Have we done enough with diabetic education?
Background: Patients’ education and empowerment are essential parts of a disease management. Patients have to beeducated on the disease as well as lifestyle changes that they need to practise for a holistic and consistent improvement intheir disease status. This study examined patients’ knowledge on diabetes and nutrition as well as the role of dietician in thepatient education.
Methods: This was a cross-sectional study of patients aged more than 18 years, in a primary care centre in Kuala Lumpur.Patients responded to a pre-tested self-administered questionnaire which contains socio-demographic profiles of patients,knowledge on diabetes and nutrition. Patients were also asked on dietician consultation and the number of dietician visits.Patients were conveniently selected on the data collection days. Only consented patients and those who could understandMalay or English language were selected.
Results: There were 110 patients who participated in the study. Overall the patients had good knowledge on diabetes andnutrition. The mean total knowledge score was 71.2% ± 9.34. Domains such as diabetes complications, exercise, mealpractice, food sources and proportion need reinforcement. Only 60 (54.9%) patients had seen a dietician. Patients who hadseen dietician showed significantly higher level of knowledge score (p=0.04). However frequent meeting with the dieticiandid not show any significant improvement in the knowledge (p=0.10). Factors such as patients’ gender, ethnicity, level ofeducation, employment status, glycaemic level, duration of illness and body mass index did not show any significant associationwith the overall diabetic and nutrition knowledge.
Conclusion: There is still a need to improve the overall diabetic education particularly in areas that patients were lackingsuch as diabetes complications, exercise, meal practice, food sources and proportion. It is equally necessary to encourageall diabetics to see a dietician since it helps to improve their level of knowledge as shown in this study.
Institute for Public Health, National Institutes of Health and Ministry of Health. The third national health morbidity survey 2006 (NHMS III). 2008:21-5.
Malaysian Diabetes Association and Academy of Medicine. Management of type 2 diabetes mellitus. 4th ed. Malaysia: Ministry of Health Malaysia; 2009:11-4.
Nathan DM, Buse JB, Davidson MB, et al. Medical management of hyperglycaemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy. Diabetes Care. 2008;31(12):1-11.
West JD, Golberg KL. Diabetes self-care knowledge among outpatients at a Veterans Affairs medical centre. Am J HealthSyst Pharm. 2002;59(9):849-52.
Siminerio LM. The diabetes education renaissance. Diabetes Spectrum. 2006;19(2):76-8.
Klien S, Sheard NF, Pi-Sunyer X, et al. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies: a statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Diabetes Care. 2004; 27(8):2067-73.
Executive summary: standards of medical care in diabetes - 2010. Diabetes Care. 2010;33(Suppl 1):S4-10.
Spikmans FJ, Brug J, Doven MM, et al. Why do diabetic patients not attend appointments with their dietitian? J Hum Nutr Diet. 2003;16(3):151-8.
Marrero DG, Kraft SK, Mayfield J, et al. Nutrition management of type 2 diabetes by primary care physicians: reported use and barriers. J Gen Intern Med. 2000;15(11):818-21.
He X, Wharrad HJ. Diabetes knowledge and glycaemic control among Chinese people with type 2 diabetes. Int Nurs Rev. 2007;54(3):280-7.
Gary TL, Genkinger JM, Guallar E, et al. Meta analysis of randomized educational and behavioural interventions in type 2 diabetes. Diabetes Educ. 2003;29(3):488-501.
Warsi A, Wang PS, LaValley MP. Self-management education programs in chronic disease: a systematic review and methodological critique of the literature. Arch Intern Med. 2004;164(15):1641-9.
Perrin B, Swerissen H. The behaviour and psychological functioning of people at high risk of diabetes related foot complications. Diabetes Educ. 2008;34(3);493-500. [PubMed]
Rhee MK, Slocum W, Ziemer DC, et al. Patient adherence improves glycaemic control. Diabetes Educ. 2005;31(2):240-50.
Kim S, Love F, Quistberg DA, et al. Association of health literacy with self-management behaviour in patients with diabetes. Diabetes Care. 2004;27(12);2980-2.
Anderson RM. Taking diabetes self-management education to the next level. Diabetes Spectrum. 2007;20(4):202-3.