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American Journal of  Medical 
Science and Innovation (AJMSI) 

Knowledge of  Diabetes Mellitus Among the Outdoor Patients in Upazilla 
Health Complexes Under Jhalakati District of  Bangladesh

Layla Azmin Akter1*

Volume 2 Issue 2, Year 2023
ISSN: 2836-8509 (Online)

DOI: https://doi.org/10.54536/ajmsi.v2i2.1448
https://journals.e-palli.com/home/index.php/ajmsi

Article Information ABSTRACT

Received: March 15, 2023

Accepted: April 10, 2023

Published: April 16, 2023

The study “Knowledge of  diabetes mellitus among the outdoor patients in Upazilla Health 
Complexes under Jhalakati District of  Bangladesh” was conducted among 100 patients 
who attended in the outpatient department of  Upazilla Health Complexes under Jhalakati 
District. The objectives of  this study are to explore the socio-demographic history and 
knowledge level of  the patients about risk factors as well as treatment and preventing ways of  
diabetes mellitus among the outdoor of  Upazilla Health Complexes under Jhalakati District. 
The study found that the demographic characteristics of  majority of  the respondents were 
above middle aged, falling the age ranges of  41-45, 46-50 and above 51 where 59 percents 
of  respondent ware female. The respondents were chosen from various educational level 
and most of  them had a fairly low income of  between 2000-5000. Slightly more than half  
the respondents did not walk regularly. Very few of  the respondents worked out every 
day whereas the majority (82%) did not. The respondents said that they knew diabetes is 
caused when blood has high sugar levels or is the production of  symptoms of  polyuria due 
to high blood sugar levels. 23 respondents who were not sure about the types of  diabetes, 
2 thought there was a single type, 24 thought there were 2 types and 26 thought there were 
3 types. A small number of  respondents knew of  type-1 diabetes (32%). Most respondents 
did not know of  gestational diabetes (79%). Symptoms of  diabetes known by the respondents 
included frequent urination, excessive thirst, extreme hunger, and very dry skin along with 
many other symptoms 32%,26%,33% and 44% respectively. Many respondents knew about 
the screening tests of  diabetes (65). As per the respondent’s opinion the study recommends 
improving the knowledge of  DM among the people through mass media like TV programs, 
theater, counseling, newspaper articles and BCC materials.

Keywords
Knowledge on Diabetes, 
Prevention of  Diabetes, 
Mellitus, Outdoor Patients

1 Nursing Institute, Munshiganj, Bangladesh
* Corresponding author’s e-mail: laylaazmin@gmail.com

INTRODUCTION
Diabetes mellitus recently reported as a leading non 
communicable public health hazards in Bangladesh 
(Islam, 2014). Bangladesh exemplifies all the problems 
of  Third World countries: poverty, hunger, reduced 
longevity, and an illiteracy rate hovering at more than 80 
percent (Barai, 2020). The status of  diabetes mellitus in 
Bangladesh was surveyed. Diabetes mellitus is a multi-
systemic illness associated in developing countries like 
Bangladesh and Pakistan prevalence of  Diabetes Mellitus 
is 11%. with a variety of  short-term and long-term 
complications (Njiru, 2022). Pakistan ranked seven in the 
world with 6.9 million Studies indicate that genetic factors 
do not account diabetics in 2007 (compared to 4.3m 
ranked 8th in entirely for the development of  diabetes, 
and several 1995) (Shinjyo, 2017). In the year 2025. The 
most important environmental risk factors for the rapid 
rise of  diabetes mellitus are one of  the major types of  
diabetes are obesity and physical inactivity (Lin, 2020). In 
fact, up to 80% of  type-2 diabetes is explosion in obesity 
rates worldwide has largely been preventable by adopting 
a healthy diet, increasing responsible for the increase 
in diabetes, and it is physical activity and promoting a 
healthy lifestyle (Zheng, 2018). Estimated that up to 80% 
of  all new cases of  diabetes can be attributed to obesity. 
Change in lifestyle has Therefore to manage diabetes; the 
individuals must have increased the incidence of  obesity 

