Assessment of knowledge, attitude and practice of Self-Monitoring of Bood Glucose (SMBG) among diabetic patients aged 18 years and above at Kawolo Hospital Buikwe District

Abstract

Diabetes mellitus (DM) is a chronic metabolic disease characterised by elevated levels of blood glucose (or blood sugar) which leads overtime to serious complications. The prevalence of diabetes has been steadily increasing over the past few decades and current reports indicate that it is taking position among the leading causes of death contributing to almost 1.5 million deaths each year. By 2021, the number of diabetics worldwide was 537million and it is expected to grow until 2045 more so in low- and middle-income countries among which Uganda is categorised. With the increasing prevalence of diabetes, there is still low sensitisation of the public about the disease. It is scientifically proved that lifestyle, medication and diet are important in managing and preventing diabetes. Concerning lifestyle, Self-Monitoring of Blood Glucose (SMBG) is believed to help the patient to understand his/her dynamic blood glucose profile and subsequently design an appropriate schedule of food, activity and medication as well as understanding the timing of blood glucose variations. Lack of regular SMBG predicts hospitalization for diabetes related complications. This study was therefore aimed at assessing the knowledge, attitude and practice of self- monitoring of blood glucose among diabetic patients aged 18 years and above at Kawolo Hospital-Buikwe district. Specific objectives included: i) Assessing the knowledge, practice and attitudes of diabetic patients towards self-monitoring of blood sugar, ii) Determining factors that affect behaviour towards monitoring blood sugars, iii) Determining the relationship between diabetic status and the ability and willingness to carryout self- monitoring of blood glucose. The study was a cross sectional descriptive study where a total of 123 were systematically sampled from the hospital registers in the outpatient department. Data was collected from the consented eligible patients using structured interviews with a well-designed questionnaire that was designed basing on the study objectives. Majority (65%) of the respondents were within the age group of 46-69 years and most (68.3%) of them were females. Majority (53.3%) of the respondents were from rural areas and married (56.7%). The highest number (38.3%) of the respondents attained only primary level education. Majority (57%) of the respondents had either average or good level of knowledge about self-monitoring of blood glucose and there was a significant positive correlation between demographic characteristics and knowledge of respondents regarding SMBG. More than half (78.3%) of the respondents didn’t monitor their blood glucose and most of them attached it to poverty. A significant positive correlation was also observed between the medical history of patients (prescription to medication, time of diagnosis and diabetes family history) and practice of SMBG at p<0.05 well as the correlation between education level and practice of SMBG was found to be insignificant. Only 6 (23.1%) respondents who monitored their glucose recorded and discussed their results with the doctor. Majority (58.3%) of the respondents had positive attitudes towards self-monitoring of blood glucose and a significant correlation between some demographics (gender and employment status) and attitude towards SMBG was observed well as the correlation between attitude and other demographics was found to be insignificant. There was a significant (p=0.000) positive correlation (r=0.506) between practice of SMBG and glycemic control at p<0.05. In conclusion, diabetic patients at Kawolo hospital are informed and positive about SMBG however, there is still much need to improve on awareness and fill knowledge gaps about SMBG as well as designing possible ways of providing the required blood glucose monitoring apparatus at reduced or free costs by the concerned bodies