25% acknowledging unhealthy diet as a risk factor for DM. Additionally, 77% recognized regular exercise and yoga as a preventive measure for DM.

What is known and what is new?

The known aspect in this abstract is the importance of assessing awareness and knowledge of diabetes mellitus (DM) risk and prevention factors. The new contribution is the specific evaluation conducted in Himachal Pradesh, focusing on attendees of a primary care center in Dhanot, District Kangra, providing insights into the level of awareness in this region.

What is the implication, and what should change now?

The implication of this study is the need for targeted health education programs to improve community awareness about DM risk factors and preventive measures in Himachal Pradesh. Changes needed include developing and implementing comprehensive educational interventions, leveraging primary care settings to reach a wider audience, and addressing knowledge gaps to empower individuals in adopting healthy lifestyle practices for DM prevention.

INTRODUCTION

With an estimated global incidence of 2.8 percent in 2000 and a projected prevalence of 4.4 percent in 2030, diabetes mellitus (DM) is a growing public health issue (171 million in 2000 to 366 million in 2030). India, a developing nation going through a rapid epidemiologic transformation, has seen a consistent rise in the prevalence of diabetes mellitus from 7.1% in 2009 to 8.9% in 2019. Although there is no known cause for DM, several of its modifiable lifestyle-related risk factors have been found and investigated. [1,2]

The growing body of research indicates that DM may be curable if its risk factors are recognised and managed early. In people who are at high risk of developing DM, lifestyle measures (such as physical activity and weight loss) have been shown to be more beneficial than medication in avoiding or delaying the beginning of the condition. However, before adopting any form of intervention, it is necessary to understand the unique needs of these communities in order to translate such research into an effective community intervention programme. [3,4]

The first step in prevention is educating the public on DM risk factors and preventative strategies so that they can decide for themselves whether to follow a healthy lifestyle. Additionally, accurate and valid data about the prevalence and contributing factors of DM-related health disorders in the population are required for both policymakers and public health practitioners. In order to create, carry out, and assess effective intervention programmes, these data are required. [5,6] 

A number of studies conducted in different parts of India reveal widespread ignorance about Diabetes Mellitus among people. As this disease largely relies on prevention and the right information at the right time is essential to bring about a behavioral change when the population is most receptive. Hence, this study was undertaken with the objective to assess the knowledge of risk and preventive factors for Diabetes Mellitus among OPD patients attending Primary Health Center, Dhanot of District Kangra. 

To evaluate the knowledge of patients attending OPD towards risk and preventive factors for Diabetes Mellitus among OPD patients attending Primary Health Center, Dhanot of District Kangra.

1. Research Approach -Descriptive

2. Research Design-Descriptive survey design

3. Setting of the study- OPD at Primary Health Center, Dhanot  of District Kangra

4. Study duration- between Aug- December 2020

5. Study population- OPD patients attending Primary Health Center, Dhanot  of District Kangra 

6. Sample size-400 OPD patients assuming 50% have adequate knowledge regarding Diabetes Mellitus, 5% absolute error, 95% confidence level, and 5% non response rate.

7. Sampling Technique- convenience  Sampling Technique

8. Sampling criteria- first five adult patients attending the OPD of Primary Health Center, Dhanot of District Kangra everyday were selected till the completion of sample size after explaining the purpose of the study. Informed consent was taken from  them and confidentiality  of the selected  participants was also maintained 

9. Inclusive Criteria- Patients selected during the day of data collection in study setting and who were willing to participate in the study.

    

• Exclusion Criteria: Patients who were not willing to participate in the study 

• Development of Tool-Knowledge related questionnaires

• Description of Tool

   

Section A-Socio-demographic characteristics of the patients (Age, Gender etc.).

Sections B- Questions regarding knowledge of risk and preventive factors for Diabetes Mellitus

• Validity of tool - by the experts in this field

• Permission- obtained from the concerned Medical Officer Incharge of the health center

• Data collection by myself and patients  was given 5 minutes time to complete that questionnaire and collected at the end of the prescribed time

• Data analysis with appropriate statistical test in terms of frequencies and percentage.

The present study was Non-experimental descriptive study carried out to evaluate knowledge of risk and preventive factors for Diabetes Mellitus at Primary Health Center, Dhanot of District Kangra.

In the present study 35% (140) of the Patients fall were below 40 years of age while 65% (260) were above 40 years.  54% (216) of patients were male and 46% (184) were female. 

Table 1: Knowledge about risk factors of Diabetes Mellitus among participants

In the present study in table 1, 102 (25.5%) participants told the Genetic is the risk factor of diabetes, 189 (47.25%) Ageing 235 (58.75%) Family History, 234 (58.5%) Lack of physical activity/Exercise, 198 (49.5%) Obesity, 87 (21.75%) Smoking, 43 (10.75%) Alcohol, 301 (75.25%) Unhealthy diet, 107 (26.75%) High blood pressure and 47 (11.75%) didn’t know any risk factors of Diabetes Mellitus

Table 2: knowledge of participants towards Prevention of Diabetes Mellitus

In the present study in table 2, 201 (50.25%) participants told that Maintenance of ideal weight is the preventive factor for diabetes, 308 (77%) Regular Exercise & yoga, 287 (71.75%) Eat healthy food, 102 (25.5%) Reduce your portion sizes, 208 (52%)           

Stop Smoking, 87(21.75%) Stop Alcohol Intake, 109 (27.25%) Control Blood Pressure, 198 (49.5%) Avoid Stress, 175 (43.75%) Skip fad diets and 43 (10.75%) didn’t know any preventive factors for diabetes.

The lack of knowledge of risk factors of a disease (DM in this case) may impede preventive efforts such as the adoption of positive lifestyle changes. Therefore, a knowledge-based perception of personal risk for the disease appears to be an important factor in many preventive health behaviors.

In this study many participants were not able to correctly mention more than two risk factors or preventive measures for diabetes. This lack of knowledge could be explained by educational status. The failure to recognize risk factors and symptoms may also reflect the public's significant lack of knowledge about diabetes. It is likely to have negative repercussions in terms of prevention or early diagnosis of diabetes. It can also have a huge negative impact on the economy of developing countries. This study underscores the urgent need to improve the knowledge and awareness about diabetes particularly in the Hilly State of Himachal Pradesh. Studies from India had shown that repeated exposures to healthy lifestyle education were necessary for achieving compliance with treatment recommendations. [7-10]

Facilities for such integrated patient education modalities are not available in countries like India where prevalence of diabetes is increasing. Creating awareness about the disease, its risk factors and preventive measures is the first step in the crusade against the disease. For countries like India having a huge burden of diabetes, a structured national program for creating awareness about the disease should be considered as a public health priority. [11,12]

We may have underestimated the level of knowledge, as a limitation of having used unaided open-ended questions within the questionnaire as opposed to mentioning specific risk factors. However, we believe that this question type allowed for identification of the most known DM risk factors and preventive measures.

Still many respondents didn’t know about the risk as well as preventive factors of Diabetes Mellitus. Several findings from this study support the need for well-designed health education programs at the community level for primary prevention of DM. The program should address each person’s unique situation and cater to interpersonal variation, and should include the local needs of the older and undereducated population in particular.

Funding: No funding sources.

Conflict of interest: None declared.

Ethical approval: The study was approved by the Institutional Ethics Committee of Himachal Pradesh.

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