Department of Community Health Nursing, Shri B.V.V.S. Institute of Nursing Sciences Bagalkot, Karnataka
Background: The requirements of people suffering from diabetes are not only confined to the control of blood glucose; there is also a need to prevent disabilities, side effects, and difficulties in rehabilitation. The variety of kind 2 diabetes mellitus (T2DM) sufferers and associated remedy fees are swiftly increasing. Consequentially, more cost-effective and efficient strategies for the treatment of T2DM are needed. One such approach is enhancing patients’ self-management. Methods: A Hospital-based cross-sectional study was conducted from June 13 to July 8, 2024. A overall of eighty college students had been decided on the usage of the stratified random sampling technique. The study was conducted at Shri Tulasigirish Diabetes Hospital & Research Foundation, Bagalkot. A established and organized questionnaire turned into used to gather baseline data. Result: Assessment of self care management among patient. The range value is 0–15, the mean value is 9.46, the minimum value is 0, the maximum value is 15, the standard deviation is 0.48, and the mean percentage is 31.95%. The calculated chi square value of 0.83 (P value 0.36) suggests there is a significant association between self care management and current medication among patients. The calculated chi square value of 1.02 (P value 0.31) suggests there is a significant association between self care management and their received information about diabetes self care among patients. Conclusion: The findings of this study showed that there is an association between self care management and their current medication, received information about diabetes self care among patients. They need to improve their self care management of patients.
Diabetes mellitus (DM), that's defined through an extended blood glucose level, is a metabolic sickness of a couple of etiologies ensuing in disturbances of carbohydrate, fat, and protein metabolism due to dysfunction in insulin secretion, insulin action, This long-lasting high blood glucose level and the resultant metabolic deregulations is associated with secondary damage in multiple organ systems, specifically the kidneys, eyes, nerves, and blood vessels.
Diabetes has its effects all over the body's system due to the derangement of metabolically activities produced due to an increase in blood glucose level, specifically when adequate maintenance of Diabetes throughout a sure duration is under the most advantageous level.1 It is important to provide them with suitable self-management support. This way, success of self management will increase and complications and related costs of T2DM can be reduced.2
Previously it was thought that diabetes happens in just developed nations, but newer studies and results have shown that there is an increase in newer patients with type 2diabetes, with graduation being very early and mainly related to facet outcomes and headaches in growing nations. 3
Self-management support is one of the essential components of the Chronic Care Model, a well-known guide to improve the management of chronic conditions.4 Diabetes Mellitus is progressive, chronic and multi factorial endocrine disorder characterized by elevated serum glucose levels. It has a direct effect to social and health related quality of life.5 A number that is expected to rise to 642 million by the year 2040, of all patients, approximately 90% has type 2 diabetes mellitus (T2DM). Prescribed self-care practices for Diabetes is related to unfavorable results like reduced best of existence and decreased existence expectancy.7
Obesity has been found to increase insulin resistance and has therefore been linked to T2DM. 8
NEED FOR STUDY:
About 80% of casualties reported due to diabetes occur in middle- and low-income nations. India leads the list globally with around 3.2 crore cases of this disease, and this figure is likely to go to 7.94 crore by the end of 2030. 9
The majority of the surveys have proven 10-16% of the populace from city regions and 5-8% of the populations from rural regions are stricken by diabetes in India, as well as Sri Lanka.10
Particularly developing countries. In the last few decades, the prevalence of diabetes increased alarmingly reaching epidemic level, affecting people in all age groups in both urban and rural settings.11
Diabetes care is of high quality as indicated by the excellent Euro Diabetes Index-scores concerning, amongst other, multidisciplinary collaboration and coordination between healthcare providers. 12 Diabetes mellitus is a growing healthcare challenge. Currently, 415 million adults worldwide have diabetes, a number that is expected to rise to 642 million by the year 2040.13 The age-exposure effects of T2DM show that adult-age incidence increases the development of severe complications (both micro and macro vascular), leading to a reduction in health-related quality of life (HRQoL).14 Diabetes Mellitus among patients with Type 2 Diabetes Mellitus attending selected tertiary healthcare facilities in Udupi taluka of Karnataka state. 15
According to the International Diabetes Federation, DM affects about 8.8% of the worldwide population over 20 years of age. 16
MATERIALS AND METHODS:
A descriptive studies layout became used within side the study. Sources of data: The present study data were collected from patients. A descriptive survey approach is designed when the purpose of the study is to describe the prevalence or incidence of phenomena or to estimate the value of phenomena for a population. In the present study, the main aim is to evaluate self care management of non dependents diabetes mellitus among patients.
