Vol 11, Issue 12, 2018 Online - 2455-3891 Print - 0974-2441 KNOWLEDGE OF THE DISEASE AMONG TYPE 2 DIABETES PATIENTS IN A TERTIARY CARE HOSPITAL IN MUMBAI, INDIA VIMAL PAHUJA 1 , GENEVIE FERNANDES 2 , NILESH CHATTERJEE 3 * 1 Consultant Metabolic Physician and Program Supervisor, Obesity and Diabetes Center of Excellence, Dr. L.H. Hiranandani Hospital, Mumbai, Maharashtra, India, 2 Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, 3 Behavioral Science Consultant, Kalyani Media Group, Chembur, Mumbai, Maharashtra, India. Email: nileshchatterjee100@gmail.com Received: 05 July 2018, Revised and Accepted: 30 July 2018 ABSTRACT Objective: An estimated 72 million in India live with diabetes; the country faces an impending health-care crisis with prevalence and complications of diabetes forecasted to multiply in the next decade. Improving patients’ knowledge about diabetes to manage the disease better is an urgent and important public health goal. Methods: Knowledge about diabetes, its complications, and management was surveyed using a structured questionnaire among 167 Type 2 diabetes patients attending a tertiary care hospital in Mumbai, India. Results: None of the participants had ever received any formal diabetes self-management education previously. Respondents’ mean and median correct knowledge scores were 20 of 32 test items. Although majority answered statements about blood sugar levels and complications, there was lack of knowledge about the causes and management of diabetes. Around 82% stated that medication was more important than dietary intake and physical activity in managing diabetes. A multiple regression model showed that postgraduate or graduate level education, not being married, having two or less children, and visiting a doctor 1–3 times a year (as compared to more than three visits) was independently associated with higher diabetes knowledge scores (*p<0.05) in this sample. Conclusion: An information disparity exists between patients who have higher levels of education versus those with lesser education. Future research will have to examine the mechanisms by which higher education contributes to better knowledge, and facilitate the design of diabetes education programs that bridge information gaps and improve required competencies in patients to better manage their condition. Keywords: Diabetes mellitus, Diabetes knowledge, Diabetes education, Urban, India. INTRODUCTION With an estimated 72 million affected, India has the second highest number of people living with diabetes in the world; second, only to China with 114 million [1]. The prevalence of diabetes in India is expected to rise to 366 million by 2030 [2]. Diabetes is also the seventh most common cause of death in India [3]. A recent study conducted in 15 of the 29 Indian states estimated diabetes prevalence at 7.3%, varying from 4.3% in Bihar to 10% in Punjab, and a higher prevalence in urban compared to rural areas [4]. Diabetes, if not well controlled, leads to a higher risk of blindness due to retinopathy, kidney disease, cardiovascular disease, lower-extremity amputations, or pregnancy complications [5]. The global cost of diabetes is set to almost double to US$2.5 trillion by 2030, and even if countries meet internationally set diabetes prevention and control targets, the global economic burden from the disease will still increase by 88% [6]. Especially in low- and middle-income countries, where the majority of health-care costs are paid out of pocket, the costs of managing diabetes and treating its associated complications place a huge economic and emotional burden on the patient and their families [7]. In 2010, diabetes costs India around US $31.9 billion [8]. Several studies in India have found that varying shares of household income are allocated to pay for diabetes care, especially hurting lower income households the most. A study of seven Indian states reported an annual median expenditure of INR 10,000 (US$149) for diabetes- related care in urban areas and INR 6260 (US$93) in rural parts of the country. Majority of the patients (89%) used their household income to fund the monitoring and treatment of their diabetes. Lower income groups spent the highest proportion of their income on diabetes costs (urban poor 34% and rural poor 27%) [9]. Diabetes patients without complications were found to have an 18% lower mean annual cost for outpatient care compared to those with three or more complications who spent 48% higher [10]. The prevailing epidemiological situation makes it imperative to understand how to prevent complications and improve management of diabetes in the country. Correct knowledge about diabetes has been found to improve self- management of the disease [11,12], prevent complications [13], and lead to better outcomes [14,15]. Studies have found that patients who do not receive formal diabetes self-management education (DSME) have knowledge gaps; they tend not to receive recommended preventive services and are more likely to develop complications than those who have received DSME [16,17]. While knowledge alone may not be sufficient in motivating behavior change for diabetes prevention and management, it remains a necessary step in helping patients accept their diagnosis and take an active role in self-care and management [12,18]. Previous studies have measured diabetes-related knowledge among general populations in India [19-21]; however, few have examined the knowledge levels of patients with diabetes in health-care facilities in urban cities [22,23]. This study aims to fill this gap in the literature by assessing the knowledge about diabetes, its complications, and management among type 2 diabetes patients attending a private © 2018 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4. 0/) DOI: http://dx.doi.org/10.22159/ajpcr.2018.v11i12.28126 Research Article