E-ISSN:2583-4487

Research Article

Type 2 Diabetes Mellitus

Global Journal of Novel Research in Applied Sciences

2022 Volume 1 Number 1 Jan-Jun
Publisherwww.adsrs.net

A Study to Assess the Awareness of the Complication of type 2 Diabetes Mellitus and to Evaluate the Effectiveness of Counselling Program for Primary Prevention of Type 2 DM in Young Adult

Hima Dutta B.1*, Gaurav K.2
DOI: https://doi.org/10.58260/j.nras.2202.0105

1* Baruah Hima Dutta, Department of Biosciences, School of Basic and Applied Sciences Galgotias University, Greater Noida, Uttar Pradesh, India.

2 Kumar Gaurav, Department of Biosciences, School of Basic and Applied Sciences Galgotias University, Greater Noida, Uttar Pradesh, India.

The rapidly increasing number of incidences, severity, its complication, and the socio-economic burden greatly demonstrate the need and importance of the preventive action for type 2 diabetes mellitus. It has been become important to emphasize the call for the primary prevention. Objectives of the study is to assess the awareness of cause complication and prevention of about type 2 diabetes mellitus among young adults, to evaluate and assess the effectiveness of a counselling program regarding causes, complication and prevention for the primary prevention of type 2 Diabetes mellitus, and to find the relationship between socio-demographical variables and level of awareness on diabetes mellitus. For this study an evaluative approach was considered. The pre-experimental design consists of pre-test and post-test observation made on different days with only one selected group and without a control group. The overall mean awareness score present in pre-test is 46.1 and the post-test 82.2% and there was enhancement of knowledge score found to be 36.4%. Therefore, it was established that there was significant increase in the awareness level after the counselling program. From this study it was found that demographic variables like educational status, family income, age group has impact on the knowledge of the respondent. The present study has demonstrated that counselling program is sufficiently effective and viable for achievement of the goal for primary prevention of Diabetes Mellitus in ordinary community.

Keywords: Type 2 Diabetes Mellitus, Primary Prevention, Counselling Program

Corresponding Author How to Cite this Article To Browse
Baruah Hima Dutta, , Department of Biosciences, School of Basic and Applied Sciences Galgotias University, Greater Noida, Uttar Pradesh, India.
Email: 		Baruah Hima Dutta, Kumar Gaurav, A Study to Assess the Awareness of the Complication of type 2 Diabetes Mellitus and to Evaluate the Effectiveness of Counselling Program for Primary Prevention of Type 2 DM in Young Adult. Glo.Jou.Nov.Res.App.Sci. 2022;1(1):23-29.
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http://nras.adsrs.net/index.php/nras/article/view/5

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-06-08 2022-06-11 2022-06-14 2022-06-23 2022-06-30
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 16%

© 2022by Baruah Hima Dutta, Kumar Gauravand Published by ADSRS Education and Research. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Dutta B et al: Complication of type 2 Diabetes Mellitus and Counselling Program

Introduction

Diabetes Mellitus (DM) is believed to be due to a complex interplay between environmental and genetic factors. However recent epidemiologic studies prove that the current world-wide epidemic of Diabetes Mellitus is mostly resulted from diet and lifestyle [1-3]. The prevention diabetes mellitus becoming more challenging and urgent especially in the developing countries because it is the developing countries which is anticipated to bear the burden of rising diabetes outbreak in the future.

The rapidly increasing number of incidences, severity, its complication, and the socio-economic burden greatly demonstrate the importance and necessity of the preventive action for type 2 DM. It has been become important to emphasize the call for the primary prevention and increase in awareness of type 2 DM. To implement the action for the primary prevention there is need for awareness and increased knowledge about the aetiology, Pathophysiology, and complication. The necessity for prevention of DM2 was recognized as early as 1920 but little was done [4-7].

Since last 15 years, the need for prevention of Diabetes Mellitus was highly emphasized. The main motive to prevent Diabetes Mellitus is to prevent or delay the long-term complication related to this disease and also to minimize the socio-economic brunt and anguish on the society [8].