(Einarson, 2018). Ample knowledge of  their disease, 
medication, diet as well as genetic and environmental 
risk factors. Thus, despite several advances in the field 
of  dialectology, it is health education is integral part in 
the management of  unfortunate that there exists a low 
awareness of  the diabetes (Paul, 2012). The present study 
was designed to assess the disease among public. Diabetes 
education is widely accepted as integral to society to 
manage the disease which was also found in diabetes 
therapy within the diabetes community (Rydien, 2013). In 
the study by Roy et al, 2010 where lack of  family supports 
this study awareness level of  the study participants was 
one of  the most dominant psychosocial issues poor, 
which is in accordance with other studies (Van Roy, 2010). 
Among diabetics who also stresses for the development 
of  diabetes education program to give patients a better 
knowledge of  their disease, and to prevent premature 
morbidity and Lifestyle modifications have key role in 
the management mortality associated with diabetes16. of  
diabetes. There was a lack of  awareness about the role 
of  lifestyle changes among the diabetic people visiting. 
Most of  the study participants had their disease at two 
major hospitals of  Karachi; and many of  them did not 
diagnose for more than five years. This suggested that 
take diabetes seriously. There is a desperate need of  they 
should have a good knowledge about management health 
education programs for diabetics and general of  the 

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Am. J. Med. Sci. Innov. 2(2) 8-15, 2023

disease; but many of  them (43%) were not taking public 
by using variety of  media. The vital role of  family regular 
treatment, their (62%) diabetes was not under, and society 
must be recognized. Health care provider’s control, 52% 
did not follow diet chart and a vast majority should play 
their part in health educating the masses. (82%) did not 
indulge in exercise (Shaikh, 2011). Several Epidemiology 
and End Results (SEER) cancer registries, it was reported 
that the service providers have significant role in aware 
the clients to early diagnosis and improve the seeking 
behavior for diabetes mellitus (Mollica, 2017).
The objective of  the study was to explore the socio-
demographic history of  the patients, to find out the 
knowledge level of  the respondents about risk factors 
of  diabetes mellitus and to explore the knowledge of  
the respondents about treatment and preventing ways of  
diabetes mellitus.

LITERATURE REVIEW
Diabetes mellitus is one of  the most significant public 
health challenges of  the 21st century. WHO estimate 
shows, globally the number of  persons with diabetes 
will rise from 221 million by the year 2010, and to 300 
million by 2025 (Amos, 1997). The most increase will 
take place in south Asia. In 2007 a UN resolution was 
adopted to mark significance of  DM as a global public 
health issue. Recently the occurrence of  type 2 diabetes 
is increasing both in rural and urban communities and 
it is considered as a major burden for national health 
budget (Zimmet, 2014). Hence, there is an urgent need 
to halt the exponential increase of  DM in Bangladesh, 
which is already overburdened with the double burden 
of  both non-communicable and communicable diseases. 
But there is lack of  population based large scale study 
in the country to assess the extent of  the problem 
and its determinants. This study topic highlights the 
epidemiology of  diabetes in rural and urban population. 
The study showed that the prevalence of  type 2 diabetes is 
higher in urban compared to rural areas with comparable 
levels of  obesity (mean BMI and WHR) (Agyemang, 
2016). During the same period trivial increase of  BMI, 
WHR and waist circumference compared to baseline 
survey were noted. The study findings hypothesize that 
urbanization and its associated lifestyle factors may 
have contributed to the rising prevalence of  diabetes in 
Bangladeshi population. Higher prevalence of  diabetes in 
lean population may also indicate genetically susceptible 
population. The findings of  that study will help develop 
policies in the health sector with a view to initiating 
appropriate preventive strategies to put off  lifelong 
entrance of  diabetes in the population (Martinez, 2017).

Sign of  Diabetes Mellitus
People (usually with type 1 diabetes) may also present 
with diabetic ketoacidosis, a state of  metabolic 
dysregulation characterized by the smell of  acetone; 
a rapid, deep breathing known as Kussmaul breathing; 
nausea; vomiting and abdominal pain; and an altered state 

of  consciousness (Umpierrez, 2016). A rarer but equally 
severe possibility is hyperosmolar nonketotic state, which 
is more common in type 2 diabetes and is mainly the result 
of  dehydration. Often, the patient has been drinking 
extreme amounts of  sugar-containing drinks, leading 
to a vicious circle regarding the water loss. Several skin 
rashes can occur in diabetes that are collectively known as 
diabetic dermadromes (Shivashankar, 2011).

