ASSESSMENT OF THE KNOWLEDGE AND PRACTISES OF TYPE TWO

DIABETIC PATIENT ON SELFCARE AT THE CENTRAL HOSPITAL

YAOUNDE

DECLARATION
This is to declare that the research project entitled “ASSESSMENT OF THE
KNOWLEDGE AND PRACTICES OF TYPE TWO DIABETIC PATIENTS ON
SELFCARE AT THE CENTRAL HOSPITAL YAOUNDE” is the original work of
NSAIRUN VERITAS SHUKA matricule Number 24NUS27776 has been read and
approved as fulfilling part of the requirements for the award of Higher National Diploma in
Nursing.

Student: NSAIRUN VERITAS SHUKA

Signed.................................... Date..................................

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 ASSESSMENT OF THE KNOWLEDGE AND PRACTISES OF TYPE TWO
DIABETIC PATIENT ON SELFCARE AT THE CENTRAL HOSPITAL
YAOUNDE

CERTIFICATION

In my capacity as supervisor of the candidate research work, I certify that the

candidate under my supervision carried out this work presented. The above
statements are to the best of my knowledge.

Signed.................................... Date..................................

MADAM TIAYO NDEME MODESTIE

BA in Modern letters DIPES I Bilingual letters

HEAD OF DEPARTMENT

Signed................................ Date....................................

MADAM EVELYN IKIAH ZUO

Msc in Anesthesia and Resuscitation

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YAOUNDE

DEDICATION
This piece of work is dedicated to my family, the Nsairun's family

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ACKNOWLEDGEMENT

I wish to acknowledge all those who have helped me in the realization of my work;
 My supervisor MADAM TIAYO NDEME MODESTIE for accepting to help me on my
report. May God continue to bless you and give you the strength to keep supporting us.
 The Director of GPHI Yaoundé MADAM EVELYN IKIAH ZUO and her staff who
gave me the support needed to realize this work and provided me with adequate framework
for the research training.
 The Director of Central hospital Yaoundé who permitted the realization of my study in his
hospital.
 All the staff working at the diabetic unit.
 The participants of the study
 To my adopted parents, Honourable WALANG RICHARD, Madam KANGSON
EUCHARIA for the sacrifice that they do every day for me.
 My husband WONGLANI ROMEO.
 Mr/Mrs MBAH NDIANER
 Mrs MBAH SANDRA and her husband
 Madam BAMNJO CLARISE
 My friends and classmate for their advice.
 I thank the Almighty GOD, for his support and for the strength he gave me to realize this
work and without him nothing would have been possible.
 To all those who have contributed directly or indirectly to the accomplishment of this work.

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 ASSESSMENT OF THE KNOWLEDGE AND PRACTISES OF TYPE TWO
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YAOUNDE

ABSTRACT
According to W.H.O diabetics is a chronic metabolic disease characterized by elevated level
of blood glucose or blood sugar which leads over time to serious damages to the heart blood
vessels, eyes, kidney and nerves. This study aimed to assess knowledge and practices of type
2 diabetic patients in self care at the Yaoundé Central Hospital in the Centre region of
Cameroon. It was cross sectional study, which was carried out among diabetic patients at the
Yaoundé Central Hospital from 22 November to the 22 December 2023. 38 participants were
conveniently enrolled into the study. A structured questionnaire was used to collect
demographics of participants. Data was analyzed using statistical package for social sciences
(SPSS) version 20. From our findings out of the 38 participants, average age of the
participants was 20years and the oldest age group 75years old. From our findings, 30
(78.9%) of participants had good knowledge on diabetes and diabetic risk factors, while
21.1% did not understand diabetes and its risk factors. Majority, 71.0%of the respondents
were aware of the best method for testing their glucose levels at home. 32(84.42%) were
aware of their unique demands due to diabetes. Above average, 20 (52.6%) of the
respondents had altered their treatment plans after starting treatment. A majority, 21 (55.3%)
of the respondents reported having attended lectures on managing diabetes on their own, and
from clinics. practice and diabetes management. To improve on patient knowledge and their
autonomy towards their self-care of diabetes. They should regularly go for checkups. For
early diagnoses of complications and to evaluate improvements in therapeutic managements.

Keywords: diabetic mellitus, patients, self-care, knowledge.

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RÉSUMÉ
Selon l'O.M.S, le diabète est une maladie métabolique chronique caractérisée par un taux
élevé de glucose dans le sang ou de sucre dans le sang qui entraîne, avec le temps, de graves
lésions des vaisseaux sanguins du cœur, des yeux, des reins et des nerfs. Cette étude visait à
évaluer les connaissances et
les pratiques des patients diabétiques de type 2 en matière d'auto-prise en charge à l'Hôpital
Central de Yaoundé dans la région Centre du Cameroun. Il s'agit d'une étude transversale
réalisée auprès de patients diabétiques à l'hôpital central de Yaoundé du 22 novembre au 22
décembre 2023. 38 participants ont été commodément inscrits dans l'étude. Un questionnaire
structuré a été utilisé pour recueillir les données démographiques des participants. Les
données ont été analysées à l'aide du progiciel statistique pour les sciences sociales (SPSS)
version 20. D'après nos résultats sur les 38 participants, l'âge moyen des participants était de
20 ans et le groupe d'âge le plus âgé de 75 ans. D'après nos résultats, 30 (78,9 %) des
participants avaient de bonnes connaissances sur le diabète et ses facteurs de risque, tandis
que 21,1 % ne comprenaient pas le diabète et ses facteurs de risque. La majorité, 71,0 % des
personnes interrogées connaissaient la meilleure méthode pour tester leur glycémie à la
maison. 32 (84,42 %) étaient conscients de leurs exigences particulières dues au diabète. Au-
dessus de la moyenne, 20 (52,6 %) des répondants avaient modifié leurs plans de traitement
après avoir commencé le traitement. Une majorité, 21 (55,3 %) des répondants ont déclaré
avoir assisté à des conférences sur la gestion du diabète, seuls ou dans des cliniques. pratique
et gestion du diabète. Améliorer les connaissances des patients et leur autonomie dans la
prise en charge autonome de leur diabète. Ils devraient régulièrement se soumettre à des
examens. Pour le diagnostic précoce des complications et pour évaluer les améliorations des
prises en charge thérapeutiques.

Mots-clés : diabète sucré, patients, soins personnels, connaissances.

