Diabetes Self Management Knowledge And Foot Complications Among Type 2 Diabetes Patients At Jaramogi Oginga Odinga Teaching And Referral Hospital, Kisumu County, Kenya. Lucy Kageha

ABSTRACT

The global burden of Diabetes is increasing. It is estimated by the year 2035 over 592

million people in the world will suffer from Diabetes. In Kenya, the prevalence of

Diabetes is 4.56% while about 14% have impaired glucose metabolism. Since Diabetes is

a complex disease affecting all areas of a person’s life, management by the patient

remains central to the control and reduction of short term and long term complications.

Diabetes self-management is a process in which the knowledge, skills and abilities

required for a patient to adequately manage his or her conditions are facilitated. Poor

management of diabetes has been linked to long term diabetic complications. The aim of

this study was to examine the association between diabetes self-management knowledge

and diabetic foot complications amongst patients with type 2 diabetes at Jaramogi Oginga

Odinga Teaching and Referral Hospital. The target population was patients with type II

diabetes and a sample of 100 participants was randomly selected. Data was collected

using a researcher administered questionnaire. A multiple logistic regression model was

used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between diabetes

self-management knowledge and foot complications of type 2 diabetes, adjusting for

potential confounders. A total of 81 questionnaires were clean and complete for data

analysis. Descriptive statistics was used to report respondents’ characteristics. Mean age

of respondents was 43years. Majority of the respondents were males (64%), were married

(77%) and had secondary level education and above (64%).Knowledge level was

assessed using the diabetes knowledge test. Respondents who were knowledgeable were

60.5%. Respondents who had experienced a diabetic foot related complication were

22.2% and 72.2% amongst them were not knowledgeable on diabetes self-management.

Knowledge of diabetes self-management was associated with age (OR: 0.4; 95% CI 0.14-

0.91), sex (OR: 0.4; 95% CI 0.14-0.92), marital status (OR: 4.9; 95% CI 1.62-14.9),

education (OR: 9.8; 95% CI 3.42-28) and years with diabetes (OR: 3.2; 95% CI 1.26-

8.18). Development of diabetic foot complication was influenced by patients’ knowledge

level of diabetes self-management (OR: 0.07; 95% CI 0.02-0.26) and availability of

diabetic educators (OR: 0.17; 95% CI 0.05-0.53). This study has shown that type 2

diabetic patients at JOOTRH were knowledgeable about diabetes self-management and

that knowledge of diabetes self-care is dependent on the knowledge of diabetes, however

efforts are needed to realize 100% of the patients being knowledgeable; this can be

achieved by giving diabetes management health education every day before patients see

clinicians. The study recommends more intensive foot care education with subsequent

follow up either through telephone call or home visit as most patients who developed foot

complications reported examining their feet only at the clinic. The study also

recommends that the government of Kenya through Ministry of Health should ensure

adequate capacity building and training of diabetes specialists. This will increase

knowledge of patients and subsequently reduce number of foot complications