Research Design: A descriptive study is a research in which a onetime evaluation of patients' knowledge regarding self care management of non dependent diabetes mellitus among patients is made. The research design defines the population, sample, size, variables, data collection tools and methods, and data analysis plan.
VARIABLES: Dependent variable: In this study, the self care management patients are the dependent variable. Independent variable: In this study, independent variables are the non dependent diabetes of patients. Socio-demographic Socio variables: It consists of 12 items: age, gender, education status, religion, residence, monthly income, marital status, duration of diabetes mellitus, Current medication, co-morbidity, Any diabetic related long term complication and Received information about diabetes self care.
Setting of study: The study was conducted at Tulasigirish Diabetes Mellitus Hospital, Bagalkot. Population: Non dependent diabetes mellitus patients at Tulasigirish Diabetes Mellitus Hospital, Bagalkot. Sample and sample technique: we chose 80 patients and used stratified random sampling techniques conducted at Tulasigirish Diabetes Mellitus Hospital, Bagalkot. Data Collection Tool: Data collection tools are the procedures or instruments used by the researcher to observe or measure the key variable in the research problem. A semi-dependent questionnaire changed into used to accumulate the records within side the gift study.
PROCEDURE FOR DATA COLLECTION: Data collected from 13/06/2024 to 08/07/2024. Data collection was carried out in 3 phases: the first phase was data collection regarding socio-demographic factors and the diabetes self care of patients. Second phase: data collection regarding self care management of patients Third phase: data collection regarding the non dependent diabetes mellitus of patients. Data collected from all patients based on their socio-demographic factors and used questionnaire on non dependent diabetes mellitus of the patients.
Data collected from all patients based on their socio-demographic factors and used questionnaire on non dependent diabetes mellitus of the patients.
Ethical Consideration: Ethical approval was obtained from B.V.V.S. Institute of Nursing Sciences and Institutional Ethics Committee, Bagalkot. Written knowledgeable consent became received from all participants.
Result: A study was conducted to determine that there was no significant association (P< 0>STATISTICAL ANALYSIS: Data analysis is the systematic organization and synthesis of research data and the testing of research hypotheses by using the collected data. The data was analyzed using both descriptive and inferential statistics.
• Demographic data was analyzed using frequency and percentage distribution.
• The mean and standard deviation were used to assess the scores of the patients.
• A chi-square test was used to find an association between the self care management and non dependent diabetes mellitus among patients.
RESULT:
Assessment of self care management among patient. The range value is 0–15, the mean value is 9.46, the minimum value is 0, the maximum value is 15, the standard deviation is 0.48, and the mean percentage is 31.95%. The calculated chi square value of 5.16 (P value 0.02) suggests there is a significant association between their religion and chi square value of 4.42 (P value 0.03) suggested there is significant association between patient current medication of diabetes self care.
Among all samples, 29 (36.25%) patients have poor diabetes self care, 46 (57.5%) patients have average diabetes self care, and 5 (6.25%) patients have good diabetes self care. So many patients have poor diabetes self care management they need to improve their life style, food pattern, walking, yoga, meditation and medication. Its helps to manage non dependent diabetes mellitus of patients.
Table No. 1. Distribution Of Participants According To Their Socio- Demographic Factors. N=80
Sl.no |
Variables |
Categories |
Frequency |
Percentage |
1 |
Gender |
|
42 |
52.5% |
|
38 |
47.5% |
||
2 |
Age |
|
13 |
16.25% |
|
32 |
40% |
||
|
22 |
27.5% |
||
|
13 |
16.25% |
||
3 |
Residence |
|
33 |
41.25% |
|
47 |
58.75% |
||
4 |
Religion |
|
35 |
43.75% |
|
15 |
18.75% |
||
|
30 |
37.5% |
||
5 |
Education status |
|
13 |
16.25% |
|
16 |
20% |
||
|
21 |
26.25% |
||
|
10 |
12.5% |
||
|
20 |
25% |
||
6 |
Marital status |
|
16 |
20% |
|
60 |
75% |
||
|
15 |
18.75% |
||
|
11 |
13.75% |
||
7 |
Monthly income |
|
19 |
23.75% |
|
37 |
46.25% |
||
|
24 |
30% |
||
8 |
Duration of diabetes mellitus |
|
21 |
26.25% |
|
37 |
46.25% |
||
|
22 |
27.5% |
||
9 |
Current medication |
|
28 |
35% |
|
39 |
48.75% |
||
|
13 |
16.25% |
||
10 |
Co- morbidity |
|
29 |
36.25% |
|
51 |
63.75% |
||
11 |
Any diabetic related long term complication |
|
35 |
43.75% |
|
45 |
56.25% |
||
12 |
Received information about diabetes self care |
|
45 |
56.25% |
|
35 |
43.75% |
Description of students based on their categories.
Distribution of the sample according to age total 80 patients. 42 (52.5%) were male patients and 38(47.5%) were female patients. 13(16.25%) were 01 to 40 years old, 32(40%) were 41to 50 years old, 22(27.5%) were 51 to 60 years old and 13(16.25%) more than 60years old. 33(41.25%) were from urban area and 47(58.75%) were from rural area. 35(43.75%) were from Hindu, 15(18.75%) were from Muslim, and 30(37.5%) were from chrishan. 13(16.25%) patients were no formal education, 16(20%) were received primary education, 21(26.25%) were received secondary education, 10(12.5%) were received degree education and 20(25%0 patients received post Graduation. 16(20%) were unmarried, 60(75%) patient got married, 15(18.75%) were Divorced and 11(13.75%) patients were widowed. Distribution of sample according to their monthly income 19(23.75%) had family monthly income less than 10000, 37(46.25%) had 10000 to 30000 and 24(30%) had family monthly income more than 30000. 21(26.25%) patients were took insulin, 39(48.75%) were took current medication and 13(16.25%) patients took insulin and OHA medication. 29(36.26%) were had co-morbidity and 51(63.75%) not have co-morbidity. 35(43.75%) were had long term complication and 45(56.25%) patients not have long term complications. 45(56.25%) patients received information about diabetes self care and 35(43.75%) not received any information about diabetes self care.
Table No. 2. Distribution Of Self Care Management Prepared Practice Scale Among Patients.
N=80
Sl.no |
Categories |
Options |
Frequency |
Percentage |
1 |
General diet |
Yes |
58 |
72.5% |
No |
22 |
27.5% |
||
2 |
Specific meal & Nutrition |
Yes |
45 |
56.25% |
No |
35 |
43.75% |
||
3 |
Good physical activities & exercise |
Yes |
31 |
38.75% |
No |
49 |
61.25% |
||
4 |
Well Monitoring Blood glucose level |
Yes |
52 |
65% |
No |
28 |
35% |
Table no. 3. Distribution And Description Of Patients According To Diabetes Self Care Management
Sl.no |
Level of assessment |
Frequency |
Percentage |
1 |
Good |
5 |
6.25% |
2 |
Average |
46 |
57.5% |
3 |
Poor |
29 |
36.25% |
According to the above table, out of 80 patients, 36.25% have poor self care, 57.5% have average self care, and 6.25% have good self care of non dependent diabetes mellitus.
Table No. 4. Distribution And Description Of Sample Based On Mean, Range, Standard Deviation Among Patient With Non Dependent Diabetes Mellitus.
Range |
Mean |
Min |
Max |
Sd |
Mean % |
40 |
11.7 |
20 |
40 |
2.43 |
58.50% |
The above table assesses diabetes self care management among patients. The range value is 40, the mean value is 11.7, the minimum value is 20, the maximum value is 40, the standard deviation is 2.43, and the mean percentage is 58.50%.
Table No. 5. Chi-square test shows an association between patient with non dependents diabetes mellitus and their socio-demographic factors
Sl.no |
Chi-square |
Df |
P value |
Association |
1 |
0.02 |
1 |
0.88 |
NS |
2 |
0.33 |
1 |
0.56 |
NS |
3 |
0.21 |
1 |
0.64 |
NS |
4 |
5.165 |
1 |
0.02 |
Significant |
5 |
0.4 |
1 |
0.52 |
NS |
6 |
0.2 |
1 |
0.88 |
NS |
7 |
0.6 |
1 |
0.80 |
NS |
8 |
0.33 |
1 |
0.56 |
NS |
9 |
04.42 |
1 |
0.03 |
Significant |
10 |
0.01 |
1 |
0.92 |
NS |
11 |
0.14 |
1 |
0.70 |
NS |
12 |
0.08 |
1 |
0.77 |
Significant |
? =0.05
Results related to assessing the patient with non dependents diabetes mellitus and their socio-demographic factors.
