INTRODUCTION:

The pancreas has both endocrine and eocrine function. Endocrine role relating to the secretion of substances of insulin and other substances within pancreatic islets and helping control blood sugar levels and metabolism within the body. Exocrine role relating to the secretion of enzymes involved in digesting substances from outside of the body.⁷

Globally, an estimated 422million adults are living with diabetes, according to the latest 2016 data from the WHO. Diabetes prevalence is increasing rapidly, previous 2013 estimates from the International Diabetes Federation put the number at 381 million people having diabetes. The number is projected to almost double by 2030.^6,7

NEED FOR THE STUDY:

Diabetes Mellitus is a disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood. The prevalence of diabetes increased by 3.3% in Chennai in the last decade, 3.9% in Kancheepuram, and 4.2% in a village near Panruti, a study by a Chennai-based diabetes research centre. There was also a significant increase in the prevalence of pre-diabetes in these areas, due to a combination of risk factors such as age, family history and obesity. One of the strong indicators to the forecast is the prevalence of prediabetes. The prevalence of prediabetes in Chennai has grown from 12.4% in 2006 to 19% in 2016, from 6.1% to 21% in Kancheepuram and from 7.8 % to 14.8% in Panruti.^5,7

Awareness of various aspects of Diabetes Mellitus (DM) is essential for the prevention, management and control of the disease. Awareness of DM in the general population is low.⁸

Poor self-help/lifestyle and reduced knowledge/ awareness about diabetic control are the factors in patients on insulin or with longer diabetic duration. This is a worrying finding as these patients are already at high risk for developing diabetic complications.⁵

STATEMENT OF THE PROBLEM:

A Study to Assess the Level of Knowledge Regarding Diabetes Mellitus among Selected Community, Coimbatore

OBJECTIVES OF THE STUDY:

1. Assess the level of knowledge regarding diabetes mellitus among selected community

2. Provide an informational booklet on self-care management of person with diabetes mellitus

OPERATIONAL DEFINITION:

Assess:

It helps to assess the level of knowledge of diabetes mellitus among selected community

Knowledge:

It refers to the response of the population on diabetes mellitus by structured questionnaire. It has 25 objective types of questions and the total knowledge score is 25.

Diabetes Mellitus:

It is a metabolic disorder of increased blood sugar.

Selected Community:

It refers to the person who resides at Rathinagiri, Coimbatore.

REVIEW OF LITERATURE:

Domenico Accili (2017), Diabetes is caused by combined abnormalities in insulin production and action. The pathophysiology of these defects has been studied extensively and is reasonably well understood. Their causes are elusive and their manifestations pleiotropic, likely reflecting the triple threat of genes, environment, and lifestyle. Treatment, once restricted to monotherapy with secretagogues or insulin, now involves complex combinations of expensive regimens that stem the progression but do not fundamentally alter the underlying causes of the disease. As advances in our understanding of insulin action and β-cell failure reach a critical stage, here I draw on lessons learned from our research on insulin regulation of gene expression and pancreatic β-cell dedifferentiation to address the question of how we can translate this exciting biology into mechanism-based interventions to reverse the course of diabetes.

Chaudhary Muhammad Junaid Nazar, Micheal Mauton Bojerenu, Muhammad Safdar (2016), Diabetes mellitus is a metabolic disorder that is characterized by high blood glucose level, and body cannot produce enough insulin, or does not respond to the produced insulin. In spite of the diabetes education campaigns and programmes, a large number of people in the United Kingdom are living with diabetes. The main objective of the study is to evaluate the role of knowledge and awareness of diabetes in fighting against diabetes and to interpret to which extent is diabetes education successful. The systematic review to be carried out will include literature from 2001 to 2011 in the United Kingdom regarding awareness of diabetes among UK population and effectiveness of diabetes education. This study is going to summarize the efficacy of diabetes education campaigns and programmes which are promising to enhance the awareness The outcome of the review will be the guideline for the government, education centres, researchers, and campaigns to implement more diabetic education programmes and easily accessible diabetes services and education interventions to increase the awareness of risk factors and complications of diabetes to overcome the increasing epidemic of diabetes in the United Kingdom.