Causes of  DM 
The cause of  diabetes depends on the type. Type 2 
diabetes is due primarily to lifestyle factors and genetics 
and Type 1 diabetes is also partly inherited and then 
triggered by certain infections, with some evidence 
pointing at Coxsackie B4 virus. There is a genetic element 
in individual susceptibility to some of  these triggers which 
has been traced to HLA genotypes (i.e., the genetic “self ” 
identifiers relied upon by the immune system). However, 
even in those who have inherited the susceptibility, type 
1 diabetes mellitus seems to require an environmental 
trigger.

Diagnostic Procedure of  Diabetes Mellitus
Diabetes mellitus is characterized by recurrent or persistent 
hyperglycemia, and is diagnosed by demonstrating any 
one of  the following:[9]

1. Fasting plasma glucose level ≥ 7.0 mmol/L (126 
mg/dL).

2. Plasma glucose ≥ 11.1 mmol/L (200 mg/dL) 
two hours after a 75 g oral glucose load as in a glucose 
tolerance test.

3. Symptoms of  hyperglycemia and casual plasma 
glucose ≥ 11.1 mmol/L (200 mg/dL).

4. Glycated hemoglobin (Hb A1C) ≥ 6.5% 
Population aging, urbanization, behavior and lifestyle 
changes, genetic susceptibility, and the health transition 
from communicable to non-communicable diseases 
account for the increasing significance of  diabetes mellitus 
in Bangladesh. In the absence of  quantified estimates of  
current and future disease burden attributable to diabetes 
mellitus in rural and urban Bangladesh, this study aimed 
to provide such estimates (Islam 2014).
Modeling methods were used to estimate the epidemiology 
of  diabetes mellitus in rural and urban Bangladesh 
currently, in 2010, and in 2020. Resultant estimates of  the 
epidemiology of  diabetes mellitus and estimates of  the 
epidemiology of  the diabetic squeal used in the Global 
Burden of  Disease Study were used to calculate disability 
adjusted life years (DALYs) attributable to diabetes 
mellitus and its sequelae in these populations.
Estimated current burden of  disease attributable to 
diabetes mellitus and its sequelae were 265,718 DALYs 
(2.6 DALYs per 1000 persons) in rural Bangladesh and 
61,829 DALYs (3.2 DALYs per 1000 persons) in urban 
Bangladesh. Disease burden in rural Bangladesh was 
estimated to increase to 311,068 DALYs (3.0 DALYs per 
1000 persons) in 2010 and 389,686 DALYs (3.2 DALYs 
per 1000 persons) in 2020. Disease burden in urban 