The calculated chi square value of 5.16 (P value 0.02) suggests there is a significant association between their religion and chi square value of 4.42 (P value 0.03) suggested there is significant association between patient current medication of diabetes self care.
DISCUSSION
To assess self care management of non-dependent diabetes mellitus among patients. A cross-sectional descriptive methodology was utilized. The research was carried out at Tulasigirish Diabetes Mellitus Hospital, Bagalkot. Total Participants were predominantly female (70%) with an average age of 53. 4 years (SD 11. 2) and a relatively recent diagnosis of T2DM, which ranged from four months to approximately four years ago. Mean HbA1c was 50. 7 (SD 6. 5) mmol/mol.17
A total of 430 patients with T2DM were involved in the study with a response rate of 94.7%. The OAM group comprised 63.0% of the study population while the remaining 37.0%was categorized sa insulin users with OAM combination group.18
Research indicates a total of 420 patients with T2DM were contacted and invited to participate in the study. From this, 22 patients (5.2%) declined to take part and an additional 58 patients (13. 8%) were ineligible to join the study as they did not meet the inclusion and / exclusion criteria. According to this study, approximately 70% of the participants were knowledgeable about how to manage cuts and abrasions on the foot, in other words, about foot care in diabetes. Further more aroud 65% of the respondents recognized the impotance of diet and exercise in diabetes.19
The research indicates knowledge regarding DM complications was somewhat low; only 24. 5% were aware of retinopathy, and merely 8. 3% were knowledgeable about the loss of sensation and numbness in extremities. 20
CONCLUSION In this longitudinal research, inadequate self care of diabetes patients was evident. The findings revealed that most of the patient exhibited average diabetes self care, with many patients displaying poor self care management. They need to enhance their diabetes self care management by engaging in physical activities exercising, adhering to a diet plan, and monitoring blood glucose levels among patients. Future prospective:
Patients demonstrated similar unbalanced self care practices such as dietary patterns, diet plans, physical activities, exercise and blood glucose monitoring. The results indicate that most patients have poor diabetes self care. By providing health education, offering health tips on how to maintain optimal blood glucose levels and overall health, promoting awareness regarding non-dependent diabetes mellitus, and elucidating the significance of diabetes self care management.
ACKNOWLEDGEMENT
We express our gratitude to the anonymous referees for their valuable suggestions. The heart is full, and words are few to convey my heartfelt thankfulness towards those helping hands. *
CONTRIBITION OF AUTHORS
Research concept: Mrs. Jayashree Itti
Research design: Ms. Lakshmavva Gondi
Supervision: Ms. Lakshmavva Gondi
Materials: All researchers
Data Collection: All researchers
Analysis and interpretation of data: All researchers
Data analysis: All researchers
Writing of the article: All researchers
Critical review: Ms. Lakshmanva Gondi
Article editing: Ms. Lakshmavva Gondi
REFERENCE
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2. Elissen Arianne M. J. Dekkers Tessa et al. Patients’ perspective on self-management: type 2 diabetes in daily life. Smoorenburg et al. BMC Health Services Research (2019) 19:605 https://doi. org/10. 1186/s12913-019-4384-7.
3. Ahmad Farhan, Joshi H Shiv, Self-Care Practices and Their Role in the Control of Diabetes. 2023 Ahmad et al. Cureus 15(7): e41409. DOI 10. 7759/cureus. 41409. file:///C:/Users/HP/Desktop/self study-24.
4. Astrid N. van Smoorenburg, Dorijn F. L. Hertroijs et al. Patients’ perspective on self-management: type 2 diabetes in daily life. Smoorenburg et al. BMC Health Services Research (2019) 19:605 https://doi. org/10. 1186/s12913-019-4384-7.
5. Syed Wasif Gillani, PhD, Irfan Altaf Ansari, MD et al. Predictors of Health-Related Quality of Life Among Patients with Type II Diabetes Mellitus Who Are Insulin Users: A Multidimensional Model. S.W. Gillani, I. A. Ansari and H. A. Zaghloul et al. / Current Therapeutic Research 90 (2019) 53–60, https://doi. org/10. 1016/j. curtheres. 2019.04.001.
6. Astrid N. van Smoorenburg, Dorijn F. L. Hertroijs et al. Patients’ perspective on self-management: type 2 diabetes in daily life. Smoorenburg et al. BMC Health Services Research (2019) 19:605 https://doi. org/10. 1186/s12913-019-4384-7.
