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Research Topic
To Assess The Knowledge, Attitudes and Practices
regarding Diabetes Mellitus among Adults in District
Ghotki Sindh.
Supervisor
Dr. Rabia Parveen Mangi
Assistant Professor
Department of Pharmacy Practice
By Faculty of Pharmacy
Sannaullah
M.Phil. Research Scholar University of Sindh Jamshoro
Department of Pharmacy Practice
Faculty of Pharmacy
University of Sindh, Jamshoro

Co-supervisor
Prof. Dr. Muhammad Ali Ghoto
Chairman Pharmacy Practice
Faculty of Pharmacy
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University of Sindh Jamshoro
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 Contents

 Introduction
 Statement of problem
 Scope of study
 Aims and Objectives
 Methodology
 Results
 Conclusion
 References

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 INTRODUCTION
 More than two-thirds (70%) of patients with diabetes mellitus (DM) reside in lower middle-
income countries [1]. The World Bank classifies Pakistan as a lower middle-income country [2
]. Pakistanis currently ranked 6th in terms of DM cases globally [3], with a DM prevalence of
6.9% [4].
 In 2020, Pakistan is projected to become the 4th leading country in the number of patients
with DM [3]. This increase may be attributed to altered lifestyles and the subtle nature of the
disease. A large proportion of Pakistan’s population remain undiagnosed until manifestation of
co-morbidities (i.e., eye disease, renal disorder [5]), with a reported 7.9 million people having
impaired glucose tolerance [1].
 Evidence suggests that various socio-demographic determinants, including poor health
knowledge, account for the epidemiologic shift of DM in lower middle-income countries [6,7
]. Growing evidence from knowledge, attitude, and practice (KAP) studies indicates there is
an urgent need to enhance DM awareness, early diagnosis, control of risk factors, and disease
management [8,9].
4
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 INTRODUCTION
 Most KAP studies have been conducted among diagnosed or newly diagnosed patients with DM
attending hospitals or healthcare centers [6,7,9]. However, KAP regarding DM and related
complications is seldom investigated in the general population. Therefore, there is a paucity of
research evidence, particularly from remote areas.

 Over the last decade, some studies were conducted to evaluate the occurrence and risk factors of
DM in rural and urban Pakistan [10,11] and others have evaluated co-morbidities associated
with diabetes [12,13]. However, no study has estimated the KAP regarding DM, along with its
treatment and management and risk factors in the general population of Punjab.

 An exception is a study that evaluated DM awareness among 383 respondents from the general
population of Bahawalpur and found that the majority (80.4%) were enthusiastic about attending
a DM awareness program [14]. Evidence from Mongolia, another low-resource country,
reported that in 2010, 20% of the general population had never heard about DM [6].

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 INTRODUCTION
 An Australian randomized controlled trial suggested that incorrect knowledge about DM risk
factors and motivation to make lifestyle changes were significantly associated with diet
modifications and exercise habits.

 That study also reported a strong association between lifestyle modifications and reduction in
waist circumference, body mass index, and blood glucose level (BGL) [15,16]. However,
these factors still remain challenges for developing countries, including Pakistan.

 In 2004, Pakistan formed a national action plan to prevent non-communicable diseases

(NCD). The main agenda in terms of DM was construction of a population-based NCD
surveillance system and integrated public health program. This aimed to integrate DM
prevention and ensure availability of anti-diabetics at all levels of healthcare [17].

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 INTRODUCTION
 Despite the high growth in NCD, the response by the National Action Plan Committee was
slow, and a World Health Organization (WHO) progress report found Pakistan lagged behind
the national NCD target level with a 25% increase in NCD-related deaths [18].

 In this context, no research has been conducted to evaluate the DM-related knowledge and
attitudes in the general population. Such research is important to clarify the knowledge levels
in the general population and evaluate the effect of increased knowledge on the prevalence of
DM.

 Therefore, our study aimed to investigate KAP regarding DM and clarify factors associated
with KAP among the general population in five districts in Punjab, Pakistan.

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 STATEMENT OF PROBLEM

Statement of the Problem: Despite the

growing prevalence of diabetes mellitus in
Ghotki City, there is a dearth of
comprehensive understanding regarding the
knowledge, attitudes, and practices (KAP)
among adults towards this chronic condition.
This knowledge gap hinders the development
of effective prevention and management
strategies tailored to the local context.
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 STATEMENT OF PROBLEM
 Key Issues:
1. Knowledge Deficiency: There is a lack of clarity regarding the
general understanding of diabetes mellitus among adults in Ghotki
City, including its etiology, risk factors, symptoms, and complications.
2. Attitudinal Barriers: Attitudes towards diabetes, including
perceptions of severity, cultural beliefs, stigma, and healthcare-
seeking behaviors, may influence individuals' engagement with
prevention and management efforts.
3. Practices and Behaviors: The daily practices and behaviors of
adults in Ghotki City concerning diet, physical activity, medication
adherence, and regular health check-ups remain poorly understood,
which can significantly impact disease outcomes.
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 SCOPE OF STUDY

The scope of the study on assessing knowledge, attitudes, and practices

regarding diabetes mellitus among adults in Ghotki City, Sindh, Pakistan can
be outlined as follows:

Geographic Scope: The study will focus specifically on Ghotki City, a

municipality in Sindh province, Pakistan. Data collection and analysis will be
limited to this geographic area to provide insights into the local context.