Beteena Kurian, Mariya Amin Qurieshi, Rajini Ganesh, Kamalamma Leelamoni (2016). The objective of this study is to assess the knowledge of diabetes mellitus in a rural populace of Kerala. A descriptive cross-sectional study was undertaken in a rural Panchayat of District Ernakulam of Kerala wherein 343 adults were randomly interviewed from six randomly selected wards. The interview schedule had 23 items on knowledge which was assessed in four domains including general awareness of diabetes mellitus, its risk factors, complications, and lifestyle modifications. Each item was given a score. Maximum possible score was 23. Knowledge score of <9 was considered as poor, 9-17 as average and above 17 was taken as good. Data were analyzed using SPSS version 11. Descriptive analysis was done for sociodemographic variables, and t-test and ANOVA were used to ascertain the level of significance of predictors of awareness. Mean age of the participants was 47.7±15.74 years with more than half (55.7%) having completed their high school education. Mean knowledge score was 15.6. Being diabetic, having completed high school education and with family history of diabetes had significantly better knowledge score (P < 0.05). Educating the community on risk factors is the key strategy for the prevention of diabetes and delaying the onset of disease among high-risk individuals.

Yee Cheng Kueh (2016), We examined the effect of diabetes knowledge and attitudes on self-management and quality of life (QOL) of people with type 2 diabetes mellitus (T2DM). We employed a cross-sectional study design. A total of 137 female and 129 male participants with T2DM completed the diabetes knowledge scale (DKN), Diabetes Integration Scale-19 (ATT19), Summary of Diabetes Self-care Activities (SDSCA) scale, and Diabetes Quality of Life (DQOL) scale, measuring diabetes knowledge, attitudes, self-management, and QOL respectively. The final model showed a good fit to the data: RMSEA = .045 (90% CI: .009, .071; Clfit = .601), CFI = .950, SRMR = .058. The findings suggest a theoretical basis to direct the development of appropriate health programs and interventions for improving QOL in people with T2DM and warrant replication in diverse samples.

METHODOLOGY:

Research Approach:

Quantitative research approach was adopted for the study.

Research Design:

Descriptive research design was adopted in this study.

Setting:

The study was conducted in selected community, Coimbatore. It is located at Rathinagiri.

Population:

In this study, population consists of person with the age group between 30- 60 years

Sampling and Sample Size:

A total of 50 persons were selected for the study using convenient sampling technique.

Criteria for sample selection:

Inclusion Criteria:

1. Persons who are residing at Rathinagiri

2. Persons who are willing to participate at the time of data collection.

3. Persons with the age group between 30-60 years

4. Both gender of samples

Exclusion Criteria:

Persons with the age group below 30 years.

Instrument and Tool used for Data Collection:

Section A: A demographic profile comprised of the information regarding age, gender, marital status, education, employment status, social habits, history of diabetes mellitus, type of physical activity, details of menopause and proportion of weight in to height.

Section B: Structured interview questionnaire was used to assess the level of knowledge on diabetes mellitus. It consists of 25 questions. The correct answer carries ‘‘one’’ and wrong answer carries “zero”.

Score Interpretation: <50%= inadequate knowledge, 51 - 75%= moderately adequate knowledge > 75%= adequate knowledge

Data Collection Procedure:

The main study was conducted at selected community, Coimbatore. 50 Samples were identified by using convenient sampling technique. Study was conducted using structured questionnaire to assess the level of knowledge regarding blood donation among selected community.

