Nutritional Knowledge, Dietary Practice, Diabetes Self-Care Activity Measures and Glycemic Control among Type 2 Diabetic Patients in Myanmar

Abstract

Introduction-Diabetes Mellitus is a metabolic disorder of multiple etiologies causing chronic hyperglycemia with carbohydrate, fat and protein metabolism disorders (WHO, 2006). Type 2 Diabetic Mellitus occurs in 85-95% of all Diabetic cases. The purpose of the clinical treatment of Diabetes is to control blood glucose level with reduction of acute and chronic complications. The management of Type 2 DM includes diet and lifestyle modification, drug and insulin injection. In Myanmar, the prevalence of Diabetes in Myanmar was 10.5% (2.5 million) and 19.7 % for pre-diabetes (5 million) in 2014.  Objective-The objective of this study is to assess nutritional knowledge, dietary practice, self-care activity measures and glycemic control in Type 2 Diabetic patients receiving care in the Diabetic Clinic in North Okkalapa General Hospital.

Methods-Cross-sectional study was conducted from October 2017 to December 2017. The sample population was Type 2 Diabetic patients receiving care at the Diabetic Clinic of North Okkalarpa General Hospital within the study period. The data collected included an interviewer structured questionnaire regarding socio-demographic characteristics, health profile, nutritional knowledge, dietary practices and self-care activity measures.  The HbA1c levels used in the study was taken within 3 months of the study period or retested if its results would not available. Data was evaluated using SPSS version 23. The Mean and standard deviation was generated for continuous and frequencies for categorical and chi squared test will apply as required.

Results- Only a small percentage of the study group had good glycemic control (18.1%) and (81.9%) of the patients had poor control with the HbA1c level of more than 6.5%. For self-care activities, 25% performed good self-care, 65% performed fair self-care and poor self-care was performed by 10.4% of the study group. Seventy five percent had good nutritional knowledge and 25% had fair nutritional knowledge .None of them exhibited poor nutritional knowledge.  The Dietary practice of Type 2 Diabetic patients was assessed using a food frequency questionnaire of different food groups consumed within seven days. There is no association between Diabetes self-care activities and glycemic control (p=0.237) and between nutritional knowledge and glycemic control (p=0.802). Although the majority of Type 2 Diabetic patients had poor glycemic control, the results of this study showed good nutritional knowledge and fair self-care activities. Further study regarding dietary practices for Diabetic patients should be conducted in Myanmar. Key words- Diabetes Mellitus, nutritional knowledge, dietary practice, self-care activities, glycemic control