Population: The target population for the study includes adults (18 years
and older) residing in Ghotki City. The study may encompass a diverse
range of demographic groups, including various socio-economic
backgrounds, ethnicities, and educational levels.
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 SCOPE OF STUDY

Variables of Interest:
1. Knowledge: Understanding of diabetes mellitus,
including its causes, risk factors, symptoms, and
complications.

Attitudes: Perceptions, beliefs, and emotional responses

towards diabetes mellitus, including perceived severity,
cultural influences, stigma, and healthcare-seeking
behaviors.
Practices: Behaviors and actions related
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 OBJECTIVES OF STUDY
1.To evaluate the relationship between knowledge, attitudes, and practices: This objective
aims to assess the correlation between individuals' level of knowledge about diabetes mellitus, their
attitudes towards the disease, and their actual practices in terms of prevention and management
strategies.

2. To determine the prevalence of diabetes mellitus: This objective involves estimating the
prevalence of diabetes mellitus among adults in Ghotki City, providing valuable epidemiological data
for healthcare planning and resource allocation.

3. To explore sources of information about diabetes mellitus: This objective seeks to identify
the primary sources from which adults in Ghotki City obtain information about diabetes mellitus,
such as healthcare providers, media, family members, or community organizations.

4. To investigate perceptions of available healthcare services: This objective aims to

understand adults' perceptions of the quality, accessibility, and affordability of healthcare services
available for diabetes prevention, diagnosis, and treatment in Ghotki City.
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 OBJECTIVES OF STUDY
5. To assess the impact of diabetes mellitus on quality of life: This objective involves
examining the impact of diabetes mellitus on various aspects of individuals' quality of life, including
physical, emotional, social, and economic well-being.

6. To identify barriers to diabetes prevention and management: This objective seeks to

identify the barriers and challenges faced by adults in Ghotki City in adopting healthy behaviors,
accessing healthcare services, and adhering to diabetes management recommendations.

7. To explore cultural beliefs and practices related to diabetes: This objective aims to
understand the cultural beliefs, traditions, and practices that may influence individuals' perceptions
of diabetes mellitus and their behaviors related to prevention and management.

7. To assess knowledge, attitudes, and practices among specific demographic groups:

This objective involves analyzing variations in knowledge, attitudes, and practices regarding
diabetes mellitus among different demographic groups, such as age, gender, education level,
occupation, and socio-economic status.
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 METHODOLOGY
A cross-sectional survey to assess knowledge and
pratices of people with diabetes was conducted in
Ghotki.

 People with diabetes were interviewed using a

structured questionnaire from which data was
collected.

 Basic knowledge about diabetes, management,

lifestyle, diet and its complications were assessed
as well as the frequency of practices such as
keeping a blood glucometer at home and
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blood sugar with it.
 Results
 This study aimed to assess knowledge, attitudes, and practices
related to diabetes mellitus among adults in Ghotki, Sindh, Pakistan.
Out of a total of 220 adults, 70 individuals were assessed,
representing 31.8% of the target population. Among the assessed
individuals, 65.7% (46 out of 70) were male, while 34.3% (24 out of
70) were female as given in table-1.

 The findings revealed pervasive deficiencies in knowledge, attitudes,

and practices concerning diabetes mellitus among the assessed
adults. All participants exhibited very poor levels of knowledge,
negative attitudes, and unhealthy practices related to diabetes
management. Additionally, a concerning prevalence of multiple
complications, physical inactivity, poor dietary habits, and foot care
issues was observed among the assessed10/21/2
individuals.
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 Results
 Furthermore, the study found that 74.3% (52 out of 70) of the
assessed adults hailed from rural areas, while 25.7% (18 out of 70)
were from urban areas as shown in table-2. This disparity highlights
the need for tailored interventions across diverse geographic settings
to address the challenges associated with diabetes management.

 The data were collected through structured questionnaires

administered in clinics across District Ghotki, with explicit consent
obtained from both patients and healthcare professionals. The study
also observed that a large number of patients were illiterate and
belonged to a very poor socioeconomic background, emphasizing the
need for comprehensive and accessible healthcare services.