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Bangladesh was estimated to increase substantially to 
197,267 DALYs (3.8 DALYs per 1000 persons) in 2010 
and 328,934 DALYs (4.4 DALYs per 1000 persons) in 
2020 (Talukder, 2020).
Many assessments have been based on assumptions and 
information of  less-than-optimal reliability. We have 
studied available information on healthcare expenditure, 
number of  hospital clinics, hospital beds, income levels 
and any health sector information that was available 
to ensure that our assessment was made as realistic as 
possible. We believe that the results provide a realistic 
picture within the given frameworks and scenarios. Our 
experiences also underline that studies of  the present 
kind are developed in a continuous process and there is 
still a need for further development and validation in the 
future (Van Dyne, 2015).
A health economic analysis of  the standard types of  
evaluation – cost effectiveness analysis (CEA), cost-utility 
analysis (CUA) or cost-benefit analysis (CBA). Some of  
the controversial issues related to either of  the standard 
types of  evaluation are relevant to our study and, therefore, 
some of  our reservations are discussed in the following 
First, the comparison of  the current situation to the 
Worst scenario involves a rather big change in the society 
whilst most economic evaluations - at least of  the CEA 
type – are made for smaller changes. Second, whereas the 
Worst scenario is not totally irrelevant for a developing 
country, the Ideal scenario may seem somewhat artificial, 
particularly in the context of  a developing country 
(Miroshnychenko, 2021). 
It is important to emphasis that the richest are those who 
already have access to care, have the highest productive 
value, are most likely to comply with treatment, and are 
most likely to become old enough to develop type 2 
diabetes. It was discussed whether it would be relevant 
explicitly to divide the model into the 10% richest, the 
10% poorest with free access and the remaining 80% 
without access to care and to analyze these groups in 
two separate models. We choose to model these aspects 
through implicit distinction between the rich and poor 
but in one model. It might be relevant in a deeper analysis 
to make analyses in two distinctly different models 
(Evans, 2017).
The current conditions for managing T2D in Bangladesh 
are poor, partly due to lack of  access to basic treatment, 
incl. insulin, for a substantial part of  the population. 
Improvements yielding equal access to treatment 
and care for all patients with T2D is costly but will be 
accompanied by somewhat larger gains in production 
value compared to the Current scenario. It is conceivable 
that as a consequence of  such improvement, some 
adjustments will take place at a macro level in society, but 
any conclusion would be rather speculative (Misra, 2019).
A major effect of  treatment of  T2D patients is gains in 
patient-years. A derived effect may be gains in terms of  
productive time and costs in terms of  spending time by 
informal caregivers and increased income from working 
(production value). It should be stressed again that the 

current population of  patients with T2D has obtained its 
size and age composition because of  any given (in the 
case of  Bangladesh uneven) access to insulin treatment 
during many decades following the introduction of  
insulin in the early 1920´s. Therefore, a comparison of  
patient-years experienced under the contrasting scenarios 
mentioned reflects the cumulative effect of  access or 
lack of  access to insulin treatment over previous decades 
and cannot be interpreted as an isolated effect of  insulin 
treatment during the year (Grunberger, 2021). 
Bangladesh has experienced economic growth since the 
nineties. Whether this growth is reflected in a rising living 
standard is still to be documented as it would depend on 
many factors. If  economic growth has led to increased 
population growth the average living standard may not 
have improved markedly. In the long term, though, a 
continued reduction of  infant mortality probably (as 
experienced in other parts of  the world) will lead to a 
lower fertility pr woman and eventually to higher average 
living standards (Henderson, 2012). An effect derived 
from increased number of  patient years is the added 
consumption that these patients have. 

MATERIALS AND METHODS
Quantitative in nature and social survey method was 
apply for conducting study among the patients who 
received treatment from the outdoor of  Upazilla Health 
Complexes under Jhalakati District.

Study Area
This study was conduct at the Upazilla Health Complexes 
under Jhalakati District.

Population and Unit of  Analysis
The target population use includes all patients who 
received treatment from the outdoor of  Upazilla Health 
Complexes under Jhalakati District. The unit of  analysis 
was individual patient.

Inclusion Criteria
1. Patients who visited outdoor for any services of  

Upazilla Health Complexes under Jhalakati District
2. Patients who were willing to participate in the study
3. Patients who were present during data collection

Exclusion Criteria
1. Patients who visited outdoor for any services of  

Upazilla Health Complexes under Jhalakati District but 
not able to responds.

2. Patients who were not willing to participate in the study
3. Patients who were not present during data collection

Sampling
Sample size was 100 patients. Sampling will be respondents 
were select that are available and interest in interview. 

Techniques of  Data Collection
By using interview and observation techniques. Through 

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purposive sampling 100 respondents were indemnified 
from patients who received treatment from the outdoor 
of  Upazilla Health Complexes under Jhalakati District. 
All the patients were included under the study as 
because a smaller number of  patients in patients who 
received treatment from the outdoor of  Upazilla Health 
Complexes under Jhalakati District. Observation will be 
watching and recording behaviour and characteristics.

Data Analysis and Processing
Microsoft Excel was used to analysis the data. Descriptive 
statistics will be  used to express percentage performance, 
mean, standard deviation table, graph charts and 
interpretation with statistical information.