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TABLE OF CONTENT

DECLARATION........................................................................................................................i

DEDICATION..........................................................................................................................ii

ACKNOWLEDGEMENT........................................................................................................iii

I wish to acknowledge with gratitude to,.................................................................................iii

ABSTRACT.............................................................................................................................iv

TABLE OF CONTENT.............................................................................................................v

LIST OF FIGURES..................................................................................................................ix

LIST OF TABLES.....................................................................................................................x

LIST OF ABBREVIATIONS..................................................................................................xi

CHAPTER ONE........................................................................................................................1

1INTRODUCTION................................................................................................................1

1.1 BACKGROUND..............................................................................................................1

1.2 PROBLEM STATEMENT..............................................................................................2

1.3 RESEARCH QUESTIONS..............................................................................................3

1.3.1 GENERAL RESEARCH QUESTION.....................................................................3

1.3.2 SPECIFIC RESEARCH QUESTIONS....................................................................3

1.4 OBJECTIVES..................................................................................................................3

1.4.1 GENERAL OBJECTIVES.......................................................................................3

1.4.2 SPECIFIC OBJECTIVES.........................................................................................3

1.5 JUSTIFICATION OF THE STUDY...............................................................................3

1.6 SIGNIFICANCE OF THE STUDY.................................................................................4

1.7 SCOPE OF THE STUDY................................................................................................4

1.8 DEFINITION OF KEY CONCEPTS..............................................................................4

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CHAPTER TWO.......................................................................................................................7

2 LITERATURE REVIEW........................................................................................................7

2.1 BRIEF HISTORY............................................................................................................7

2.2 EPIDEMIOLOGY............................................................................................................7

2.3 Types of Diabetes.............................................................................................................8

2.3.1 Type 1 Diabetes........................................................................................................8

2.3.2 Type 2 Diabetes........................................................................................................8

2.3.3 Gestational Diabetes.................................................................................................9

2.4 RISK FACTORS..............................................................................................................9

2.4.1 Type 1 Diabetes........................................................................................................9

2.4.2 Type 2 Diabetes........................................................................................................9

2.4.3 Gestational Diabetes...............................................................................................10

2.5 MODE OF TRANSMISSION.......................................................................................11

2.6 COMPLICATION OF DIABETES...............................................................................11

2.6.1 Acute complications................................................................................................12

2.6.2 Chronic complications............................................................................................12

2.7 CLINICAL FEATURES................................................................................................14

2.8 IMMUNE RESPONSE................................................................................................16

2.9 DIAGNOSIS................................................................................................................16

2.10 TREATMENT.............................................................................................................18

2.11 Some self care activities that can be performed by type 2 diabetic patient.................19

CHAPTER THREE.................................................................................................................23

3 MATERIALS AND METHODS..........................................................................................23

3.1 STUDY AREA...............................................................................................................23

3.2 STUDY DESIGN...........................................................................................................23

3.3 SAMPLING METHOD.................................................................................................23

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3.4 STUDY POPULATION................................................................................................23

3.5 SELECTION CRITERIA...............................................................................................23

Inclusion criteria...............................................................................................................23

Exclusion Criteria.............................................................................................................23

3.6 DATA COLLECTION...................................................................................................24

3.7 DATA MANAGEMENT AND ANALYSIS................................................................24

3.8 ETHICAL CONSIDERATION.....................................................................................24

3.9 MATERIALS.................................................................................................................24

CHAPTER FOUR...................................................................................................................25

4 RESULTS..............................................................................................................................25

4.1SOCIODEMOGRAPHIC CHARACTERISTICS OF STUDY PARTICIPANTS..25

4.2PARTICIPANTS’ KNOWLEDGE ON DIABETES AND DIABETES SELF-

CARE MANAGEMENT.....................................................................................................26

4.3 PARTICIPANTS PRACTICES TOWARDS DIABETES SELF-CARE MANAGEMENT....28

CHAPTER FIVE...................................................................................................................................29

5 DISCUSSION, CONCLUSION, RECOMMENDATIONS..............................................................29

5.1 DISCUSSIONS...........................................................................................................................29

5.2 CONCLUSION...........................................................................................................................33

5.3 RECOMMENDATION..............................................................................................................33

5.4 LIMITATIONS...........................................................................................................................33

REFERENCES......................................................................................................................................34

APPENDICES.......................................................................................................................................40

CONSENT FORM............................................................................................................................40

QUESTIONNAIRE...............................................................................................................................41

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LIST OF TABLES
Table 1:Sociodemographic characteristics of the study participants.......................................26
Table 2:Participants’ knowledge on diabetes and diabetes self-care management.................28

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LIST OF ABBREVIATIONS
A.D.A: American Diabetes Association

D.K.A: Diabetic ketoacidosis

D.M: diabetes mellitus

H.H.S: Hyperosmolar Hyper Glycemic State

H.I.V/A.I.D.S: human immunovirus/acquired immune deficiency syndrome

I.D.D.M: insulin-dependent diabetes mellitus

I.D.F: International Diabetic Federation

N.I.D.D.M: non-insulin-dependent diabetes mellitus

S.P.S.S: statistical package for social sciences.

P.C.O.S: polycystic ovary syndrome

W.H.O: world health organization

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CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND
According to W.H.O diabetics is a chronic metabolic disease characterized by elevated level
of blood glucose or blood sugar which leads over time to serious damages to the heart blood
vessels eyes kidney and nerves. They are exist 3 types Type 1 (insulin dependent ) , types 2
diabetic (insulin independent) and gestational diabetics (Shaw JE, Sicree RA, et
al.,2016).Type 1 diabetics is a chronic condition in which the pacrease produces little or no
insulin by itself (Wynn Nyunt S, , et al., 2010) .Type 2 diabetics stop the body from using
insulin properly .Gestational diabetics is diabetics developed during pregnancy and goes
away after birth (Ciechanowski P, Russo J, , et al.,2014) .The prevalence of the diabetes is
increasing at an alarming rate particularly in developing countries. Estimate of global
diabetes prevalence predict 6.4%, affecting 285 million adults in 2010, and will increase to
7.7% and 439 million adults by 2030 (Shaw JE, Sicree RA, et al., 2016). India harbors the
largest number of diabetic patients in the world. The International Diabetes Federation (IDF)
reported that the total number of diabetic subjects in India is 41 million in 2006 and that this
would rise to 70 million by the year 2025 (Sicree R, Shaw J, et al., 2016). Increased
prevalence in India is attributed to the lifestyle transition coupled with urbanization,
industrialization and lifestyle changes (Ramachandran A, et al., 2014). Its high mortality and
disability burdens are disproportionate in Sub-Saharan African countries. There were
680,300 cases of diabetes reported in Cameroon (Feng B, et al., 2017). The adoption of
appropriate self-care management approaches is low and is heavily influenced by patients’
poor knowledge, perceptions of their conditions, and experiences. Diabetes prevalence in
Cameroon, according to the World Bank collection of development indicators, is high and on
a continuous rise. (Fitzgerald JT, et al., 2016).

Poor awareness and practices among diabetic patients are some of the important variables
influencing the progression of diabetes and its complications, which are largely preventable.
Compared with the general population incidence of coronary heart diseases and stroke are
more among patients of diabetes. Quality of life further impacted by complications like

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diabetic renal disease and diabetic retinopathy and neuropathy which are frequently
occurring among the patients having poor glycemic control. Developing countries which are
already overburdened have to muddle through with the additional challenges posed by the
chronic non communicable disease. Sub-optimal treatment, inadequate health education and
follow up leads to the poor glycemic control and increase the toll of unnecessary disabilities
among the people (K Park. Park’s Textbook of Preventive and Social Medicine, 2011). It is
therefore essential to provide comprehensive services including health education regarding
the self- management of the disease in order to prevent the debilitating complications which
in long term reduces the enormous financial burden on the health care system. Helping
patients to achieve their best possible level of glycemic control will require the utilization of
appropriate therapy, appropriate monitoring, and comprehensive instruction in diabetes self-
management. Selfcare in the form of adherence to diet and drugs, blood glucose monitoring,
foot care, exercise, recognition of symptoms is crucial elements in secondary prevention.
Interventions to promote better self-management have reported improvements in blood
glucose control and improved glycemic control is highly advantageous in preventing the
long-term complications of type 1 and type 2 diabetes as demonstrated by various studies
(Jones H, Edwards L, et al.,2013). Diabetes self-management education is teaching people to
manage their diabetes has become an important part of the clinical management of diabetes
however the process is often complex, demanding and not given much emphasis at
professional level because of the time constraint of clinicians. Assessment of patient’s
knowledge and practices about diabetes is imperative in developing various intervention
strategies and educational material. The study aimed to assess the knowledge, perceptions,
and experiences of type II diabetic patients at the Yaoundé Central Hospital.