A randomized control trial was conducted by Diabetes prevention program group, a to compare the safety and efficacy of a rigorous intervention of life style modification or life style recommendations which is standard and was combined with either metformin or placebo had demonstrated that intensive life style modification intervention helped in reduction in type 2 diabetes mellitus risk by 58 percent and was superior to the group that combined metformin [Diabetes Prevention Research Group, 2002]. The objective of current study is to assess the awareness of cause complication and prevention of about type 2 diabetes mellitus among young adults [9]. To evaluate the effectiveness of a counselling program regarding causes, complication and prevention for the primary prevention of type 2 DM. The find the relationship between socio-demographical variables and level of awareness on diabetes mellitus.


Materials and Methods

The present study is to evaluate the effectiveness of counselling program on causes, hazards and prevention of type 2 Diabetes Mellitus and for the objectives to be accomplished, an evaluative approach was considered for the present study. The classical approach for the conduct of evaluative research consists of: Determining the objectives, developing a means of measuring, Collection of data and interpretation of the data. The pre-experimental design consists of pre-test and post-test observation made on different days with only one selected group and without a control group.

The tool was developed by reviewing of literature, preparing the blue print and then developed the structured Knowledge Questionnaire (items). The blue print of the items was prepared based on the four domains of learning, mainly; knowledge on general aspect of Diabetes Mellitus10 items (25%), causes of type 2 Diabetes Mellitus 10 items (25%), Complication of type 2 Diabetes Mellitus 10 items (25%) and prevention of Diabetes Mellitus 10 items (25%) [9-12].

A prior permission was obtained from the authorities of urban family welfare center in West Delhi. The survey was done to identify young adult’s age between 20-30 years at Hari Nagar area and sample was drawn for study. The purpose of the study was explained an informed consent was taken before starting the study. A pre-test was conducted by administering a structured knowledge questionnaire on causes complication and prevention of type 2 Diabetes Mellitus. On the same day, the Counseling program was administrated [13-14]. The post-test was conducted by using the same structured knowledge questionnaire after 7th day of the administration of counselling program.

Result

The result deals with the analysis and interpretation of the data collected in order to determine the effectiveness of counselling program on “Causes, complication and prevention of type 2 Diabetes Mellitus” in increasing the knowledge regarding the type 2 Diabetes Mellitus of 40 young adult who completed the three major phases of the study. The results were computed descriptive and inferential statistics based on the objectives of the study.


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Dutta B et al: Complication of type 2 Diabetes Mellitus and Counselling Program

It is observed from the result that among 40 young adults, 19 (47.5%) were between the age group of 22 to 25 years, 11 (27.5%) were age group of 25 to 27 years and 10 (25%) from the age group of more than 27 years.

Educational status of the respondents reveals that 18 (45%) subjects’ educational status are High school, 12 (30%) subjects’ educational status are PUC, 5 (12.5%) with middle school and 5 (12.5%) are studied University.

Occupation of the respondents reveal that 24 (60%) of respondents were student, 11(27.5%) of the respondents were employee and 5 (12.5%) of respondents were business.

Percentage distribution of subjects according to the family history of Diabetes Mellitus Majority of the 24(60%) said yes and 16 (40%) said no to family history of Diabetes Mellitus [13-17].

Representing the frequency and percentage of distribution of subjects according to the source of information Majority of subjects that is 28 (70 %) mentioned as source of information as T.V., 6 (15%) mentioned as family members, 6 (15%) mentioned as newspaper.

a. Aspect wise Pre-test Mean Knowledge scores of Respondents on Diabetes Mellitus

Table-1: N=40

No. Knowledge Aspects on Diabetes Mellitus Statements Max. Score Respondents Knowledge
Mean Mean (%)  SD
I General aspects 10 10 5.03 50.3 10.3
II Causes 10 10 4.25 42.5 10.3
III Complication 10 10 4.85 48.5 10.8
IV Prevention 10 10 4.33 43.3 17.2
V Combined 40 40 18.45 46.1 5.3

Table-1 depicts the distribution of aspect wise pre-test mean knowledge score regarding general aspect, causes, complication and prevention of type 2 Diabetes Mellitus.

