The knowledge attitude and practice of diabetic patients at a tertiary hospital in an eastern caribbean nation-a cross-sectional study

Background: Diabetes Mellitus (DM) is a chronic, lifestyle disease, and an emerging epidemic of the 21st century. Assessing the Knowledge, Attitude, and Practice (KAP) related to diabetic patients among the public is important to modify or create strategies for prevention &management in an effort to curb the current rise in DM and its complications. As of today, two KAP studies were conducted related to diabetic patients in Trinidad & Tobago (T&T) but both of these studies were conducted on diabetic patients attending local health centres and neither of these studies assessed the patient’s knowledge on HbA1c testing as well as their level of education. Purpose of this study: The purpose was to conducta KAP study for the first time on hospitalized diabetic patients in Trinidad & Tobago and also to assess their knowledge of HbA1c testing as well as their level of education in addition to other parameters. Method: This is a cross-sectional study (KAP) conducted at San-Fernando General Hospital, Trinidad and Tobago between 01st January 2018-31st December 2018 on 1005consecutive diabetic patients who were admitted on both medical and surgical wards. Diabetic patients who denied taking part in this study were excluded. Patients were assessed by a pre-structured, interviewer-administered questionnaire. Result: 1005 diabetic patients were included in the study.55.52% of our study group were male and 78.2% were of East Indian. The mean age of our patients was 45 years and 2/3rd of them(63.38%) fell between the age groups 34-65 years. Only 9.85% of our patient had a higher level of education however, rest had an education up to secondary level.90% of our study population were generally aware of diabetes, its complications and preventative measures; however, 72.5% of them had knowledge on foot care.It was found that approximately 80% of our diabetic patients were counselled by a dietician and were aware of the proper diabetic diet,yet49.3% still used sugar in their diet. Despite the availability of free HBA1C testing in the tertiary hospital, it is still unknown to the majority of this cohort. Conclusion: The overall level of knowledge of diabetes, its complications, prevention, and management in our study population was good and well above average however, their practice still remained grossly below average. Bridging this gap involves interventions a bit more complex and requires lifestyle and attitude modifications. Point of care HBA1c testing, as well as integrated health education to our health care providers and to our patients, might help to bridge the gaps. Integrated health education involving the patients as well as the family members who taking care of them can perhaps bring a change in their attitude towards their health and physical wellbeing.