ABSTRACT

The Project entitled “Knowledge and Practice in Relation to Preventing complications of Diabetes Mellitus Among Diabetics at the Buea Regional Hospital “was carried out from December 2022 to March 2023 with sample size of 50charts.The main instrument for data collection was a semi structured questionnaire made up of opened and closed ended questions. The specific objectives of the study was :To assess the knowledge of diabetics on the preventing complications of DM, To assess the practices of Diabetics on the preventing complications of DM and To assess the challenges faced by diabetics on the preventing complications of DM. From the findings of the study, it was realized that majority 36(70%) were women while 15(30%) were men .29(58%) had adequate knowledge on what diabetes is all about. And also, 42(84%) carried out the practice in preventing complications of Diabetes Mellitus but majority of the patients faced challenges in the preventing complications of diabetes mellitus. Thus, it can be concluded that most of the diabetic’s adequate knowledge on diabetes mellitus but a hand full of then still faces challenges which the Health Care officials needs to pay more attention by organizing sensitization programs.

CHAPTER ONE

INTRODUCTION

1.1 Background of Study

Diabetes mellitus (DM) appears to be a global epidemic and increasingly a major non-communicable disease threatening both affluent and non-affluent society. The potential severity of increasing prevalence rate of diabetes mellitus in the African continent may be translated into severe economic burden, high morbidity and mortality rates, and will surpass the ravages. Diabetes increases susceptibility for many life-threatening infections such as tuberculosis which is fast becoming more prevalent in this group of patients with Diabetes.

 Elfein (2021), estimates that over 537 million people throughout the world have diabetes in 2021. WHO (2021), reports that approximately 537million adults (20 -79 years) are living with diabetes. It further stipulates that the number of people living with diabetes is projected to rise to 643 million by 2030 and 783 million by 2045 and that 3 in 4 adults with diabetes live in low- and middle-income countries.  Zimmet and Albert (2001), suggested that this drastic rise or increase in the incidence of diabetes mellitus worldwide is as a result of changes in human behavior and lifestyle over the last century. Moreover, Wild (2020), reveals that the greatest increase in prevalence occurs in low and middle income countries where most patients will probably be found by 2030. WHO (2021), reports that diabetes is the major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputations. Furthermore, in 2019, diabetes was the ninth leading cause of death with an estimated 1.5 million deaths directly caused by Diabetes and another 2.2 million deaths were attributed to complications related to diabetes that occurs before the age of 70 years. According to the International Diabetes Federation (IDF) (2015), nearly half  a million adults are living with diabetes in Cameroon, giving a comparative prevalence of 5.9%.  Furthermore, according to a report by Cameroon’s National Diabetes and Hypertension Program (CNDAHP), the prevalence of diabetes in Cameroon has increased from fewer than 1 million cases in 2010 to more than 3 million cases in 2020 with the prevalence of diabetes in urban areas currently estimated at 6.8% and 11,500 deaths recorded. This report clearly states that 80% of people living with diabetes in Cameroon are currently undiagnosed.

Knowledge on diabetes complications has the key role in the management of the diabetes. Research however indicates that knowledge and practice on diabetes complications is generally lacking among type 2 diabetes patients. Moreover, preventive strategies can reduce the risk and complications of diabetes. Life style modification in relation to obesity, eating habit, and physical exercise can also play a major role in the prevention of diabetes. This therefore implies that with simple preventive measures and subtle changes in lifestyle, its complication can be prevented to a great extent, hence it is important to have adequate knowledge on the above phenomenom. This study therefore sought to assess the knowledge, practices and challenges in relation to preventing complications of diabetes mellitus amongst diabetics in a health facility in Buea.

Diabetes comes from Greek and it means a ^,siphon^,,. Aretus the cappadocian, a greek physician during the second centuryA.D, named the condition diabainein. He described patients who were passing too much water (polyuria) like a siphon. The word became diabetes from the English adoption of the Medieval Latin diabetes. In 1675, Thomas Willis added mellitus to the term although it is commonly too simply as diabetes. Mel in Latin “means honey’’ the urine and blood of people with diabetes has excess glucose and glucose is sweet like honey. Diabetes mellitus could literally mean siphoning of sweet water. In ancient China, people observed that ants would be attracted to some people’s urine because it was sweet. The term sweet urine disease was coined.

1.2 Statement of Problem

Diabetes mellitus is considered one of the main threats to humans in the 21^st century. DM is a group of metabolic diseases where the blood glucose level is higher than normal either from an autoimmune destruction of the pancreatic islets which inhibits the secretion of insulin or because the body’s insulin receptor cells have become resistant to insulin. The condition is termed type1 and type2 respectively. It is estimated to affect 537 million people worldwide, 24million people in Africa, and approximately 3 million in Cameroon as of 2020. Though the management of diabetes either type1 or type2 includes easy strategies such as control of diet, regular exercise, reducing body weight, and insulin therapy, a majority of the patients usually end up with complications. Diabetes mellitus is usually associated with very severe complications such as; cardiovascular disease, end stage renal disease (ESRD), kidney failure, retinopathy, peripheral neuropathy, diabetes ketoacidosis, hyperosmolar hyperglycemic state, diabetic foot and ulcers etc. These complications can be life threatening if care is not taken during the course of the disease.

The investigator while on his clinical experience in a health facility in Douala came across a 26 year old patient who was diagnosed with DM in his early 20s. Very little attention was accorded to the management of the disease which led to the development of a gangrene wound after sustaining an injury that further led to the amputation of the limb and then the death of the patient. May be this situation amongst many others could have been prevented if the patient had adequate knowledge and practices in relation to prevention of complications of DM. This therefore sought to research on the knowledge and practices related to preventing complications of diabetes mellitus amongst diabetics in a health facility in Buea.

1.3 Rational

This study is significant because of the prevalence rate of diabetes mellitus among adults which may be translated into severe economic burden, high mobility and mortality rate affecting individuals and the society at large.

The purpose of this study is to understand  the knowledge and preventive measures and related complications of diabetes mellitus among adults at the Buea Regional Hospital.

1.4 Research Question

1.4.1 Main research question

What is the knowledge and practice in relation to diabetes complications of DM among diabetes at the Regional Hospital Buea?

1.4.2 Specific research questions

The study sought to respond to the following questions:

1. i) What knowledge do diabetic patients have on DM?
2. ii) What are their practices in the prevention and management of DM?

iii) What are the challenges faced by diabetics on the prevention of diabetic complications?

1.5 Objectives of the Study

1.5.1 General objectives

The main objective is to assess the knowledge and practices related to the prevention of diabetes complications of Diabetes Mellitus amongst diabetics in the Regional Hospital Buea .

1.5.2 Specific Objectives

1. To assess the knowledge of diabetics on prevention of diabetic complications.
2. To assess the practices of diabetics in relation to preventing complications of diabetes mellitus.

• To assess the challenges faced by diabetics in the prevention of diabetic complications.