DIABETES AWARENESS AMONG PATIENT'S ATTENDANT VISITING IN TEACHING HOSPITAL OF EASTERN NEPAL

Results Among 503 ar cipants, six out of 10 said that diabetes have complica ons related to kidney, heart and eyes. Seven out of 10 said diabe c should go for regular check-up of kidney, heart and eyes. Similar findings were reported on diabe c having higher chances of developing hypertension or dyslipidaemia. Literate par cipants had more awareness on diabetes and its associated factors than illiterate par cipants (p<0.001). There was no significant associa on found on diabetes and its factors awareness with gender in all components except female par cipants were more aware about diabetes related complica ons than male.


INTRODUCTION
Type 2 diabetes mellitus and pre-diabetes condi on is increasing 1 rapidly among middle-aged and older adults.Among all the diseases measured in years lived with disability, type 2 2 diabetes mellitus has increased the most from 1990 to 2013.
3 About 50% of those with diabetes remain undiagnosed.Community awareness on diabetes is the key step for early 4 detec on and preven on of diabetes and its complica on.Type 2 diabetes can be prevented when people with 5,6 increased risk for diabetes have their lifestyle modifica on.Increasing public awareness on diabetes could improve overall health of the society and reduce the risk of developing 7 diabetes.For preven ng type 2 diabetes, it is important to develop tools and strategies so that individuals at high risk 8 could make lifestyle changes.This study was conducted to assess the diabetes awareness among pa ent's a endant visi ng a teaching hospital in eastern Nepal.

METHODOLOGY
A hospital based cross-sec onal study was conducted at st Birat Medical College & Teaching Hospital from 1 September th to 30 October 2016.The par cipants were explained about the aim of the study.Par cipa on was voluntary and those who were not willing to par cipate could withdraw any me from the study.Only the pa ents' a endant willing to give a wri en consent were included for the study.Ques ons were pretested prior to data collec on and necessary correc on was made.The data were collected from 503 par cipants (pa ents' a endant) using pretested semi-structured ques onnaires.Collected data were entered in Microso excel and analysed by sta s cal package for social sciences (SPSS), version 16.Data were presented in frequency, percentage, mean and standard devia on and Chi square test was used to find the associa on between variables.

RESULTS
A hospital based cross sec onal study was conducted among 503 pa ent's a endant visi ng teaching hospital of eastern Nepal.Among them both gender had equal propor on.The age of the par cipants was in the range from 15 to 83 years,

Table 1: Socio-demography of study popula on (n=503)
As shown in table 2, among the par cipants, 57.5% cited diabetes could lead to heart, eyes and kidney diseases.Almost 70% answered that people suffering from diabetes should go for regular check-up of kidney, heart and eyes.About 70% par cipants said that diabe c people could have higher chances of ge ng hypertension or dyslipidaemia than normal person.Among the par cipants, 39.8% were not aware about normal salt intake in their diet and 43.9% were not aware on normal amount of fat intake in their diet.Only 3% par cipants were aware that regular daily exercise helps to prevent diabetes.

Table 2: Awareness on diabetes and related factors among the par cipants (n=503)
Ghimire HB et al with mean and standard devia on of 42.3±16 years.Table 1 shows the basic socio-demography of study par cipants.

Table 3: Associa on between diabetes related awareness with literacy status.
As shown in table 3, among 251 literate people, 97.6% responded diabetes have complica ons related to kidney, heart and eyes, whereas among 252 illiterate people only 17.5% were aware of its complica ons.Literate par cipants were more aware on diabetes than illiterate and it was sta s cally significant (p<0.001).Regarding whether diabe c should get regular check-up of kidney, heart and eyes, among 251 literate 98% and among 252 illiterate 40.9% correctly responded which was sta s cally significant people need regular kidney, heart and eyes check-up compared to illiterate.Higher number of females cited that diabetes could lead to kidney, eyes and heart complica ons.This finding is supported by a study where par cipants with no formal educa on were found to have less awareness about diabetes and its associated factors compared with the 13 educated group.Similarly, in a study, it was found that Ghimire HB et al (p<0.001).When par cipants were asked whether diabe c have higher chances for developing hypertension or dyslipidaemia, among 251 literate 97.6% and among 252 illiterate 40.9% were aware.A sta s cally significant associa on (p<0.001) was shown with literate being more aware than illiterate.

Table 4: Associa on between diabetes related awareness with gender
*Significant Table 4 depict that among 252 male, 53.2% responded diabetes have complica ons related to kidney, heart and eyes, whereas among 251 female 61.8% were aware on above complica ons.Female par cipants were more aware than male which was sta s cal significant (p<0.05).Regarding the knowledge for diabe c should get regular check-up of kidney, heart and eyes, among 252 male 64.7% were aware and among 251 74.1% were aware.Female had more awareness than male however; it was sta s cally not significant (p 0.070).Regarding diabe c having higher chances of developing hypertension or dyslipidaemia, among 252 male 64.7% were aware and among 251 female 73.7% were aware.Female had more awareness than male but it was not sta s cally significant (p 0.088).diabetes awareness was low especially in par cipants with low educa on but in contrast to this study diabetes 14 awareness was found to be low in women.In this study,it may be possible that literate people have heard about diabetes related complica ons from friends or have read in newspaper or any informa on booklets leading to higher level of knowledge about disease related problems.In this study, almost four out of 10 par cipants were aware on normal salt intake in their diet and similar number of people were aware on normal fat intake in their diet.Only three out of 100 par cipants were aware on regular exercise.According to World Health Organisa on, by elimina ng common risk factors, such as tobacco use, harmful use of alcohol, high salt intake, unhealthy diet, high sugar intake and physical inac vity, around 80% of heart disease, stroke, and type 2 diabetes and over a third of cancers could be 15 prevented.As suggested by World Health Organisa on, we need interven on earlier in common risk factors because this study found high risk behaviour for diabetes occurrence.It is possible to achieve significant reduc on in high blood pressure; diabetes related complica ons such as stroke and cardiovascular disease by reducing salt intake in 16,17 people with and without hypertension.

CONCLUSIONS
This study gives general outline about people's awareness on diabetes and its associated factors.Literate people had significantly more awareness on diabetes and its associated factors.Therefore, we could say that literacy have role in awareness on diabetes.Gender difference have no role in awareness in diabetes and its factors.However, risk behaviour for diabetes was high in all par cipants.

DISCUSSION
In this study, almost six out of 10 par cipants were aware on the fact that diabetes will have complica ons related to kidney, heart and eyes, seven out of 10 were aware that diabe c should get regular check-up of kidney, heart and eyes.Similar number of people cited diabetes pa ents have higher chances of developing hypertension or dyslipidaemia.In a study it was reported that, knowledge of the visible complica ons (loss of eye-sight, poor wound healing) of diabetes appeared to be some what be er than knowledge of other complica ons (kidney disease, heart disease,