Techniques of Data Analysis and Interpretation: Descriptive statistics was applied for the analysis of demographic variables and level of knowledge regarding diabetes mellitus

Data Analysis and Interpretation:

Table 4.1: Frequency and Percentage Distribution of Demographic Variables

S. No.	Demographic variables	Frequency	%
1	Age in Years
	a. 30-40 years	23	46
	b. 41-50 years	11	22
	c. 51-60 years	10	20
	d. More than 61 years	6	12
2	Gender
	a. Male	21	42
	b. Female	29	58
3	Educational status
	a. Illiterate	19	38
	b. Primary	5	10
	c. Middle school	7	14
	d. High school	6	12
	e. Higher secondary and above	13	26
4	Employment status
	a. Employed	33	66
	b. Unemployed	16	32
	c. Others	1	2
5	Marital status
	a. Single	6	12
	b. Married	40	80
	c. Widowed	4	8
6	Duration of Diabetes mellitus and its treatment
	a. Yes	20	40
	b. No	30	60
7	Social habit	Yes
	a. Smoking	11	22
	b. Alcohol	15	30
8	Smoking habit
	a. Less than 10 years	6	12
	b. 11-15 years	2	4
	c. 16-20 years	2	4
	d. More than 21 years	1	2
9	Number of cigarettes per day
	a. 1-10	3	6
	b. 11-20	8	16
10	Habit of alcohol intake
	a. Monthly once	3	6
	b. Weekly once	10	20
	c. Daily	1	2
	d. occasionally	1	2
11	Menopause
	a. Yes	17	34
	b. No	12	24
12	Proportion of weight in to height
	a. Yes	36	72
	b. No	14	28
13	Physical activity
	a. Light	15	30
	b. Moderate	17	34
	c. Active	18	36

· Table 4.1 reveals that, 23(46%) of samples were age between 30-40 years, 11(22%) were in the age group between 41-50 years, 10(20%) of samples were age between 51-60 years and 6(12%) of samples were age above 61 years

· 29 (58%) of samples belong to female and remaining 21(42%) of samples belong to male.

· 19 (38%) samples were illiterate, 5(10%) of samples were primary school education, 7 (14%) of samples were middle school education, 6 (12%) of samples were high school and 13(26%) of samples were higher secondary and above.

· It portrays that, 33 (66%) of samples were employed, 16 (32%) of samples were unemployed and 1(2 %) of sample was retired.

· Majority of samples 40 (80%) were married, 6 (12%) of samples were single and 4(8%) of samples were widowed.

· 20 (40%) of samples had history of diabetes mellitus.

· 11(22%) of samples were smokers and 15(30%) of samples were alcoholic.

· 6 (12%) of samples were smoker less than 10 years, 2 (4%) of samples were smoker between 11-15 years 2(4%) of samples were smoker between 16-20 years and 1 (2%) of sample were smoker more than 21 years

· 3(6%) of samples smoked nearly 1-10 cigarettes per day and 8(16%) of samples smoked approximately 11-20 cigarettes per day.

· Among 15 samples, majority of samples 10(20%) had alcohol weekly once, 3 (6%) of samples had alcohol monthly once and 1(2%) of samples had alcohol daily and occasionally

· 29 samples, 17(34%) of samples attained menopause.

· Most of the samples 36(72%) had proportion of weight into height.

· 18(36%) of samples were active, 15(30%) of samples were light type of physical activity and 17 (34%) of them were moderate type of physical activity.

Analysis of Level of Knowledge on Diabetes Mellitus:

Table 4.2: Analysis on Level of Knowledge on Diabetes Mellitus among sample [n=50]

Sl. No.	Level of Knowledge	Frequency	%
1	Inadequate (<50%)	29	58
2	Moderately adequate (51-75%)	13	26
3	Adequate (>75%)	8	16

Table 4.2 shows that 13(26%) samples had moderately adequate level of knowledge, 8(16%) of samples had adequate level of knowledge and 29(58%) of the samples had inadequate level of knowledge regarding diabetes mellitus.

RESULTS AND DISCUSSION:

· In this present study, 50 samples were selected based on the criteria. Regarding age group distribution, 23(46%) of samples were age between 30-40 years, 11(22%) were in the age group between 41-50 years, 10(20%) of samples were age between 51-60 years and 6(12%) of samples were age above 61 years

· Gender distribution among samples, 29(58%) of samples belong to female and remaining 21(42%) of samples belong to male.

