Assessment of knowledge and practice of non-insulin diabetes patients living in Davidashen district of Yerevan during 1999 about prevention of diabetes complications

Abstract

Davidashen is one of the districts of Yerevan, located in a suburban area. The population is about 50,000 people. It is a newly built district with population of people with different backgrounds. Diabetes continues growing progressively all over the world. It is classified into two main types: type 1 and type 2. The most common, type 2 affects 90-95% of people with diabetes and usually appears after the age of 40. Diabetes is a major public health problem in Armenia and abroad. In 1995 the absolute number of deaths from diabetes was 917, in 1996 it was 1058, from 1988, the mortality rate increased from 11.72 per 100,000 population to 31.78 in 1998, or 1206 (2). The main risk factors to be considered are knowledge and practice about: physical inactivity, improper diet, and infrequent glucose monitoring One key informant interview was conducted with the district endocrinologist to reveal insight into shortcomings that type 2 diabetes patients have. It helped also in preparing and designing the questionnaire. After the translation and pretesting of the questionnaire with five patients, some changes were made, and it was administered to, and completed by 68 type 2 diabetes patients out of 142. The list of type 2 diabetes patients who were diagnosed more than 1 year was obtained from the district endocrinologist. Before starting an actual interview, oral consent was obtained from the interviewees. The data were entered and analysed in Epi Info statistical program. Unemployment rate among interviewees was 84%. Many of them had higher education, others more than secondary; some studied less than 8 years. About seventy-five percent of interviewed diabetes patients were females. The knowledge and practice of non-insulindependent diabetes patients living in Davidashen about prevention of diabetes complications were poor. Most diabetes patients never tried to keep their weight under control. In contrast to the latter, more patients tried to follow a diet. Ninety percent of interviewed diabetes patients knew that they were at risk to develop complication. It is worth mentioning that interviewed diabetes patients had low knowledge about what carbohydrate, fat, and protein were. This was associated with education level. Based on the survey it was revealed that 34% of diabetes patients used pastas, potato, and meat frequently. Twenty one out of 68 monitored their blood glucose level at least once a month during the last year. The following preliminary recommendations are suggested: more research is needed to reveal the attitude of diabetes patients about the risk factors; and to observe social, environmental, epidemiological, and behavioural factors of type 2 diabetes patients; there is a priority need to develop public health education for diabetes patients; different media should be used to reach diabetes patients; train health care providers; the availability and accessibility of health care services to the vulnerable population should be increased; the quality of health care services should be improved, and free drug and diet food distribution for diabetes patients needs to be organised.