7. Anjali Shrivastva, Manisha Gore et al. A study on knowledge and self-care practices about Diabetes Mellitus among patients with type 2 Diabetes Mellitus attending selected tertiary healthcare facilities in coastal Karnataka. Clinical Epidemiology and Global Health 8 (2020) 689–692 https://doi. org/10. 1016/j. cegh.2020.01.003.
8. faisal K. Alanazi, Jazi S. Alotaibi et al. Knowledge and awareness of diabetes mellitus and its risk factors in Saudi Arabia. www.smj.org.sa Saudi Med J 2018; Vol. 39 (10). file:///C:/Users/HP/Desktop/self study-24.
9. Ahmad Farhan, Joshi H Shiv, Self-Care Practices and Their Role in the Control of Diabetes. 2023 Ahmad et al. Cureus 15(7): e41409. DOI 10. 7759/cureus. 41409. file:///C:/Users/HP/Desktop/self study-24.
10. Elissen Arianne M. J. Dekkers Tessa et al. Patients’ perspective on self-management: type 2 diabetes in daily life. Smoorenburg et al. BMC Health Services Research (2019) 19:605 https://doi. org/10. 1186/s12913-019-4384-7.
11. Astrid N. van Smoorenburg, Dorijn F. L. Hertroijs et al. Patients’ perspective on self-management: type 2 diabetes in daily life. Smoorenburg et al. BMC Health Services Research (2019) 19:605 https://doi. org/10. 1186/s12913-019-4384-7.
12. Syed Wasif Gillani, PhD, Irfan Altaf Ansari, MD et al. Predictors of Health-Related Quality of Life Among Patients with Type II Diabetes Mellitus Who Are Insulin Users: A Multidimensional Model. S.W. Gillani, I. A. Ansari and H. A. Zaghloul et al. / Current Therapeutic Research 90 (2019) 53–60, https://doi. org/10. 1016/j. curtheres. 2019.04.001.
13. Anjali Shrivastva, Manisha Gore et al. A study on knowledge and self-care practices about Diabetes Mellitus among patients with type 2 Diabetes Mellitus attending selected tertiary healthcare facilities in coastal Karnataka. Clinical Epidemiology and Global Health 8 (2020) 689–692 https://doi. org/10. 1016/j. cegh.2020.01.003.
14. faisal K. Alanazi, Jazi S. Alotaibi et al. Knowledge and awareness of diabetes mellitus and its risk factors in Saudi Arabia. www.smj.org.sa Saudi Med J 2018; Vol. 39 (10). file:///C:/Users/HP/Desktop/self study-24.
15. faisal K. Alanazi, Jazi S. Alotaibi et al. Knowledge and awareness of diabetes mellitus and its risk factors in Saudi Arabia. www.smj.org.sa Saudi Med J 2018; Vol. 39 (10). file:///C:/Users/HP/Desktop/self study-24.
16. 6. Astrid N. van Smoorenburg, Dorijn F. L. Hertroijs et al. Patients’ perspective on self-management: type 2 diabetes in daily life. Smoorenburg et al. BMC Health Services Research (2019) 19:605 https://doi. org/10. 1186/s12913-019-4384-7.
17. Elissen Arianne M. J. Dekkers Tessa et al. Patients’ perspective on self-management: type 2 diabetes in daily life. Smoorenburg et al. BMC Health Services Research (2019) 19:605 https://doi. org/10. 1186/s12913-019-4384-7.
18. Astrid N. van Smoorenburg, Dorijn F. L. Hertroijs et al. Patients’ perspective on self-management: type 2 diabetes in daily life. Smoorenburg et al. BMC Health Services Research (2019) 19:605 https://doi. org/10. 1186/s12913-019-4384-7.
19. Astrid N. van Smoorenburg, Dorijn F. L. Hertroijs et al. Patients’ perspective on self-management: type 2 diabetes in daily life. Smoorenburg et al. BMC Health Services Research (2019) 19:605 https://doi. org/10. 1186/s12913-019-4384-7.
20. faisal K. Alanazi, Jazi S. Alotaibi et al. Knowledge and awareness of diabetes mellitus and its risk factors in Saudi Arabia. www.smj.org.sa Saudi Med J 2018; Vol. 39 (10). file:///C:/Users/HP/Desktop/self study-24.
Lakshmavva Gondi, Jayashree Itti, To Evaluate Knowledge of self care management among patient with non dependent diabetes mellitus, Int. J. Sci. R. Tech., 2024, 1 (12), 213-219. https://doi.org/10.5281/zenodo.14502463