Ethical Consideration of  the Study
Prior to the commencement of  this study, the research 
protocol was approved by the research committee (local 
ethical committee). The aims and objectives of  the study 
along with its procedure, risks and benefits of  this study 
were explained to the respondents in easily understandable 
local language and then informed consent was taken from 
each participant. Then it was assured that all information 
and records was keep confidential and the procedure was 
used only for research purpose and the findings will be 
helpful for developing awareness package to increase 
awareness and improve hygiene awareness among the 
pregnant mother in hospitals in Bangladesh.

RESULTS AND DISCUSSION
Socio-Demographic Characteristics of  the Respondents.
Most of  the respondents were above middle aged, falling 
the age ranges of  41-45(39), 46-50 (30) and above 51 (9). 
A small number (22) of  them were below 40.

Figure 1: Distribution of  the respondents by age

Figure 2: Distribution of  the respondents by sex

Figure 3: Distribution of  the respondents by religion

The number of  female (59) respondents was a bit higher 
than the number of  male respondents (41) that was 59% 
and 41% respectively.  

Slightly mre than half  the respondents were followers of  
Islam while small numbers of  them were Hindus (22) or 
Christian (23). 

A fairly small number of  the respondents had received 
higher education (2 had done their Masters and 20 of  
them had done their degree level). The rest had studied 
up to finishing their SSCs (20), HSCs (10), were below 
class X but above VI (16) or had only studied up to class 
V or below (16). 

Figure 4: Distribution of  the respondents by educational 
level

The respondents came from a wide variety of  
employments (or businesses) of  which the most common 
sector was the service sector (2), tailoring (10) or owning 
a small business (11). Small numbers of  them were 
scattered across jobs such as fishing (2), farming (7), 
running/working at poultry farms (5), day labouring (4), 
tutoring (2), teaching (3) or being a maid (6). A fairly large 
number of  the woman were housewives (30). 

Table 1: Distribution of  the respondents by occupation
Criteria n %
Housewife 30 30.0
Housemaid 6 6.0
Teacher 3 3.0
Service 20 20.0
Tailoring 10 10.0
Tutoring 2 2.0
Small business 11 11.0
Day laborer 4 4.0
Poultry farm 5 5.0
Agriculture 7 7.0
Fishing 2 2.0
Total 100 100.0

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A very large number of  the respondents were married 
(77). Others were unmarried (1), separated (11), divorced 
(9) or had been deserted (2). 

Figure 5: Distribution of  the respondents by marital 
status

The highest number of  respondents had a fairly low 
income of  between 2000-5000 (54). 32 of  them earned 
between 5000-10000 and only 14 of  them earned more 
than 10000. 

Figure 6: Distribution of  the respondents by income

Slightly more than half  the respondents (51) did not walk 
regularly. The rest did. 

Figure 7: Distribution of  the respondents by regular 
walking status

Very few of  the respondents actually worked out every 
day (18). The majority (82%) did not. 

Figure 8: Distribution of  the respondents by regular 
exercise status

Based on multiple responses, the respondents said that 
they knew diabetes is caused when blood has high sugar 
levels (37) or is the production of  symptoms of  polyuria 
due to high blood sugar levels (56). Only 2 of  them knew 
the fact that it happens when the body does not produce 
enough insulin, or because cells do not. 

Table 2: Distribution of  the respondents by knowledge 
about diabetes mellitus
Criteria n %
Metabolic diseases 9 9.0
A person has high blood sugar 37 37.0
Body does not produce enough 
insulin, or because cells do not

2 2.0

High blood sugar produces the 
classical symptoms of  polyuria

56 56.0

* Multiple responses

A moderately large number of  respondents knew about 
the monitoring tests of  diabetes (61). 

Figure 9: Distribution of  the respondents by knowledge 
about the monitoring tests of  diabetes mellitus

Respondents said the diabetes monitoring tests include 
detecting both hyperglycemia or hypoglycemia (7), 
checking blood glucose concentrations (6), monitoring 
the diet (34) and suggesting exercise (32). 

