Results and Discussion

Chapter 6
Discussion
DISCUSSION
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia

resulting from defects in insulin secretion, insulin action, or both. The chronic
hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure
of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.
This study was conducted to improve the knowledge regarding disease characteristics,
natural course, complications and management of diabetes mellitus. The study was
conducted for 6 months from December 2015 to May 2016 in a tertiary care hospital. A
total of 150 participants were selected in the study of which 100 are diabetic patients and
50 were non diabetic subjects.
Table 1 shows demographic characteristics of participants. Most of the patients were in
the age group of 41-59 yrs and the lowest age group was 20-40yrs. Diabetic patients
which include 64(64%) men, 36(36%) women and non diabetic patients include 21(42%)
men, 29(58%) women. The mean and standard deviation of diabetic and non diabetic
patients regarding gender was 5019.8 and 465.65. In our study knowledge regarding
diabetes mellitus was increase in graduates which was consistent with the study done by
(Nehad M. Hamoudi et al 2012). The mean and standard deviation of educational status
of diabetic patients was 19.85.44 and non diabetic subjects were 39.610.8. 36%
diabetic and 14% non diabetic patients had family history of diabetes where as 64%
diabetic and 72% non diabetic had no family history of diabetes. The mean and standard
deviation for family history of diabetic patients was 5019.8 while in non diabetic
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Assessment of diabetes related health knowledge, attitude and practice among diabetics and non
diabetics using self prepared questionnaire for awareness of health promotion
Chapter 6
Discussion
patients 5031.1. Most of the responders had duration of disease >5 yrs where as 27% of
people were having duration of disease <1yr .Mean and standard deviation of their
duration of illness was 337.77.Majority of the diabetic and non diabetic subjects are
overweight and their mean and standard deviation were 2022.29,1012.38.
Knowledge regarding risk factors of diabetes mellitus
Table 8, Figure 7 shows the knowledge regarding the risk factors of diabetes. 63%
diabetic patients and 78% non diabetic patients were having idea that hereditary is one of
the major risk factor for diabetes mellitus. 48% diabetic and 45% non diabetic were
aware that obesity can cause diabetes mellitus. While coming to other risk factors 19%
diabetic and 40% non diabetic, 27% diabetic and 24% non diabetic have the awareness
on hypertension and lack of physical activity. Smoking also one cause and it was found to
be aware in 19% diabetic and 28% non diabetic subjects. In the present study 28%
diabetic patients and 8% non diabetic patients was found to be not aware of any risk
factor of diabetes. Mean and standard deviation of diabetic and non diabetic patients
regarding risk factors was found to be 23.120.73, 27.5 24.5.
Knowledge regarding complications of diabetes mellitus
In this study regarding knowledge and awareness on diabetes Table 10, Figure 9 shows
the percentage of knowledge on complications of diabetes for both diabetic and non
diabetic subjects. It shows 4% diabetic and 4% non diabetic was aware on all
complications.
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Chapter 6
Discussion
Eye Complications: 69% diabetic patients and 58% non diabetic patients knew that DM
can affect your eye.
Cardiac complications: 51% diabetic and 54% non diabetic patients knew that DM is a
risk factor for developing heart diseases.
Kidney complications: As regards the kidney complication of DM, 59% diabetic and 54%
non diabetic were aware that DM is a risk factor for renal diseases.
CNS complications: 28% diabetic and 18% non diabetic respondents were aware that
Diabetes can affect nerves leading to neuropathy while 1% diabetic and 2% non diabetic
knew that it can affect the blood vessels. 21% diabetic and 18% non diabetic patients
were unaware of diabetes mellitus.
Knowledge regarding symptoms of diabetes mellitus
Tab 9, fig 8 shows the comparison between diabetic and non diabetic patients towards
knowledge of symptoms. The results showed that the respondents had a fairly good
understanding of the symptoms of diabetes. Early recognition of symptoms may aid in
early detection of the disease, allowing for prompt treatment, the public would not take
the symptoms lightly and would seek prompt medical attention. The symptoms of Type
2 diabetes are so mild those patients who are fortunate to be diagnosed early do not
require long term therapy. It is important to educate the public about the complications
of diabetes mellitus, so that they could encourage their diabetic friends or relatives to
comply with therapy. This may reduce the burden of diabetes and its complication. Only
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Chapter 6
Discussion
1% diabetic and none of diabetic patients were aware on diabetic symptoms. Majority of
Responders (71% diabetic and 80% non diabetic) were aware on Polyuria as a diabetic
symptom for where 37% diabetic and 34% non diabetic were aware on polydypsia as a
diabetic symptom, 34% diabetic and 26% non diabetic, 67% diabetic and 36% non
diabetic, numbness of hands as 38% diabetic and 14% non diabetic, 48% diabetic and
20% non diabetic, 6% diabetic and 4% non diabetic were aware on abnormal sensation of
feet ,numbness of hands, nocturia weight loss as a symptoms of diabetes mellitus.
4% diabetic and 4% non diabetic participants were unaware of any of the symptoms
of diabetes.
Knowledge regarding management of diabetes
It is essential that diabetic patients should possess good knowledge about their illness in
order to improve their self-management skills and there by prevent complications.
Research has found that less frequent self-care behaviors were evident among particularly
high -risk diabetic patients with lower educational levels. For instance, while over 90%
Knew that diabetes can be managed with dietary modification and drugs, only about a third
(Mostly males) of our study participants knew that exercise is an essential component of
diabetes management. Lifestyle patterns and exercise is known to be very important in
management of metabolic disorders like type 2 diabetes mellitus. This study included a set
of questions addressing the lifestyle and exercise status of the respondents. Fig 11
shows that 27% diabetic and 20% non diabetic subjects check their glucose levels by the
glucometer. 50% diabetic and 44% non diabetic patients are aware on the advantage of
physical activity in diabetic patients. 28% diabetic and 84% non diabetic participants gave
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Chapter 6
Discussion
correct responses to the daily physical activity. 72% diabetic and 16% non diabetic gave
incorrect response to daily physical activity. But only 23% diabetic and 4% non diabetic
subjects with sedentary lifestyle did walking, 8% diabetic and 2% non diabetic subjects
did the aerobic exercises for 30 minutes a day for four or more days a week. The general
awareness about the metabolic disorders and associated conditions was found to be much
lower in the study Population.
In this study fig 14 shows that the mean of FBG and PPBG values were very high during
their first visit and after providing necessary interventions like diet chart, insulin
administration technique chart and patient counseling. The mean of FBG and PPBG values
has been decreased during their second visit.
By using the study done by (Shahnooshi Javad et al 2014) we gave scores for the each
question. (Aware =2, partially aware=1, unaware=0) answered by both diabetic and non
diabetic patients. The mean score for each section (risk actors, and complications,
symptoms and self care practices) was calculated based on the total possible score in each;
then it was expressed as mean standard deviation (SD) and then analysis was done by
using one way ANOVA. The P value =0.001 which is highly significant .It shows that
diabetic patients had more knowledge than non diabetic patients .overall study show
that in diabetic male patients have good knowledge towards DM etiology and
complications than females. But in non diabetics, females have more knowledge towards
risk factors and low knowledge towards DM clinical manifestation than males.
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Chapter 6

Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia

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