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 Results
 Table-1 Gender wise distribution of Patients:
Gender Number Of Patients Percentage

Male 46 66%

Female 24 34%

Number Of Patients

34%
Male
Female

66%

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 Results
 Table-2 Area wise distribution of Patients:
Gender Number Of Patients Percentage

Urban 18 26%

Rural 52 74%

Number Of Patients

26%
Urban
Rural

74%

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 Results
 Table-3 Age wise distribution of Patients:
Age Number Of Patients Percentage

25-30 2 3%

30-35 9 13%

35-40 21 30%

40-45 38 54%

Number Of Patients

3%
13%

25-30 30-35
54%
30%
35-40 40-45

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 Results
 Table-4 Literacy rate wise distribution of Patients:
Literacy Rate Number Of Patients Percentage

Primary 34 48%

Secondary 20 29%

High Secondary 16 23%

Number Of Patients

23% Primary
Secondary
High Secondary
49%

29%

20
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 Conclusion
 In Ghotki, Sindh, Pakistan, our study showed that many adults have
little knowledge about diabetes and don't practice healthy habits to
manage it. Their attitudes toward the disease are also negative. We
found that many people face multiple health problems related to
diabetes, like not being active enough, having poor diets, and not
taking care of their feet.
 Most of the people we talked to were from rural areas and didn't have
much education or money. This means they might face more
challenges in managing their diabetes.
 Our study is done with the help of patients and healthcare workers in
clinics across Ghotki. It's clear that we need to do more to help
people understand and manage diabetes better. By working together
and focusing on education and support, we can improve the health of
our community and reduce the impact of10/21/2diabetes.
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 REFERENCES
 [1] International Diabetes Federation. (2010). Types of diabetes.Retrieved September 25, 2014, from
http://www.idf.org/types-diabetes.
 [2] Global report on Diabetes, World Health Organization. ISBN 978 92 4 156525 7 (NLM classification:
WK 810), 2016.
 [3] DIABETES IN PAKISTAN – 2015,Middle East and North Africa region (MENA), International Diabetes
Federation (2015). 166 Chaussee de La Hulpe, B-1170 Brussels, Belgium.
 [4] Din I. Health Outcomes and the Pakistani Population. Cambridge Scholars Publishing; 2014.
 [5] Rashid M Ansari, John B Dixon, Jan Coles. Type 2 Diabetes: Challenges to Health Care System of
Pakistan, International Journal of Diabetes Researchp-ISSN: 2163-1638 e-ISSN: 2163-1646 2015; 4(1):
7-12. doi:10.5923/j.diabetes.20150401.02
 [6] Arshad Hussain, Iftikhar Ali, Diabetes Mellitus in Pakistan: A major Public Health Concern.
Article; January, 2016. DOI: 10.4103/2045-080X.174943.
 [7] Ansari RM, Dixon JB, Browning CJ. Self‑management of type 2 diabetes in middle‑aged population of
Pakistan and Saudi Arabia. Open J Prev Med 2014;4:396‑407.
 [8] Médicins du Monde, Pathway Component: Caring capacity & practices; health care. Date of Design:
2011 Search Category: health & nutrition services; caring capacity, norms, & Contact Institution:
http://www.medecinsdumonde.org/Outils/Nous-contacter practices URL: http://tinyurl.com/ok9p72y.
10/21/2 22
024
 REFERENCES
 [9] Standards of Medical Care in Diabetes—2014. American Diabetes Association, Diabetes
Care 2014 Jan; 37(Supplement 1): S14-S80. http://dx.doi.org/10.2337/dc14-S014.
 [10] David M. Nathan, for the DCCT/EDIC Research Group. The Diabetes Control and
Complications Trial/Epidemiology of Diabetes Interventions and Complications Study at 30
Years: Overview.Diabetes Care 2014 Jan; 37(1): 9-16.http://dx.doi.org/10.2337/dc13-2112.
 [11] Alexandria, VA, Medical Management of Type 2 Diabetes, 2012. American Diabetes
Association.
 [12] David K McCulloch, MD, Patient education: Preventing complications in diabetes mellitus
(Beyond the Basics). Sep 2016.
 [13] A McInnes, W Jeffcoate, L Vileikyte, F Game, K Lucas, N Higson, L Stuart, A Church, J
Scanlan, and J Anders. Foot care education in patients with diabetes at low risk of
complications: a consensus statement. Diabet Med. 2011 Feb; 28(2): 162–167.doi:
10.1111/j.1464-5491.2010.03206.x
 [14] Kent D1, D'Eramo Melkus G, Stuart PM, McKoy JM, Urbanski P, Boren SA, Coke L, Winters
JE, Horsley NL, Sherr D, Lipman R.Reducing the risks of diabetes complications through
diabetes self-management education and support.Popul Health Manag. 2013 Apr;16(2):74-
81. doi: 10.1089/pop.2012.0020. Epub 2013 Feb 13. 10/21/2 23
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