The mean knowledge score was 50.3% in general aspect, 42.5% in causes, 48.5% Complication and 43.3% in preventive aspect of type 2 Diabetes Mellitus. The total mean pre-test knowledge score was 46.1% with standard deviation of ±5.3. This is depicted in fig.1

nras_05_01.JPG

Fig.1: Aspect wise Pre-test Mean Knowledge scores on Diabetes Mellitus

b. Aspect wise Post-test Mean Knowledge scores of Respondents on type 2 Diabetes Mellitus:

Table-2: N=40

No. Knowledge Aspects on type 2 Diabetes Mellitus Statements Max. Score Respondents Knowledge
Mean Mean (%)  SD
I General aspects 10 10 8.13 81.3 15.1
II Causes 10 10 8.50 85.0 8.5
III Complication 10 10 8.45 84.5 6.8
IV Prevention 10 10 7.95 79.5 9.6
V Combined 40 40 33.03 82.6 6.8

Table-2 depicts the distribution of aspect wise post-test mean knowledge score regarding general aspect causes, hazards and preventive aspects.

The mean knowledge was 81.3% in general aspect, 85.0% in cause’s aspects, 84.5% in the aspects of complication and 79.5% in preventive aspects.

The total mean post-test knowledge score was 82.6 % with standard deviation of ±6.8. This is depicted in fig.2

nras_05_02.JPG

Fig 2: Aspect wise Post-test Mean Knowledge scores on type 2 DM



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Dutta B et al: Complication of type 2 Diabetes Mellitus and Counselling Program

c. Aspect wise mean Pre-test and Post-test Knowledge on type 2 Diabetes Mellitus [18-20] 
Table–3: N= 40

No. Knowledge Aspects on type 2 Diabetes mellitus Respondents Knowledge (%) Paired ‘t’ Test
Pre test Post test Enhancement
Mean SD Mean SD Mean SD
I General aspects 50.3 10.3 81.3 15.1 31.0 15.0 13.07*
II Causes 42.5 10.3 85.0 8.5 42.5 13.3 20.21*
III Complication 48.5 10.8 84.5 6.8 36.0 11.3 20.15*
IV Prevention 43.3 17.2 79.5 9.6 36.3 16.4 14.00*
  Combined 46.1 5.3 82.6 6.8 36.4 7.8 33.85*

* Significant at 5% level t (0.05, 39 d.f) = 1.96

Table-3 Depicts that young adult has lowest knowledge score in the general aspects (31%) and highest in the causes (42.5%) The pre-test and post test score in general aspect were 50.3% and 81.3% and mean percentage 31% respectively. The knowledge in the aspect of causes were 42.5%(pre-test) and 85% (post-test) with mean percentage 42.5% respectively. The pretest and post-test knowledge score in the complication aspects were 48.5% and 84.5% with mean percentage 36 % respectively the pre-test and post test score in the preventive aspect were 43.3 % and 79.5% with mean percent 36.3% respectively.

The statistical paired “t” test implies that the difference in pre-test and post-test knowledge score in various aspects found statistically significant at 5% level. The post-test mean knowledge enhancement was 31.0 with paired “t” value of 13.07* in the general aspect of type 2 diabetes mellitus. The post-test mean knowledge score in the aspect of causes is 42.5% with paired “t” value of 20.21* %. The post-test mean knowledge enhancement of in the aspect of complication was 36.0% with a paired “t” value of 20.15*%. The post-test mean knowledge enhancement in preventive aspect was 36.3% with a paired “t” value of 14.00*%. The combine post-test knowledge enhancement was 36.4 with a paired “t” value of 33.85*. 

