• Users Online: 110
  • Print this page
  • Email this page


 
 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 4  |  Issue : 4  |  Page : 239-244

Diabetes knowledge and self-care practices among people living with type 2 diabetes mellitus in a diabetes clinic in Southwestern Nigeria


1 Department of Nursing Science, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
2 Department of Nursing, University of Ibadan, Ibadan, Oyo State, Nigeria
3 Department of Chemical Pathology, University of Medical Sciences Teaching Hospital, Ondo, Ondo State, Nigeria
4 Department of Nursing Science, Bowen University, