Abstract:

Background: Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessel (1). In all countries the prevalence of DM is on rise, a substantial contributing factor to the rise is the steady increase in body weight and obesity in many parts of the world (2). It was estimated that in 2017 there are 451 million (age 18-99 years) people with diabetes worldwide, and were expected increase to 693 million by 2045. In 2017, approximately 5 million deaths worldwide were attributable to diabetes in the 20-99 years age range. (3) In Africa region mortality attributable to diabetes in 2013 is estimated to be over half a million with three-quarter of these deaths occurring in those <60 years old. The prevalence of undiagnosed diabetes is unacceptably high at 50.7% and is much higher in low income (75.1%) compared to lower-and upper-middle income Africa countries (46.0%). (4) Tanzania is among five sub-Saharan African countries with high rate of type 2 DM. current data from IDF of 2017 stated that there were 897,000 new cases of diabetes in the country, a prevalence rise of 3.6% from baseline.

Objectives: The aim of this study is to assess the awareness of diabetic complications among diabetic patients attending diabetic clinic at Mbeya zonal referral hospital.

Methodology: cross sectional study was conducted among 130 diabetic patients attending diabetic clinic at Mbeya zonal referral hospital. Sampling method was simple random and questionnaires were used to obtain data which was analysed by using SPSS program. Ethical clearance was sought from CUHAS research and ethics review committee and from MZRH managing director’s office.

Results: A total of 130 patients were included in the study and 45.4% of them had good knowledge about diabetic and its associated complications. There was association between knowledge and education level and duration of diabetes since diagnosis (p-value 0.000). 86.9% had good adherence to their medication and 89.2% reported to attend diabetic clinic monthly. Adherence to treatment was associated with area of residence (p-value 0.042), education level (p-value 0.032) and duration of diabetes since diagnosis (p-value 0.033). On practice assessment, many participants had bad practices as only 59.2% had diet and lifestyle modification and only 49.2% reported to check their blood sugar level regularly. There was association between practices of participants and education level (p-value 0.005) and duration of diabetes since diagnosis (p-value 0.001). Majority of participants (78.5%) was diagnosed to have diabetes mellitus when they have already developed complications.

Conclusion and recommendations: Despite that majority of recruited participants had good education level (50.8%) and majority of them are those lived with diabetes for five years or more (53.1%), still there is inadequacy in knowledge of participants as less than half of them (45.4%) had good knowledge about diabetes mellitus and its associated complications, therefore there should be more classes to educate our patients on complications that may arise due to DM, prevention and possible symptoms of those complications. But also, only 59.2% of all participants reported a change in their diet and lifestyle as recommended by their doctors and nutritionists and there was inadequate individual blood sugar monitoring as only 49.2% had glucometer at home and checked blood sugar regularly. More emphasis should be made on diet and lifestyle modification as it plays a crusual role in DM management and patients should be insisted on how regular sugar monitoring is important in assessing efficiency of medications they are kept on.

Keywords: Diabetes mellitus, diabetic patients, MZRH diabetes clinic, awareness of diabetic complications.