Table 3: Distribution of  the respondents by knowledge 
about the monitoring tests procedure of  diabetes 
mellitus
Criteria n %
To check blood glucose concentrations 6 6.0
Detecting both hyperglycaemia and 
hypoglycaemia

7 7.0

Monitor the diet required 34 34.0
To suggest exercise 32 32.0
NA 39 39.0
*Multiple responses

Many of  the respondents replied that the hospital has 
enough facilities to provide treatment for diabetes. 25 of  
them were unsure and 18 of  them disagreed saying the 
hospital was not good enough. 

Figure 10: Distribution of  the respondents by attitude 
about this hospital there is enough facilities to provide 
treatment of  diabetes mellitus.

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Table 4: Distribution of  the respondents by opinion 
about the awareness program is necessary to improve 
the knowledge of  DM among the people.
Criteria n %
Yes 100 100.0
Total 100 100.0

All respondents agreed that the awareness program is 
necessary to improve the knowledge of  DM among the 
people.
Based on multiple responses, the respondents said that the 
things required to improve knowledge of  DM among the 
people are TV programs (48), a theater (57), counseling 
(54), newspaper articles (12) or BCC materials.

Table 5: Distribution of  the respondents by knowledge 
about type of  awareness program is necessary to 
improve the knowledge of  DM among the people.
Criteria n %
BCC materials 7 7.0
Theater 57 57.0
Article in newspaper 12 12.0
TV program 48 48.0
Counseling 54 54.0
*Multiple responses

Other than the 23 respondents who were not sure about 
the number of  types of  diabetes, 2 thought there was a 
single type, 24 thought there were 2 types and 26 thought 
there were 3 types. 

Figure 11: Distribution of  the respondents by knowledge 
about the types of  diabetes mellitus

A small number of  respondents knew of  type-1 diabetes 
(32%). Many respondents did not have any knowledge 
about type-1 diabetes (68). The ones who did said that it 
is from the bodies failure to produce insulin (13), requires 
the person to inject insulin (21) or is known as IDDM 
for short (2) 

Most respondents did not know of  gestational diabetes 
(79%). 

Table 6: Distribution of  the respondents by knowledge 
about type 1 diabetes mellitus
Criteria n %
Results from the body's failure to 
produce insulin

13 13.0

Requires the person to inject insulin 21 21.0
Referred to as IDDM for short 2 2.0
Don't know 68 68.0

Figure 13: Distribution of  the respondents by knowledge 
about gestational diabetes

The respondents said that gestational diabetes is when 
pregnant women have a high blood glucose level during 
pregnancy (17) and some knew that it may precede 
development type 2 DM. 

Table 7: Distribution of  the respondents by knowledge 
about gestational diabetes
Criteria n %
When pregnant women have a 
high blood glucose level during 
pregnancy

17 17.0

It may precede development of  
type 2 DM.

4 4.0

I don't know 79 79.0
Total 100 100.0

Figure 12: Distribution of  the respondents by knowledge 
about type 1 diabetes mellitus

CONCLUSION
Bangladesh is a poor country and struggle to manage its 
disease burden. Here, there is a lack of  access to basic 
treatment. In the case of  managing diabetes, insulin is 
a substantial part. Improvements need to be made and 
access to treatment and care for all patients with T2D and 
T1D. It is conceivable that because of  such improvement, 
some  adjustments will take place at a macro level in 
society, but any conclusion would be rather speculative. 
The economic analyses of  the “improved” and I deal 
scenarios assume 100% access to healthcare systems for 
everybody in the country at current prices. The population 
of  Bangladesh Is not literate enough to assess their own 
health to attend the health service provider. Diabetes may 
cause both hyperglycemia as well as hypoglycemia based 
on the situation. It is very important to know the sign 

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symptoms of  both hyperglycemia and hypoglycemia for 
them who are suffering from diabetes to take specific 
precautions. The patient will be aware through the health 
service providers to whom they attend during their 
sickness to be cured. If  the service providers provided 
rationale training on diabetes, then it would be easy for 
them to provide adequate information to the patient to 
prevent and control of  diabetes to reduce the disease 
burden of  Bangladesh.

RECOMMENDATIONS
The study was carried out among the patients attending 
the OPD of  Upazilla Health Complexes under Jhalakati 
District to know their knowledge on diabetes mellitus. 
After analyzing the findings, the study recommends for the 
followings.   