1.2 PROBLEM STATEMENT

There is a continuous increase in the prevalence diabetes mellitus, although there is evidence
that the complications of diabetes can be prevented, there are still patients who lack the
required knowledge and skills to manage and control their condition. It is generally accepted
that diabetics must take responsibility for their own care and treatment. Coming from a home
with a mother who was a diabetic, who never took into consideration her self- care and only
did when she felt severe pains. She did not pay attention to feeding limits given to her and it

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caused her life. These pushes the researcher to ask the question. How do type two diabetic
patient practice on their self- care?

1.3 RESEARCH QUESTIONS

1.3.1 GENERAL RESEARCH QUESTION

What is the knowledge do type 2 diabetic patients have towards self-care at Yaoundé Central
Hospital?

1.3.2 SPECIFIC RESEARCH QUESTIONS

 What is the knowledge of Type 2 diabetes on self-care?

 What are the self-care activities practiced by diabetics patient?

1.4 OBJECTIVES

1.4.1 GENERAL OBJECTIVES

To assess the knowledge and practices of type 2 diabetic patients on self-care at the Central
Hospital Yaoundé

1.4.2 SPECIFIC OBJECTIVES

 To assess the knowledge and to evaluate patients adherence to self-care practices
concerned with Type 2 diabetes mellitus.

 To assess the self-care activities practiced by diabetics patient

1.5 SIGNIFICANCE OF THE STUDY.

This study seeks to promote skilled care for all patients and encourage them on good health.
This study will provide information that can be used to encourage house hold and communiti
es to put in place when anyone is suffering from diabetes. This study may be useful toYaou
ndé Central Hospital and other stakeholders in the health care system.

1.6 SCOPE OF THE STUDY

This study was delimited to diabetic patients at Yaounde Central Hospital irrespective of age,
sex, religion, ethnicity etc.

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1.7 DEFINITION OF KEY CONCEPTS

a) Diabetes Mellitus
Diabetes mellitus is a disease characterized by a chronic elevation in the level of glucose in
the blood. The normal range for blood glucose is 3.5-7.0 mmol/L. According to W.H.O
diabetics is a chronic metabolic disease characterized by elevated level of blood glucose or
blood sugar which leads over time to serious damages to the heart blood vessels eyes kidney
and nerves Operational definition: For the purpose of this study, it will mean type II diabetes
mellitus with a blood sugar level of 10mm1/L and above and the diabetes mellitus patient
must be on oral
/injection (insulin) treatment.
b) Complication
A complication refers to a confused condition or state, which complicates circumstances.
According to Thompson et al. 2015 it is a disease or condition aggravating or arising out of a
previous one. For the purpose of this study a complication is accepted as an accidental
condition or second disease occurring in the course of a primary process.
c) Keto-acidosis
It is a condition where excessive ketone bodies are produced by the liver and those ketone
bodies accumulate in the urine .Diabetic keto-acidosis is caused by an absence of or
inadequate amount of insulin which results in disorders in the metabolism of carbohydrate,
protein and fat.
This leads to the clinical manifestations of dehydration, electrolyte loss and acidosis
d) Glucose control
It means avoiding hypoglycemia i.e. elevated blood glucose .

e) Hypoglycemia
Hypoglycemia is reduced blood sugar level lower than normal. It is an abnormally low blood
glucose concentration characterized by sweating, hunger, faintness, confusion and coma .For
the purpose of this study hypoglycemia is a clinical state associated with decreased blood
glucose below the critical level for an individual, characterized by hunger, nervousness,
profuse sweating, faintness, and sometimes convulsions.
f) Diabetic ketoacidosis (DKA) is the admission of blood glucose >250 mg/l and urine
dipstick ketone level ≥ +2.

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g) Hyperosmolar hyperglycemic state (HHS) is the presence of significant

hyperglycemia (plasma glucose>600mg/dl), alteration in mental status and mild or absent
ketonuria.
h) Outcome: the main outcome of the study was in hospital mortality due to
hyperglycemic emergencies.
i) Side-effects
They are secondary (usually undesirable or unwanted) effects of medicines. These effects
occur following the administration of drugs.
j) Treatment
It is a mode of dealing with a patient or diseases in which specific medical or surgical
treatment is undertaken.
k) Treatment regimen
It is a manner of behaving towards the prescribed course of exercise, way of life and diet.
l) Knowledge
Knowledge is awareness or understanding of facts, skill, or information. In this case, I is
awareness or familiarity gained by experience of diabetes mellitus and its treatment.
m) View
It is a manner of considering a subject, opinion or point.

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CHAPTER TWO

LITERATURE REVIEW

1.8 BRIEF HISTORY

Diabetes is a chronic (long-lasting) health condition that affects how your body turns food
into energy. (Cavalot F, et al., 2015). Your body breaks down most of the food you eat into
sugar (glucose) and releases it into your bloodstream. When your blood sugar goes up, it
signals your pancreas to release insulin. Insulin acts like a key to let the blood sugar into your
body’s cells for use as energy (Cavalot F, et al., 2015). With diabetes, your body doesn’t
make enough insulin or can’t use it as well as it should. When there isn’t enough insulin
or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over
time, that can cause serious health problems, such as heart disease, vision loss, and kidney
disease. (Shiraiwa T, Mitsuyoshi T, et al., 2015) There isn’t a cure yet for diabetes, but losing
weight, eating healthy food, and being active can really help. Other things you can do to
help: Take medicine as prescribed, get diabetes self-management education and support,
Make and keep health care appointments (Barnard KD et al.2015).

1.9 EPIDEMIOLOGY
Diabetes is a major health problem in Africa where management is complicated by poor
socioeconomic conditions. Atypical presentations of diabetes appear to be common in
tropical countries although there is still little accurate data in this regard. We describe 550
diabetic patients treated in Cameroon between December 1990 and July 1994. According to
WHO criteria 136 of these patients (24.7%) were classified as insulin-dependent (IDDM),
405 (73.5%) as non-insulin-dependent (NIDDM), and 9 as secondary diabetes (1.6%) related
to other diseases. There were no cases of malnutrition-related diabetes but 18 patients (3%)
met the criteria for "African diabetes" defined by Cuisinier-Raynal. Study of this cohort
revealed several differences with diabetic populations in industrialized countries. Insulin-
dependent diabetes was observed in all age groups with a mean age of onset 40.0 +/- 14.8
years which is close to the mean age of onset of non-insulin-dependent diabetes (49 +/- 10.9
years). The overall M/F sex ratio was 1.63 demonstrating a clear-cut male predominance.

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There was a high incidence of non-insulin-dependent diabetes in young, non-obese subjects.
In many cases classification was difficult because insulin requirements fluctuated greatly.
The incidence of obesity in non-insulin-dependent diabetic patients was lower than in
industrialized countries. These findings suggest the existence of a tropical diabetes syndrome
unrelated to malnutrition. Thus African diabetes appears to be another aspect of the disease
which has a variety of heterogeneous etiologic features that cannot be classified on the basis
of available data. The current WHO system does not take atypical African diabetes into
account.

1.10 Types of Diabetes

There are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes
while pregnant). (Ciechanowski P, Russo J, et al., 2014)

1.10.1 Type 1 Diabetes

Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by
mistake). This reaction stops your body from making insulin. Approximately 5-10% of the
people who have diabetes have type 1. Type 1 diabetes can be diagnosed at any age, and
symptoms often develop quickly. If you have type 1 diabetes, you’ll need to take insulin
every day to survive. Currently, no one knows how to prevent type 1 diabetes. (Norris SL,
Nichols PJ, et al., 2012)

1.10.2 Type 2 Diabetes

With type 2 diabetes, your body doesn’t use insulin well and can’t keep blood sugar at
normal levels. About 90-95% of people with diabetes have type 2. It develops over many
years and is usually diagnosed in adults (but more and more in children, teens, and young
adults). You may not notice any symptoms, so it’s important to get your blood sugar tested if
you’re at risk (Kumar N, Shekhar C, et al.,2017). Type 2 diabetes can be prevented or
delayed with healthy lifestyle changes, such as:

- Losing weight.

- Eating healthy food.

- Being active.

1.10.3 Gestational Diabetes

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Gestational diabetes develops in pregnant women who have never had diabetes. If you have
gestational diabetes, your baby could be at higher risk for health problems. Gestational
diabetes usually goes away after your baby is born. However, it increases your risk for type 2
diabetes later in life. Your baby is more likely to have obesity as a child or teen and develop
type 2 diabetes later in life. (American College of Endocrinology.,2012)

1.11 RISK FACTORS

1.11.1 Type 1 Diabetes

Type 1 diabetes is thought to be caused by an immune reaction (the body attacks itself by
mistake). Risk factors for type 1 diabetes are not as clear as for pre-diabetes and type 2
diabetes. Known risk factors include:

Family history: Having a parent, brother, or sister with type 1 diabetes.

Age: You can get type 1 diabetes at any age, but it usually develops in children, teens, or
young adults.

In the United States, White people are more likely to develop type 1 diabetes than African
American and Hispanic or Latino people.

Currently, no one knows how to prevent type 1 diabetes.

1.11.2 Type 2 Diabetes

You’re at risk for type 2 diabetes if you:

- Have pre-diabetes.

- Are overweight.

- Are 45 years or older.

- Have a parent, brother, or sister with type 2 diabetes.

- Are physically active less than 3 times a week?

- Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby
who weighed over 9 pounds.

- Are an African American, Hispanic or Latino, American Indian, or Alaska Native person.

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Some Pacific Islanders and Asian American people are also at higher risk.

If you have non-alcoholic fatty liver disease you may also be at risk for type 2 diabetes.

You can prevent or delay type 2 diabetes with proven lifestyle changes. These include losing
weight if you’re overweight, eating a healthy diet, and getting regular physical activity.

1.11.3 Gestational Diabetes

You’re at risk for gestational diabetes (diabetes while pregnant) if you:

- Had gestational diabetes during a previous pregnancy.

- Have given birth to a baby who weighed over 9 pounds.

- Are overweight.

- Are more than 25 years old.

- Have a family history of type 2 diabetes.

- Have a hormone disorder called polycystic ovary syndrome (PCOS).

- Are an African American, Hispanic or Latino, American Indian, Alaska Native, Native
Hawaiian, or Pacific Islander person.

Gestational diabetes usually goes away after you give birth, but increases your risk for type 2
diabetes. Your baby is more likely to have obesity as a child or teen, and to develop type 2
diabetes later in life. Before you get pregnant, you may be able to prevent gestational
diabetes with lifestyle changes. These include losing weight if you’re overweight, eating a
healthy diet, and getting regular physical activity. (Shiraiwa T, Mitsuyoshi T, et al., 2010)

1.12 MODE OF TRANSMISSION

Too much glucose circulating in your bloodstream causes diabetes, regardless of the type.
Hcowever, the reason why your blood glucose levels are high differs depending on the type
of diabetes.

Causes of diabetes include:

Insulin resistance: Type 2 diabetes mainly results from insulin resistance. Insulin resistance
happens when cells in your muscles, fat and liver don’t respond as they should to insulin.
Several factors and conditions contribute to varying degrees of insulin resistance, including

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obesity, lack of physical activity, diet, hormonal imbalances, genetics and certain
medications Miller KM, et al (2013).

Autoimmune disease: Type 1 diabetes and LADA happen when your immune system attacks
the insulin-producing cells in your pancreas.

Hormonal imbalances: During pregnancy, the placenta releases hormones that cause insulin
resistance. You may develop gestational diabetes if your pancreas can’t produce enough
insulin to overcome the insulin resistance. Other hormone-related conditions like acromegaly

and Cushing syndrome can also cause Type 2 diabetes. (American College of
Endocrinology.,2012)

Pancreatic damage: Physical damage to your pancreas — from a condition, surgery or injury
— can impact its ability to make insulin, resulting in Type 3c diabetes. (Shah VN, Kamdar
PK, et al., 2019)

Genetic mutations: Certain genetic mutations can cause MODY and neonatal diabetes.

Long-term use of certain medications can also lead to Type 2 diabetes, including HIV/AIDS
medications and corticosteroids Miller KM, et al (2013).

1.13 COMPLICATION OF DIABETES

High sugar levels in your blood over a long period of time can seriously damage your blood
vessels. If your blood vessels aren’t working properly, blood can’t travel to the parts of your
body it needs to. This means your nerves won’t work properly either and means you lose
feeling in parts of your body. Once you’ve damaged the blood vessels and nerves in one part
of your body, you’re more likely to develop similar problems in other parts of your body. So
if your feet are damaged, serious heart problems can follow. (Shah VN, Kamdar PK, et al.,
2019)

We know that the higher your HbA1c level, the more you’re at risk of developing
complications. HbA1c is glycated hemoglobin. This is made when glucose, which we call
sugar, sticks to your blood cells and builds up in your blood. It's measured by a blood test
that shows your average blood sugar levels over the last three months. A high HbA1c means
you have too much sugar in your blood. Even a slightly high HbA1c increases your risk but
it’s not just about blood sugars. High blood pressure, smoking and a lot of fat in your blood

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(cholesterol) can all damage your blood vessels and put you even more at risk. (Priyanka CK,
et al., 2010)

1.13.1 Acute complications

These can happen at any time and may lead to chronic, or long-term, complications.

Hypo sugar: when your blood sugars are too low

Hyper sugar: when your blood sugars are too high

Hyperosmolar Hyper glycemic State (HHS).

Life threatening emergency that only happens in people with type 2 diabetes, it’s brought on
by severe dehydration and very high blood sugars.

Diabetic ketoacidosis (DKA):

A life threatening emergency where the lack of insulin and high blood sugars leads to a build
up of ketones. (Priyanka CK, et al., 2010)

1.13.2 Chronic complications

These are long-term problems that can develop gradually, and can lead to serious damage if
they go unchecked and untreated.

Eye problems (retinopathy)

Some people with diabetes develop an eye disease called diabetic retinopathy which can
affect their eyesight. If retinopathy is picked up – usually from an eye screening test - it can
be treated and sight loss prevented. (Barnard KD, et al., 2010)

Foot problems

Diabetes foot problems are serious and can lead to amputation if untreated. Nerve damage
can affect the feeling in your feet and raised blood sugar can damage the circulation, making
it slower for sores and cuts to heal. That’s why it’s important to tell your GP if you notice
any change in how your feet look or feel (Allemann S, Houriet C, et al., 2019).

Heart attack and stroke

When you have diabetes, high blood sugar for a period of time can damage your blood
vessels. This can sometimes lead to heart attacks and strokes (Bigna JJ, Nansseu JR, et

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al,.2018).

Kidney problems (nephropathy)

Diabetes can cause damage to your kidneys over a long period of time making it harder to
clear extra fluid and waste from your body. This is caused by high blood sugar levels and
high blood pressure. It is known as diabetic nephropathy or kidney disease. (Brunetti L, et
al,.2012)

Nerve damage (neuropathy)

Some people with diabetes may develop nerve damage caused by complications of high
blood sugar levels. This can make it harder for the nerves to carry messages between the
brain and every part of our body so it can affect how we see, hear, feel and move. (Bigna JJ,
Nansseu JR, et al,.2018),

Gum disease and other mouth problems

Too much sugar in your blood can lead to more sugar in your saliva. This brings bacteria
which produces acid which attacks your tooth enamel and damages your gums. The blood
vessels in your gums can also become damaged, making gums more likely to get infected.
(Bigna JJ, Nansseu JR, et al,.2018),

Related conditions, like cancer

If you have diabetes, you’re more at risk of developing certain cancers. And some cancer
treatments can affect your diabetes and make it harder to control your blood sugar. (Anekwe
TD, et al., 2018)

Sexual problems in women

Damage to blood vessels and nerves can restrict the amount of blood flowing to your sexual
organs so you can lose some sensation. If you have high blood sugar, you are also more
likely to get thrush or a urinary tract infection. (Schnell O, Alawi H, et al., 2013)

Sexual problems in men

The amount of blood flowing to your sexual organs can be restricted which may cause you to
have difficulty getting aroused. It may lead to erectile dysfunction, sometimes called
impotence. (Schnell O, Alawi H, et al., 2013)

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1.14 CLINICAL FEATURES
Symptoms of diabetes may occur suddenly. In type 2 diabetes, the symptoms can be mild
and may take many years to be noticed Diem P, et al (2009).

Symptoms of diabetes include:

- feeling very thirsty

- Needing to urinate more often than usual

- blurred vision

- Feeling tired

- losing weight unintentionally

Over time, diabetes can damage blood vessels in the heart, eyes, kidneys and nerves.

People with diabetes have a higher risk of health problems including heart attack, stroke and
kidney failure.

Diabetes can cause permanent vision loss by damaging blood vessels in the eyes.

Many people with diabetes develop problems with their feet from nerve damage and poor
blood flow. This can cause foot ulcers and may lead to amputation.

Type 1 diabetes

Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is

characterized by deficient insulin production and requires daily administration of insulin. In
2017 there were 9 million people with type 1 diabetes; the majority of them live in high-
income countries. Neither its cause nor the means to prevent it are known. (Schnell O, Alawi
H, et al., 2013)

Type 2 diabetes

Type 2 diabetes affects how your body uses sugar (glucose) for energy. It stops the body
from using insulin properly, which can lead to high levels of blood sugar if not treated. Over
time, type 2 diabetes can cause serious damage to the body, especially nerves and blood
vessels. Type 2 diabetes is often preventable. Factors that contribute to developing type 2

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diabetes include being overweight, not getting enough exercise, and genetics. Early diagnosis
is important to prevent the worst effects of type 2 diabetes. The best way to detect diabetes
early is to get regular check-ups and blood tests with a healthcare provider. Symptoms of
type 2 diabetes can be mild. They may take several years to be noticed. Symptoms may be
similar to those of type 1 diabetes but are often less marked. As a result, the disease may be
diagnosed several years after onset, after complications have already arisen.

More than 95% of people with diabetes have type 2 diabetes. Type 2 diabetes was formerly
called non-insulin dependent or adult onset. Until recently, this type of diabetes was seen
only in adults but it is now also occurring increasingly frequently in children. (Schnell O,
Alawi H, et al., 2013)

Gestational diabetes

Gestational diabetes is hyperglycemia with blood glucose values above normal but below
those diagnostics of diabetes. Gestational diabetes occurs during pregnancy.

Women with gestational diabetes are at an increased risk of complications during pregnancy
and at delivery. These women and possibly their children are also at increased risk of type 2
diabetes in the future.

Gestational diabetes is diagnosed through prenatal screening, rather than through reported
symptoms. (Priyanka CK, et al.,2010)

1.15 IMMUNE RESPONSE

Your immune system recognizes and fights off germs that can make you sick. Many people
think of the immune system as protection inside the body. But your first line of defense is
your skin, which keeps unwanted germs out. The second layer of your immune system is a
type of white blood cells circulating throughout your body known as lymphocytes. These
white blood cells are on the lookout for threats that could make you sick, like bacteria,
viruses, toxins, or fungi. Once your immune system recognizes these germs, it fights them
off, often without you even noticing.

Your immune system also helps you build up immunity, or protection, against some viruses.
Once your immune system has learned to fight off a certain virus, it often remembers how to
do it again, if needed. This means if you’re exposed to a virus more than once, your immune

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system can usually fight it off faster, and with fewer or no symptoms at all. When you get a
vaccine, it gives your immune system instructions on how to fight off a virus, protecting you
from getting severely ill. (Shah VN, Kamdar PK, et al., 2019)

Type 1 Diabetes and Your Immune System

Type 1 diabetes is an autoimmune disorder, which is when your body’s immune system
mistakenly attacks a part of your body. For this reason, people with type 1 diabetes may have
weaker immune systems. (Shah VN, Kamdar PK, et al., 2019)

1.16 DIAGNOSIS
Type 1 diabetes symptoms often start suddenly and are often the reason for checking blood
sugar levels. Because symptoms of other types of diabetes and pre-diabetes come on more
gradually or may not be easy to see, the American Diabetes Association (ADA) has
developed screening guidelines. The ADA recommends that the following people be
screened for diabetes

Anyone with a body mass index higher than 25 (23 for Asian Americans), regardless of age,
who has additional risk factors. These factors include high blood pressure, non-typical
cholesterol levels, an inactive lifestyle, a history of polycystic ovary syndrome or heart
disease, and having a close relative with diabetes Fitzgerald JT, et al (2016).

Anyone older than age 35 is advised to get an initial blood sugar screening. If the results are
normal, they should be screened every three years after that.

Women who have had gestational diabetes are advised to be screened for diabetes every
three years.

Anyone who has been diagnosed with pre-diabetes is advised to be tested every year.

Anyone who has HIV is advised to be tested.

❖ Tests for type 1 and type 2 diabetes and pre-diabetes

1. A1C Test

The A1C test measures your average blood sugar level over the past 2 or 3 months. An A1C
below 5.7% is normal, between 5.7 and 6.4% indicates you have pre-diabetes and 6.5% or
higher indicates you have diabetes.

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2. Fasting Blood Sugar Test

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This measures your blood sugar after an overnight fast (not eating). A fasting blood sugar
level of 99 mg/Dl or lower is normal, 100 to 125 mg/Dl indicates you have pre-diabetes, and
126 mg/dL or higher indicates you have diabetes.

3. Glucose Tolerance Test

This measures your blood sugar before and after you drink a liquid that contains glucose.
You’ll fast (not eat) overnight before the test and have your blood drawn to determine your
fasting blood sugar level. Then you’ll drink the liquid and have your blood sugar level
checked 1 hour, 2 hours, and possibly 3 hours afterward. At 2 hours, a blood sugar level of
140 mg/dL or lower is considered normal, 140 to 199 mg/dL indicates you have pre-diabetes,
and 200 mg/dL or higher indicates you have diabetes.

4. Random Blood Sugar Test

This measures your blood sugar at the time you’re tested. You can take this test at any time
and don’t need to fast (not eat) first. A blood sugar level of 200 mg/dL or higher indicates
you have diabetes.

5. Tests for Gestational Diabetes

Gestational diabetes is diagnosed using blood tests. You’ll probably be tested between 24
and 28 weeks of pregnancy. If your risk is higher for getting gestational diabetes (due to
having more risk factors), your doctor may test you earlier. Blood sugar that’s higher than
normal early in your pregnancy may indicate you have type 1 or type 2 diabetes rather than
gestational diabetes.

1.17 TREATMENT
Early diagnosis can be accomplished through relatively inexpensive testing of blood glucose.
People with type 1 diabetes need insulin injections for survival.

One of the most important ways to treat diabetes is to keep a healthy lifestyle.

Some people with type 2 diabetes will need to take medicines to help manage their blood
sugar levels. These can include insulin injections or other medicines. Some examples
include:

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-Metformin

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- Sulfonylureas

- Sodium-glucose co-transporters type 2 (SGLT-2) inhibitors.

Along with medicines to lower blood sugar, people with diabetes often need medications to
lower their blood pressure and statins to reduce the risk of complications.

Additional medical care may be needed to treat the effects of diabetes:

- Foot care to treat ulcers

- Screening and treatment for kidney disease

- Eye exams to screen for retinopathy (which causes blindness).

1.18 Some self care activities that can be performed by type 2 diabetic
patient
Self-care practices are a set of behavioral practices used by individuals suffering from
diabetes in order to manage and control the disease on their own. These self-care practices
are found to have an association with blood glucose levels and thereby reduce the incidence
of complications associated with diabetes. Various studies and evidence show that when a
patient performs self-care practices in a correct and systematic manner, they can improve
blood sugar control. These practices have proven effective in achieving the therapeutic goals
of diabetes (Cooper HC, Booth K, et al., 2016). The Association of Endocrinologists
(clinical) in America depicts the significance and need for patients to remain physically
active and have some sort of knowledge of their self-care activities. The Association of
American Diabetes has done studies and reviewed the results of standards for diabetes self-
care and personal management and understands that there is a four-fold increase in
complications of diabetes in people who have not taken any advice or education related to
self-care practices. A study of self- management education for individuals dealing with type
2 diabetes has shown that there is improvement in blood glucose control in the follow-up.
However, this improvement in blood glucose decreases after one to three months of stoppage
of self-care activities, which suggests that education on self-management is helpful in
reducing glycosylated hemoglobin (Nam S, Chesla C, et al., 2011).The following tips for
personal care, i.e., daily exercise, diet, quitting

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smoking, foot care, fiber intake, tooth care, eye care, and stress management, will help in the
self-management of diabetes. The details of each are given below.

Daily Exercise

Physical exercise is of the utmost importance in dealing with diabetes. Daily exercise aids in
the digestion of food. Daily exercise helps to control the level of blood sugar in diabetic
patients (Cooper HC, Booth K, et al., 2016)

Personal care with physical exercise is an internal part of managing this disease and helping
with the motion of skeletal muscles (Norris SL, Lau J, et al., 2012). The goal of physical
exercise is to achieve blood sugar level regulation, improve the action of insulin, improve the
metabolism of protein and fat, avoid complications of diabetes, and increase life quality and
expectancy. Sufficient physical exercise leads to lower levels of HbA1c. The only condition
included is that it should be integrated with dietary advice. Younger generations should know
the needs and significance of regular physical exercise, which helps them lose calories,
reduce weight, and maintain blood glucose levels. In addition, the combined changes in diet
and daily physical activity aid in balancing normal weight and increasing weight loss in
individuals with obesity (Mora S, Lee IM, et al., 2016).

Monitoring glucose levels

Monitoring glucose level in the blood of patients with diabetes is an important cornerstone of
diabetes care and can help patients participate in achieving glycemic targets. The ultimate
aim of monitoring blood glucose is the overall assessment of glucose control and taking
optimal steps in time to achieve an optimal blood glucose level. Monitoring glucose levels in
the blood gives information about current blood glucose levels, allowing individuals to assess
their progress and undergo adjustments in medication, diet, and physical exercise so that
optimal blood glucose levels can be achieved (Cahn A, Akirov A, et al., 2018) [31].

Diet

Blood sugar levels can be maintained by avoiding foods with high-calorie counts, cutting
back on salt and sugar, and avoiding junk food (Paterson B, et al., 2020)

Quit Smoking

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Individuals diagnosed with diabetes mellitus should quit smoking and remain completely
away from drugs because they will cause blood vessels to narrow, which will further cause a
decrease in blood circulation (Johnson SB., 2012).

Foot Care

Individuals suffering from DM type 2 should properly wash and clean their feet using warm
water, then dry and clean them neatly. Any edema or injury to the foot has to be given the
utmost observation, and consultation from a physician should be sought (McNabb WL,et al.,
2015).

Intake of Fiber

Food with a high fiber content should be consumed. High fiber intake enhances the process
of digestion, maintains the blood sugar level, and decreases cholesterol (Povey RC, et al.,
2017).