Classification of Respondents on Knowledge level on Causes, Complication, and Prevention of type 2 diabetes mellitus [21-23]
Table– 4

Knowledge Level Category Classification of Respondents
Pre test Post test
Number Percent Number Percent
Inadequate < 50% Score 26 65.0 0 0.0
Moderate 51-75 % Score 14 35.0 15 37.5
Adequate > 75 % Score 0 0.0 25 62.5
Total   40 100.0 40 100.0

Table: 4 shows that the knowledge level of young adults regarding causes, complication and prevention of type 2 diabetes mellitus that result indicate that 26 (65%) of respondents had inadequate knowledge on pre-test, 14 (35%) of respondents noticed with moderate knowledge on pre-test. After post-test 25 (62.5%) of respondents got adequate knowledge level and 15 (37.5%) Respondents got moderate knowledge on cause hazard and prevention of type 2 diabetes mellitus.

However, the difference in the knowledge level of respondents between pre and post-test found to be statistically significant.

Association between demographic variables and pre-test knowledge scores [23-24]

Table 5 N=40

S. N Variable Category  Knowledge scores  c2  value d.f  Table value
Inadequate Moderate Total
N % N %
1   Age (Years) 22-25 16 84.2 3 15.8 19 6.36* 2 5.991
25-27 6 54.5 5 45.5 11
>30 4 40.0 6 60.0 10
2 Religion Hindu 16 55.2 13 44.8 29 4.47* 1 3.841
Others 10 90.9 1 9.1 11
3 Educational level High school 1 20.0 4 80.0 5 10.05* 2 5.991
PUC 16 88.9 2 11.1 18
University 9 52.9 8 47.1 17
4  Occupation Student 14 58.3 10 41.7 24 3.17NS 2 5.991
Business 5 100.0 0 0.0 5
Service 7 63.6 4 36.4 11
5 Family income 19 79.2 5 20.8 24 5.29*   1   3.841
>Rs.20,000 7 43.8 9 56.2 16
6 Type of family  Nuclear  14 70.0 6 30.0 20   1.06NS    2   5.991
Joint 5 71.4 2 28.6 7
Extended 7 53.8 6 46.2 13
7 Father history of Diabetes Yes 15 62.5 9 37.5 24 0.17NS 1 3.841
No 11 68.7 5 31.3 16
8 Source of information Television 18 64.3 10 35.7 28 1.49NS 2 5.991
News paper 3 50.0 3 50.0 6
Family member 5 83.3 1 16.7 6

NS: Non Significant P value: 0.05 *: Significant at 5% level

Table 6 describe significant association between age, religion, education and family income with the pre-test knowledge score young adults. Hence research hypothesis H2 is accepted.


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Dutta B et al: Complication of type 2 Diabetes Mellitus and Counselling Program

Whereas occupation, type of family, family history of type 2 Diabetes Mellitus, and Source of information found non-significant in pre-test. Hence null hypothesis HO2 stated in study is accepted and research hypothesis H2 rejected since there is no significant impact on demographic variables.

Association between demographic variables and post-test knowledge scores:

Table- 6: N 40

S.N.   Variable   Category  Knowledge scores  c2 value df Table value 
Moderate Adequate Total
N % N %
1   Age (Years) 22-26 7 36.8 12 63.2 19 1.16NS 2 5.991
27-31 3 27.3 8 72.7 11
>31 5 50.0 5 50.0 10
2 Religion Hindu 12 41.4 17 58.6 29   0.67NS   1 3.841
Others 3 27.3 8 72.7 11
3 Educational level High school 2 40.0 3 60.0 5 0.86NS 2 5.991
PUC 8 44.4 10 55.6 18
University 5 29.4 12 70.6 17
4 Occupation Student 8 33.3 16 66.7 24   0.49NS   2 5.991
Business 2 40.0 3 60.0 5
Private 5 45.5 6 54.5 11
5 Family income 8 33.3 16 66.7 24   0.44NS 1 3.841
>Rs.20,000 7 43.7 9 56.3 16
6 Type of family  Nuclear  8 40.0 12 60.0 20   2.36NS    2   5.991
Joint 4 57.1 3 42.9 7 
Extended 3 23.1 10 76.9 13
7 Family history of Diabetes Yes  9 37.5 15 62.5 24   0.00NS   1   3.841
No 6 37.5 10 62.5 16
8 Source of information Television 11 39.3 17 60.7 28 0.13NS 2 5.991
News paper 2 33.3 4  66.7 6
Family member 2 33.3 4 66.7 6