1. The knowledge of  the respondents about the sign 
symptoms of  diabetes mellitus is found to be poor as they 
have less scope to know about the disease. Awareness 
package should be developed to increase the knowledge 
level of  the patients to decrease the morbidity and mortality 
of  the patients due to diabetes mellitus. 

2. The patients who suffer from diabetes were expected to 
be more knowledgeable about the diagnostic procedure of  
the disease diabetes mellitus. But those who are not suffering 
from the disease are found less knowledgeable. It was due 
to the experience they got during the diagnostic procedure. 
General knowledge regarding the diagnostic procedure of  
diabetes mellitus needs to be increased to decrease the fear 
of  the patients about the diagnostic procedure. 

3. The respondents have the considerable knowledge 
about the risk factors of  diabetes mellitus. But the 
knowledge level needs to be further increased so that they 
can avoid the risk factors to get them healthy to live a 
healthful leaving free from diabetes mellitus. 

4. The knowledge of  the respondents about treatment 
procedure is fear because it is very easy to them to 
understand and recall. Intervention to be continued to 
maintain the knowledge level of  the respondents. 

5. Preventing ways of  diabetes mellitus need to be 
broadcast through the national mass media to make 
the people aware. The health service providers should 
be providing enough knowledge, so that they can 
disseminate the knowledge when patients come to them 
for their health service.  
     
REFERENCES 
Agyemang, C., Meeks, K., Beune, E., Owusu-Dabo, E., 

Mockenhaupt, F. P., Addo, J., ... & Stronks, K. (2016). 
Obesity and type 2 diabetes in sub-Saharan Africans–
Is the burden in today’s Africa similar to African 
migrants in Europe? The RODAM study. BMC 
medicine, 14, 1-12.

Amos, A. F., McCarty, D. J., & Zimmet, P. (1997). The 
rising global burden of  diabetes and its complications: 
estimates and projections to the year 2010. Diabetic 
medicine, 14(S5), S7-S85.

Barai, M. K. (2020). Introduction: Construction of  a 

development model for Bangladesh. Bangladesh’s 
Economic and Social Progress: From a Basket Case to a 
Development Model, 3-62.

Einarson, T. R., Acs, A., Ludwig, C., & Panton, U. H. 
(2018). Prevalence of  cardiovascular disease in type 
2 diabetes: a systematic literature review of  scientific 
evidence from across the world in 2007–2017. 
Cardiovascular diabetology, 17(1), 1-19.

Evans, R. G., & Stoddart, G. L. (2017). Producing health, 
consuming health care. In Why are some people 
healthy and others not? 27-64. Routledge.

Grunberger, G., Sherr, J., Allende, M., Blevins, T., Bode, 
B., Handelsman, Y., ... & Unger, J. (2021). American 
Association of  Clinical Endocrinology clinical 
practice guideline: the use of  advanced technology in 
the management of  persons with diabetes mellitus. 
Endocrine practice, 27(6), 505-537.

Henderson, J. V., Storeygard, A., & Weil, D. N. (2012). 
Measuring economic growth from outer space. 
American economic review, 102(2), 994-1028.

Islam, S. M. S., Purnat, T. D., Phuong, N. T. A., 
Mwingira, U., Schacht, K., & Fröschl, G. (2014). 
Non‐Communicable Diseases (NCDs) in developing 
countries: a symposium report. Globalization and health, 
10(1), 1-8.

Lin, X., Xu, Y., Pan, X., Xu, J., Ding, Y., Sun, X., ... & 
Shan, P. F. (2020). Global, regional, and national 
burden and trend of  diabetes in 195 countries and 
territories: an analysis from 1990 to 2025. Scientific 
reports, 10(1), 1-11.

Martinez, N. G., Niznik, C. M., & Yee, L. M. (2017). 
Optimizing postpartum care for the patient with 
gestational diabetes mellitus. American journal of  
obstetrics and gynecology, 217(3), 314-321.

Misra, A., Gopalan, H., Jayawardena, R., Hills, A. P., 
Soares, M., Reza‐Albarrán, A. A., & Ramaiya, K. L. 
(2019). Diabetes in developing countries. Journal of  
diabetes, 11(7), 522-539.