Eat healthy plant foods

Plants provide vitamins, minerals and carbohydrates in your diet. Carbohydrates include
sugars and starches — the energy sources for your body — and fiber. Dietary fiber, also
known as roughage or bulk, is the part of plant foods your body can't digest or absorb. (Boulé
NG, Haddad E,et al., 2014)

Fiber-rich foods promote weight loss and lower the risk of diabetes. Eat a variety of healthy,
fiber-rich foods, which include:

Fruits, such as tomatoes, peppers and fruit from trees

Non starchy vegetables, such as leafy greens, broccoli and cauliflower

Legumes, such as beans, chickpeas and lentils

Whole grains, such as whole-wheat pasta and bread, whole-grain rice, whole oats, and quinoa

The benefits of fiber include:

Slowing the absorption of sugars and lowering blood sugar levels

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Interfering with the absorption of dietary fat and cholesterol

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Managing other risk factors that affect heart health, such as blood pressure and

inflammation Helping you eat less because fiber-rich foods are more filling and energy rich

Avoid foods that are "bad carbohydrates" — high in sugar with little fiber or nutrients: white
bread and pastries, pasta from white flour, fruit juices, and processed foods with sugar or
high- fructose corn syrup.

Eat healthy fats

Fatty foods are high in calories and should be eaten in moderation. To help lose and manage
weight, your diet should include a variety of foods with unsaturated fats, sometimes called
"good fats."

Unsaturated fats — both monounsaturated and polyunsaturated fats — promote healthy

blood cholesterol levels and good heart and vascular health. Sources of good fats include:

-Olive, sunflower, safflower, cottonseed and canola oils

-Nuts and seeds, such as almonds, peanuts, flaxseed and pumpkin seeds

-Fatty fish, such as salmon, mackerel, sardines, tuna and cod

Saturated fats, the "bad fats," are found in dairy products and meats. These should be a small
part of your diet. You can limit saturated fats by eating low-fat dairy products and lean
chicken and pork.

Tooth Care

After every meal, proper brushing and flossing of the teeth will prevent infection of the
gums. Inflammation of the gums, indicating redness and swollen gums, needs immediate
intervention (Boulé NG, Haddad E, et al., 2014).

Eye Care

Regular eye checks need to be done, failure of which will lead to retinopathy. Regular
checkups can prevent this complication [12]. (Boulé NG, Haddad E,et al., 2014)

Stress Management

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Management of stress with methods like yoga should be implemented and managed
effectively because the hormones produced in response to stress lead to improper functioning
of insulin, leading to an increase in blood glucose (Paterson B, et al., 2020).

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CHAPTER THREE

MATERIALS AND METHODS

1.19 STUDY AREA

The study was carried out at the Central Hospital, Yaounde Cameroon. Yaounde is the
political capital of Cameroon, Spread over seven hills. The Yaounde Central Hospital is
located at the Central town of Yaounde.

1.20 STUDY DESIGN

A cross sectional descriptive survey study design was used to carry out this study; A cross
sectional study is a type of observational studies that analyses data from a population, or a
representative subset, at a specific point in time.

1.21 SAMPLING METHOD

A cross sectional study was carried out among diabetic patients at the Yaounde Central
Hospital.

STUDY POPULATION
This study included a total of 38 participants at the Yaounde Central Hospital from 21st
November to 22nd December.
SELECTION CRITERIA

Inclusion criteria

 Eligible participants who supported data collection.

 The study included all diabetes patients that are diagnosed as having diabetes mellitus
for at least 6 months.
 Patients who provided informed written concert.

Exclusion Criteria
 Any participant who denied taking part in the study.

1.22 DATA COLLECTION

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Data was collected from 21 November to 22nd December 2023 in the Yaounde Central
st

Hospital. The data contained sociodemographic characteristics such as age, gender of the
participants in order to provide answers to the research questions asked.

1.23 DATA MANAGEMENT AND ANALYSIS

Data was accessed only by the researcher in order to ensure confidentiality and in other to
avoid data loss. The data was entered into Microsoft word 2017 using a computer with
password protection and was analyzed according to the various objectives. Descriptive
Statistical tools such as frequency distribution for each were produced and the information
arranged according to age group and sensitivity pattern were used to gauge the number of
occurrences of the variables being studied. This enabled analysis of the data to obtain
meaningful results for further discussions. Results were presented in the form of graphs,
frequency tables and bar charts.

1.24 ETHICAL CONSIDERATION

Before the beginning of the Study, a letter of authorization was obtained from Global
University Higher Institute Yaoundé and by the participants taking part in the research. The
participants was educated on the advantages of complying with this and an informed consent
was sought and accepted before data collected.

1.25 MATERIALS
Materials used for the collection of data
The register
Pens
Jotting books.
Questionnaires where used

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CHAPTER FOUR

RESULTS

1.26 SOCIODEMOGRAPHIC CHARACTERISTICS OF STUDY

PARTICIPANTS
The study included 38 patients, the average age of the participants was 20years the and
oldest 75years old. The most represented age group was from 40 years with 52.6%, majority
were Married (39.5%) and (42.1%) workers as seen in the table below

VARIABLE FREQUENCY PERCENTAGE

(no=38) (%)

GENDER
Male 15 39.5
Female 23 60.5

TOTAL 38 100

AGE(years)

20-30 5 13.2
31-40 13 34.2
40-75 20 52.6

Total 38 100
EDUCATIONAL LEVEL

Unive 8 21.1
rsity 14 36.8
Gradu 16 42.1
ates
worke
Total 38 100
MARITAL
\Single 06 15.8
Married 15 39.5
Divce 09 23.7
08 21.0
Widow
38 100
Total

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Table 1:Sociodemographic characteristics of the study participants

1.27 PARTICIPANTS’ KNOWLEDGE ON DIABETES AND

DIABETES SELF-CARE MANAGEMENT
From our findings, 30 (78.9%) of participants had good knowledge on diabetes and diabetic
risk factors, while 21.1% did not understand diabetes and its risk factors. Majority, 71.0%of
the respondents were aware of the best method for testing their glucose levels at home. A
few, 13.2% of the respondents reported urine as the best sample for blood sugar testing,
while 7.9% were unsure which method was best for glucose level testing at home. When
asked about the effects of different food types on blood sugar levels, 23.7% of the
respondents said that unsweetened fruit juice raises blood glucose levels. Unsweetened fruit
juice, on the other hand, was reported to lower blood glucose levels by 44.7%. A vast
majority 90.9% participants were aware that exercise and diet are important in the
prevention and management of diabetes. In terms of diabetes symptoms, 68.4% of
respondents agreed that blurred vision is one of the symptoms of diabetes, while 31.6% were
unaware of the symptom of diabetes. Regarding insulin intake, most of the respondents
84.2% were aware that irregular insulin injection will rise blood glucose level as seen on the
table below.

Variables Frequency (%)

Knowledge of what is diabetes

Yes 30 (78.9)

No 8 (21.1)

Total 100

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Knowledge on the best method for home

glucose testing

Urine 5 (13.2)
Blood testing 27 (71.0)
Both are good 3(7.9)
I don't know 3 (7.9)
Total 100

Knowledge on the effect of unsweetened

fruit juice have on blood glucose

Lowers it 17 (44.7)

Raises it 9 (23.7)

Has no effect 7 (18.4)

I don't know 5 (13.2)

Total 100

Knowledge on the best way to take care

of their feet with the use of alcohol to
massage them with

Yes 32 (84.2)

No 6 (15.8)

Total 100

Knowledge on the importance of Exercises

and diet in diabetes management

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Yes 36 (90.9)

No 2 (9.1)

Total 100

Knowledge on the sign of diabetes

Yes 26 (68.4)

No 12 (31.6)

Total 100

Knowledge on the effect insulin if not

taken

Yes 32(84.2)

No 6(15.8)

Total 100

Table 2: Participants’ knowledge on diabetes and diabetes self-care management

1.28 PARTICIPANTS PRACTICES TOWARDS DIABETES SELF-

CARE MANAGEMENT
Of the 38 respondents,32( 84.42%) were aware of their unique demands due to diabetes.
Above average, 20 (52.6%) of the respondents had altered their treatment plans after
starting treatment. A majority, 21 (55.3%) of the respondents reported having attended
lectures on managing diabetes on their own, and from clinics. 17 (44.7%) of the
respondents had not received any official health education about their health situation as
seen on the table below.