NS: Non-Significant P value: 0.05 *: Significant at 5% level

Discussion

Text In 1994, the WHO study group put forward a powerful implication that the diabetes prevention nationwide program should be given importance. But there was nothing implemented so far. From the abundance of observational data from all over the world, it was apparently evident that the lifestyle factors including obesity and physical inactivity are growing throughout the world and along with these trends, there is a steep rise in the no of prevalence of type 2 diabetes mellitus.

The sedentary life style pattern not only becomes an issue for the adult but also for the children and adolescents.

What is important is there is a need for systematic approach like counselling to target life-style modification in those individuals. Screening of the high-risk individual is not sufficient for effective prevention of DM2.

Conclusion and Recommendation

It has been demonstrated by earlier studies that the lack of awareness of Diabetes Mellitus is the main reason behind high prevalence of this disease in urban areas.

As per a study conducted in South India [CURE study] around 25% of people are not even aware of condition called Diabetes Mellitus. Additionally, it was also noted that the knowledge and awareness regarding the complication of Diabetes Mellitus was poor and less than 50% aware of the fact that Diabetes is preventable. Awareness program and counselling program not only facilitate prevention of Diabetes Mellitus, but also considered as a tool for increasing the awareness of other disease. Several epidemiological studies showed that there is a rapid increase in the prevalence of Diabetes Mellitus in the urban areas. Moreover, there has been a shift in age of onset to younger group of adults which alarming on the nation’s economy.

In conclusion the present study demonstrated effectiveness and feasibility of counselling program in increasing the level of awareness and knowledge level in terms of prevention of type 2 diabetes mellitus.

The study included young adults aged between 20-30 years. The objective was to increase the knowledge level and awareness about life style modification primary prevention of Diabetes Mellitus. It was noted that the counselling program was effective to increase the awareness and knowledge level of the young adult regarding dietary pattern, importance of physical activity and necessity for modification of life style for prevention of type 2 Diabetes mellitus 

Acknowledgement: A prior permission was obtained from the authorities of urban family welfare center in West Delhi.


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Declaration: We Author(s) of the above titled paper hereby declare that the work included in the above paper is original and is an outcome of the research carried out by the authors indicated in it. Further, We author(s) declare that the work submitted has not been published already.

Reference

1. Joshlin E. The prevention of diabetes mellitus. JAMA 76: 79-84, 1921

2. Wild Sarah, Sircee R et al. Global prevalence of Diabetes: Estimate for the 2000 and projection for 2030. Diabetes Care, 27(5): 1047-1053, 2004

3. Morris RD, Rimm DL, Hartz AJ, Kalkhoff RK, Rimm AA: Obesity and heredity in the etiology of non-insulin dependent diabetes mellitus in 32,662 adult white women. Am J Epidemiol130:112-121, 1989

4. Van Dam RM, Rimm EB, Willett WC, Stampher MJ, and Hu FB: Dietary patterns and risk for type 2 Diabetes Mellitus in U.S. men. Ann Intern Med 136:201-209, 2002.

5. McKeigue PM, Shah B, Marmot MG. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet 1991; 337: 382-386.

6. Mohan V. Sharp PS, Cloke HR, Burrin JM, Schumer B, Kohner EM. Serum Immunoreactive insulin responses to a glucose load in Asian Indian and European type 2 (non-insulin-dependent) diabetic patient and control subjects. Diabetogia 1886; 29: 235-237.