Miroshnychenko, A., Uhlman, K., Malone, J., Waltho, 
D., & Thoma, A. (2021). Systematic review of  
reporting quality of  economic evaluations in plastic 
surgery based on the Consolidated Health Economic 
Evaluation Reporting Standards (CHEERS) 
statement. Journal of  Plastic, Reconstructive & Aesthetic 
Surgery, 74(10), 2458-2466.

Mollica, M. A., Lines, L. M., Halpern, M. T., Ramirez, 
E., Schussler, N., Urato, M., ... & Kent, E. E. (2017). 
Patient experiences of  cancer care: scoping review, 
future directions, and introduction of  a new data 
resource: Surveillance Epidemiology and End Results-
Consumer Assessment of  Healthcare Providers and 
Systems (SEER-CAHPS). Patient Experience Journal, 
4(1), 103-121.

Njiru, L. N. (2022). Association between depression, 
anxiety and adherence to treatment among patients 
attending the Kenyatta National Hospital (KNH) 
diabetes outpatient clinic (Doctoral dissertation, 
University of  Nairobi).

https://journals.e-palli.com/home/index.php/ajmsi


Pa
ge

 
15

https://journals.e-palli.com/home/index.php/ajmsi

Am. J. Med. Sci. Innov. 2(2) 8-15, 2023

Paul, R., & Norbury, C. (2012). Language disorders from 
infancy through adolescence-E-Book: Listening, 
speaking, reading, Writing, and Communicating. 
Elsevier Health Sciences.

Rydén, L., Grant, P. J., Anker, S. D., Berne, C., Cosentino, 
F., ... & Xuereb, R. G. (2013). ESC Guidelines on 
diabetes, pre-diabetes, and cardwiovascular diseases 
developed in collaboration with the EASD: the Task 
Force on diabetes, pre-diabetes, and cardiovascular 
diseases of  the European Society of  Cardiology 
(ESC) and developed in collaboration with the 
European Association for the Study of  Diabetes 
(EASD). European heart journal, 34(39), 3035-3087.

Shaikh, Z. A., SHAIKH, M. Z., & ALI, G. (2011). Diabetic 
patients: Awareness about life style modifications. The 
Professional Medical Journal, 18(2), 265-268.

Shivashankar, M., & Mani, D. (2011). A brief  overview 
of  diabetes. International Journal of  Pharmacy and 
Pharmaceutical Sciences, 3(4), 22-27.

Shinjyo, N., & Green, J. (2017). Are sage, rosemary and 
lemon balm effective interventions in dementia? A 
narrative review of  the clinical evidence. European 
Journal of  Integrative Medicine, 15, 83-96.

Talukder, A., & Hossain, M. Z. (2020). Prevalence 
of  diabetes mellitus and its associated factors 
in Bangladesh: application of  two-level logistic 
regression model. Scientific Reports, 10(1), 10237.

Umpierrez, G., & Korytkowski, M. (2016). Diabetic 
emergencies—ketoacidosis, ]hyperglycaemic 
hyperosmolar state and hypoglycaemia. Nature Reviews 
Endocrinology, 12(4), 222-232.

Van Dyne, L., Ang, S., & Koh, C. (2015). Development 
and validation of  the CQS: The cultural intelligence 
scale. In Handbook of  cultural intelligence, 34-56. 
Routledge.

Van Roy, B., Groholt, B., Heyerdahl, S., & Clench-Aas, 
J. (2010). Understanding discrepancies in parent-child 
reporting of  emotional and behavioural problems: 
Effects of  relational and socio-demographic factors. 
BMC psychiatry, 10(1), 1-12.

Zheng, Y., Ley, S. H., & Hu, F. B. (2018). Global aetiology 
and epidemiology of  type 2 diabetes mellitus and its 
complications. Nature reviews endocrinology, 14(2), 88-98.

Zimmet, P. Z., Magliano, D. J., Herman, W. H., & Shaw, 
J. E. (2014). Diabetes: a 21st century challenge. The 
lancet Diabetes & endocrinology, 2(1), 56-64.

https://journals.e-palli.com/home/index.php/ajmsi