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100
90 Participants practices towards diabetes self-
80
70
care management
60
50
40
30
20
10
0
Have any Ever Ever Have any Sometimes Alcohol Regularity of
special changed received physical forget to consumption sport
diabetic diabetes lectures on limitations take your
needs regimen diabetic self that may medication
management affect ability
to perform
self-care

Yes No Sometimes Often Rarely Never

Figure 1:Participants practices towards diabetes self-care management

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CHAPTER FIVE

DISCUSSION, CONCLUSION, RECOMMENDATIONS

5.1 DISCUSSIONS

SOCIODEMOGRAPHIC CHARACTERISTICS OF STUDY

PARTICIPANTS
The study included 38 patients, the average age of the participants was 20years the and oldest
75years old this due to the fact that old people are are subccessible to diabetes due to the
degeneration of their cells. The most represented age group was from 40 years with 52.6%,
majority were (42.1%) workers.

PARTICIPANTS’ KNOWLEDGE ON DIABETES AND DIABETES

SELF-CARE MANAGEMENT
From our findings, 30 (78.9%) of participants had good knowledge on diabetes and diabetic
risk factors, while 21.1% did not understand diabetes and its risk factors. Majority, 71.0%of
the respondents were aware of the best method for testing their glucose levels at home. A
few, 13.2% of the respondents reported urine as the best sample for blood sugar testing,
while 7.9% were unsure which method was best for glucose level testing at home. When
asked about the effects of different food types on blood sugar levels, 23.7% of the
respondents said that unsweetened fruit juice raises blood glucose levels. Unsweetened fruit
juice, on the other hand, was reported to lower blood glucose levels by 44.7%. A vast
majority 90.9% participant were aware that exercise and diet are important in the prevention
and management of diabetes. This study is in line with studies carried out on Thailand by
Nitikorn . P et al., 2022 on the knowledge and relating factors among people with diabetes
type 2 in which (96.7%) of participants had poor knowledge on the control of blood glucose
and (92.3% ) had poor knowledge on insulin use and importance on its regular use.

PARTICIPANTS PRACTICES TOWARDS DIABETES SELF-

CARE MANAGEMENT

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Of the 38 respondents, 32(84.42%) were aware of their unique demands due to diabetes.
Above average, 20 (52.6%) of the respondents had altered their treatment plans after starting
treatment. A majority, 21 (55.3%) of the respondents reported having attended lectures on
managing diabetes on their own, and from clinics. 17 (44.7%) of the respondents had not
received any official health education about their health situation. This study goes in line
with studies done by Asim M et al 2018, which displayed a study of 744 participants in
which (20%) had a glucometer, (27.7%) had daily meal planned. This showed that, most
diabetes had knowledge but did not displayed them in their life time.

5.2 CONCLUSION
Patients had strong understanding about diabetes, but this knowledge was not applied to the
self-care management routines they should have followed every day to manage their
condition and avoid complications. Exercise, which is a fundamental self-care management
behavior, was not consistently practiced. Patients reported frequently forgetting to take their
medications, and medication adherence was found to be poor. Some reported they were
unaware of how insulin injections affected their blood sugar levels even though they took
insulin daily. The gap between diabetes self-care education and the practice of diabetes self-
care management requires that diabetes education be customized to the patient's situation and
level of adaptability to corresponding lifestyle modifications. Patients must continue to
receive contextualized information about managing their diabetes on their own. Every
diabetes patient needs to be aware of how to manage their disease and the benefits of self-
care. Diabetes education in a setting like Cameroon and Yaoundé should consider the
patients’ demographic history while making excellent use of what is easily accessible and
affordable.

5.3RECOMMENDATION
To nurses

Continuing medical education on self-care practice and diabetes management. To improve

on patient knowledge and their autonomy towards their self-care of diabetes.

To patients

They should regularly go for checkups. For early diagnoses of complications and to evaluate
improvements in therapeutic managements.

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5.4LIMITATIONS
- The study was a cross-sectional design and the inferences have limits as they only based on
interconnection of self-care adherence patterns.

-The data collected from self-reported data that can be susceptible to recall bias.

- Limited period.

- Some patients refused to participate in the survey.

- Language Barrier.

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APPENDICES

CONSENT FORM

I (your name) having understood the study,

after having the participant information sheet well explained to me, having being given the
opportunity to ask questions and time to consider my participation in the study, do hereby agree
to participate in this study.

Date/signature of participant Date/signature of investigator

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QUESTIONNAIRE
Dear
respondents,
I am ----------a third year student of GLOBAL POLYTECHNIQUE HIGHER INSTITUTE
YAOUNDE of the Department of Health and Biomedical Sciences, Option Nursing. I am
currently out on a research on “ASSESSMENT OF THE KNOWLEDGE AND PRACTISE
OF TYPE 2 DIABETIC PATIENTS ON SELFCARE IN CENTRAL HOSPITAL
YAOUNDE” . The
data to be collected is to build academic bases and the information you will provide will be used
strictly for educational purposes. I therefore appeal for honesty and comprehension in your
responses.

Date………/…………./2024

Instructions: please place a tick (√) on the correct answer and fill in the space where necessary

SECTION A. SOCIODEMOGRAPHIC CHARACTERISTICS OF PARTICIPANTS

1. Gender: male female

2. Age

3. Educational level

University

Graduate

Worker

6. Marital status

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SECTION B: PARTICIPANTS’ KNOWLEDGE ON DIABETES AND DIABETES SELF-

CARE MANAGEMENT

1 Knowledge of what is diabetes? Yes no

2 The best method for home glucose testing? Urine blood both

I don’t know

3 What is the effect of unsweetened fruit juice having on blood glucose?

Lowers it

Raises it

No effect

I don’t know

4 One of the best ways to take care of your feet is to massage with alcohol? Yes

no

5 Exercises and diet are very important in diabetes management? no

6 One of the sign of diabetes is blur vision? no

7 Blood glucose level increases if insulin is not taken? Yes no

SECTION C: PARTICIPANTS PRACTICES TOWARDS DIABETES SELF-CARE

MANAGEMENT

1 Have any special diabetic needs? no

2 Ever changed diabetes regimen? Yes no

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3 Ever received lecture on diabetes self management? Yes no

4 Have any physical limitations that may affect ability to perform self-care? Yes

no

5 Sometimes forget to take your medication? Yes no

6 Do you consume alcohol? Yes no

7 Regularity of sport?

Sometimes

Often

Rarely

Never

Thanks for your respond

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