7. Sratton IM, Adler Al, Neil HA, Mathews DR, Manley SE, Cull CA, Hadden D, Turner R: Association of Glycaemia with macrovascular and microvascular complication of type 2 diabetes (UKPDS 35). Br Med J 321: 405-412, 2000.

8. Mohan D, Raj D, Shantirani CS et al. Awareness and knowledge of Diabetes in Chennai – the Chennai Urban Rural Epidemiology study (CURES – 9). J Assoc Physicians India 2005; 283-7.

9. American Diabetes Association. Economic cost of Diabetes in the US in 2002. Diabetes Care. 2003; 26: 917-932.

10. Unger R.H.: Reinventing type 2 Diabetes Mellitus: Pathogenesis, treatment and Prevention. JAMA 299. (10):1185-1187: 2008.

11. Lee Y, Hirose H, Ohneda M et al: B-cell lipotoxicity in the pathogenesis of non-insulin dependent Diabetes Mellitus of obese rats: impairment in adipocyte-beta cell relationships. Proc Natl Acad Sci US A 91. (23): 10878 -10882.1994.

12. Knowler W.C. Barrett-Corner E, Fowelr S. E. et al: Reduction of incidence of type 2 Diabetes by changes in Lifestyle Invention or Metformin. New Eng J Med 346. 393-403. 2002

13. Tuomilehto J., Lindstorm J, Erikson J. G. et al: Prevention of type 2 Diabetes by changes in lifestyle among subject with impaired glucose tolerance. N Eng J med 344. 1343-1350. 2001

14. Pan X R, Li G W., Hu Y. H. et al: Effect of Diet and Exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing and diabetes study. Diabetes Care 20. 537-544. 1997

15. UKPDS Group. UK Prospective diabetes study 16: Overview of six years therapy of type 2 Diabetes – A progressive disease – Diabetes 1995; 44: 1249-58

16. The Diabetes Prevention Program Research Group. The Diabetes Prevention Program. Design and methods for clinical trial in prevention of type 2 diabetes mellitus. Diabetes Care 1999; 22: 623-24.

17. Sicree R., Shaw J., Zimmet P et al. Diabetes and Impaired glucose tolerance. Diabetes Atlas. International Diabetes Federation. 3rd Edition. Belgium: International Diabetes Federation; 2006: 15-103.

18. Ahuja MMS. Epidemiological studies on Diabetes Mellitus in India. In: Ahuja MMS, Editor. Epidemiology of diabetes in developing countries. 1979: 29-38.

19. Raman kutty V, Joseph A. Soman CR et al. High prevalence of type 2 Diabetes in an urban settlement in Kerela, India. Ethn Health 1999; 231-9.

20. 20 Shah SK, Saikia M. Burman NN, Snehalata et al. High prevalence of type 2 Diabetes in urban population in North-eastern India. Int J Diabetes Dev Countries 1999; 19: 144-7.

21. Zargar AH, Khan AK, Masoodi SR et al. High prevalence of type 2 Diabetes and impaired glucose tolerance in the Kashir valley of the Indian subcontinent. Diabetes Res Clin Pract 2000; 47: 135-6.


Global Journal of Novel Research in Applied Sciences 2022;1(1)28
Dutta B et al: Complication of type 2 Diabetes Mellitus and Counselling Program

22. Ramchandran A, Snehalatha C, Kapur A, Vijay V et al. Diabetes epidemiology study group in India. High prevalence of Diabetes and impaired glucose tolerance in India: National Urban society survey. Diabetologia 2001; 44: 1094-101.

23. Gupta A, Gupta R, Sarna M et al. Prevalence of Diabetes and impaired fasting glucose and insulin resistance syndrome in an urban Indian population. Diabetes Res Clin Pract 2003; 61: 69-76.

24. 25. Menon VU, Kumar KV, Gilchrist A et al. Prevalence of known and undetected diabetes and associated risk factor. Diabetes Res Clin Pract 2006; 74: 289-94.


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