Assessment of Diabetes Management Regimens and Effect of Diabetes Educational Intervention Among Diabetics Attending Nnamdi Azikiwe University Teaching Hospital Nnewi Anambra State, Nigeria.

Abstract:

This study investigated diabetes management regimens and effect of diabetes educational intervention on diabetics attending Nnamdi Azikiwe University Teaching Hospital(NAUTH), Nnewi. A total of 146 diabetics were interviewed with structured questionnaire to obtain information on their lifestyles, diabetes management, diabetes knowledge and compliance to management regimens. Diabetes educational intervention materials were developed to educate the subjects on 3 crucial areas of diabetes management- diet, exercise and drug. A sub-sample of 33 subjects with uncontrolled diabetes (fasting blood sugar >160 mg/dl) was followed up for 3 months to assess the immediate effect of the intervention on blood-sugar. Post intervention questionnaire interview was repeated on the subjects after two years of the intervention to assess the long term effect of the intervention. The subjects were predominantly non- insulin dependent (type 2) diabetics (96%) and a few insulin dependent (type1) diabetics (4%); 62 % females and 38% males. Majority (75.7%) of the subjects used drugs and diets for diabetes management, 7% used drugs alone, 0.7% used diet alone and 16.6% used liquid extract of bitter and pumpkin leaves in addition to drug and diet. Fifty seven percent of the subjects had poor diabetes knowledge while 43% had good diabetes knowledge. Similarly, 53% and 47% of the subjects had poor and good nutrition knowledge respectively. Diabetes knowledge had significant (p<05) effect on diabetes control. The subjects restricted the consumption of some carbohydrate foods like rice (10%) and garri (2%) and increased the consumption of unripe plantain (78%). Consumption of legumes was high; cowpea and its products ranked highest (82%) followed by bread fruit pottage (27%). Fruits mostly consumed were garden eggs (56%), avocado pear (27%), firm-ripped pawpaw (14%) and orange (9%). There was marked decrease in the intake of alcohol (17%) and cigarette (23%). Sixty-three percent (63%) of the subjects were either inactive or maintaining light physical activity in their daily life, while 37% were active. Controlled diabetes (Fasting blood sugar < 160 mg/dl) was significantly (p<0.05) higher among active subjects. The educational intervention had significant (p<0.05) effect on the blood-sugar levels of the subjects within 3 months of the intervention. There were positive lifestyle changes on the diabetics two years after the intervention. Diabetes knowledge significantly (p<0.05) improved from 43% to 57%. More subjects became more active, blood sugar control significantly (p<0.05) improved from 59% to 63%. Rigidity and monotony in their food consumption pattern became less and there was more diversification in their food selection.