· Regards to educational status among samples, 19 (38%) samples were illiterate, 5(10%) of samples were primary school education, 7(14%) of samples were middle school education, 6 (12%) of samples were high school and 13(26%) of samples were higher secondary and above.

· Regarding the employment status, 33(66%) of samples were employed, 16(32%) of samples were unemployed and 1(2 %) of sample was retired.

· According to marital status of samples, majority of samples 40(80%) were married, 6(12%) of samples were single and 4(8%) of samples were widowed.

· History of Diabetes mellitus, 20(40%) of samples had history of diabetes mellitus. 11(22%) of samples were smokers and 15(30%) of samples were alcoholic.

· Social habit of samples, 6(12%) of samples were smoker less than 10 years, 2(4%) of samples were smoker between 11-15 years 2(4%) of samples were smoker between 16-20 years and 1 (2%) of sample were smoker more than 21 years

· Number of cigarettes per day among samples, 3(6%) of samples smoked nearly 1-10 cigarettes per day and 8(16%) of samples smoked approximately 11-20 cigarettes per day. Regarding alcohol intake, among 15 samples, majority of samples 10(20%) had alcohol weekly once, 3(6%) of samples had alcohol monthly once and 1(2%) of samples had alcohol daily and occasionally

· Details of menopause, among 29 samples, 17(34%) of samples attained menopause.

· Most of the samples 36(72%) had proportion of weight into height.

· According to physical activity, 18(36%) of samples were active, 15(30%) of samples were light type of physical activity and 17(34%) of them were moderate type of physical activity.

· 13(26%) samples had moderately adequate level of knowledge, 8(16%) of samples had adequate level of knowledge and 29(58%) of the samples had inadequate level of knowledge regarding diabetes mellitus.

CONCLUSION:

Diabetes mellitus affects 1in 4 people over the age of 65. The blood sugar should be controlled with proper medications and lifestyle changes. Education is important for both types of diabetes. Informational booklet will definitely help to the public regarding 5 D’S may help to manage the diabetes such as Diabetic diet, Drug, Daily monitoring of blood glucose levels, Daily exercises and Diabetic foot care.

REFERENCES:

1. Domenico Accili (2017) The Banting Medal for Scientific Achievement Lecture was presented at the American Diabetes Association’s 77th Scientific Sessions in San Diego, CA, on Sunday, 11 June 2017. Diabetes 2018; 67(9): 1701-1709. https:// doi.org/10.2337/dbi18-0025

2. Chaudhary Muhammad Junaid Nazar , Micheal Mauton Bojerenu , Muhammad Safdar, Jibran Marwat (2016) Effectiveness of diabetes education and awareness of diabetes mellitus in combating diabetes in the United Kigdom, 1(2): 59-64

3. Beteena Kurian, Mariya Amin Qurieshi, Rajini Ganesh, Kamalamma Leelamoni (2016), A community-based study on knowledge of diabetes mellitus among adults in a rural population of Kerala, DOI: 10.4103/2468-8827.191925

4. Yee Cheng Kueh (2016), The effect of diabetes knowledge and attitudes on self-management and quality of life among people with type 2 diabetes , Psychology, Health and Medicine 22(2): 1-7, DOI: 10.1080/13548506.2016.1147055

5. William T.Cefalu, (2021), “Medical Management of Diabetes Mellitus”, Taylor and Francis.

6. Krishna G Seshadri, KM Prasanna Kumar and Aravind Sosale, “Clinician’s Handbook of Diabetes” 3^rd ed, Tree Life Media

7. Kamlakar Tripathi and Anju Maheswari (2015),” Fundamentals of Diabetes”. Jaypee Brothers Medical Publishers.

Received on 20.03.2021 Modified on 18.04.2021

Int. J. Nur. Edu. and Research. 2021; 9(3):317-321.

DOI: 10.52711/2454-2660.2021.00074