Babu M Suresh, Gowdappa H Basavana, Kalpana T, Vidyalaxmi K, Nikhil B, Chakravarthy T
Associate Professor of Medicine.
Professor of Medicine.
J Assoc Physicians India. 2015 Aug;63(8):96.
The prevalence rates of diabetes are rising rapidly both in urban and rural India with the present prevalence in urban India being 12-19% and in rural India 4 - 10% in different published Indian studies.1 All involved in diabetes care agree that patients play a major role in the successful management of diabetes. There is an increasing amount of evidence that patient education is the most effective way to lessen the diabetic complications and its management.2 Education is likely to be effective if we know the characteristics of the patients in terms of knowledge, attitude and practices about diabetes. This study was conducted in Mysore to know the knowledge, attitude and practices of diabetic patients attending JSS Hospital. A total of 900 patients were included in the study. Five hundred sixteen (57.3%) patients were males, while 384 (42.7%) patients were females. Four hundred twenty-three (47%) patients were from urban area, while 477 (53%) were from rural area. Five hundred sixty-five (62.5%) diabetic patients were unaware of the diagnostic criteria for diabetes mellitus, 661 (73.4%) patients about cause of diabetes, 264 (29.3%) patients about common symptoms of diabetes, 256 (28.4%) patients about symptoms of hypoglycemia. Diabetes is a chronic disease which can affect many systems in the body like the heart, eyes, kidneys and nerves contributing to increased morbidity and mortality. 29%, 30.7%, 31.2% and 35.7% of diabetic patients were not aware of the diabetic complications to heart, eyes, kidneys and nerves respectively. Even patients with diabetes for more than 10 years, 18.8% were not aware of the heart complications while 21.5% were not aware of the diabetes complications to eyes, kidneys and nerves. 834 (92.6%) diabetic patients were not aware of HbA1C. 790 (87.7%) diabetic patients did not know that fruits can be eaten by diabetics. Eight hundred seventeen (90.8%) diabetic patients had not attended a formal diabetic education class. This possibly is a major reason for diabetic patients to have poor awareness of different aspects of diabetes. The low awareness in diabetes patients are noted in different studies done in different parts of India. Education is not just a part of diabetes treatment. It is the treatment. According to WHO, education is the cornerstone of diabetes care. For a physician, diabetes is one of the many diseases calling for his attention in his practice. The time constraints prohibit physicians from delivering optimal diabetes care to their patients which include performing all the necessary tests, educating their patients about the disease, its complications and management. Diabetes educator who can be a nurse, a dietician, a social worker or in a more sophisticated centre a qualified diabetes educator can fill up this important void and play a major role in optimal diabetes care. The key aims of diabetes education are to change behavior of people and promote self management. Self management implies that the person with diabetes will understand the importance of factors like food intake, exercise and medications on blood glucose. PACE project study has concluded that through direct public education and mass media campaigns, awareness about diabetes and its complications can be improved.3 To conclude, education has the biggest role to play in containing diabetes epidemic in India. Responsibility should be at every level from individual doctors to organizations to governments. Effective utilization of the limited available resources is critical for a country like India. We in India are blessed with a large youth population and we should not turn this blessing of a vibrant young nation to a curse of an unhealthy young nation.
在印度，无论是城市还是农村，糖尿病的患病率都在迅速上升。在已发表的不同印度研究中，目前印度城市的患病率为12%-19%，农村为4%-10%。1所有参与糖尿病护理的人员都认为，患者在糖尿病的成功管理中起着主要作用。越来越多的证据表明，患者教育是减轻糖尿病并发症及其管理的最有效方法。2如果我们了解患者在糖尿病知识、态度和行为方面的特征，教育可能会更有效。本研究在迈索尔进行，旨在了解在JSS医院就诊的糖尿病患者的知识、态度和行为。共有900名患者纳入研究。其中516名（57.3%）为男性，384名（42.7%）为女性。423名（47%）患者来自城市地区，477名（53%）来自农村地区。565名（62.5%）糖尿病患者不知道糖尿病的诊断标准，661名（73.4%）患者不知道糖尿病的病因，264名（29.3%）患者不知道糖尿病的常见症状，256名（28.4%）患者不知道低血糖症状。糖尿病是一种慢性疾病，可影响身体的许多系统，如心脏、眼睛、肾脏和神经，导致发病率和死亡率增加。分别有29%、30.7%、31.2%和35.7%的糖尿病患者不知道糖尿病对心脏、眼睛、肾脏和神经的并发症。即使是患有糖尿病超过10年的患者，18.8%不知道心脏并发症，21.5%不知道糖尿病对眼睛、肾脏和神经的并发症。834名（92.6%）糖尿病患者不知道糖化血红蛋白（HbA1C）。790名（87.7%）糖尿病患者不知道糖尿病患者可以吃水果。817名（90.8%）糖尿病患者没有参加过正规的糖尿病教育课程。这可能是糖尿病患者对糖尿病各方面认识不足的一个主要原因。在印度不同地区进行的不同研究中都发现糖尿病患者的认知度较低。教育不仅仅是糖尿病治疗的一部分。它就是治疗本身。根据世界卫生组织的说法，教育是糖尿病护理的基石。对于医生来说，糖尿病是他在临床工作中需要关注的众多疾病之一。时间限制使医生无法为患者提供最佳的糖尿病护理，包括进行所有必要的检查、向患者传授有关疾病、其并发症及管理的知识。糖尿病教育者可以是护士、营养师、社会工作者，或者在更专业的中心是合格的糖尿病教育者，他们可以填补这一重要空白，并在最佳糖尿病护理中发挥主要作用。糖尿病教育的关键目标是改变人们的行为并促进自我管理。自我管理意味着糖尿病患者将理解食物摄入、运动和药物等因素对血糖的重要性。PACE项目研究得出结论，通过直接的公众教育和大众媒体宣传活动，可以提高对糖尿病及其并发症的认识。3总之，教育在控制印度的糖尿病流行方面起着最大的作用。责任应从个体医生到组织再到政府，各级都要承担。对于像印度这样的国家，有效利用有限的可用资源至关重要。我们印度拥有大量年轻人口，我们不应将这个充满活力的年轻国家的福祉变成一个不健康的年轻国家的祸根。
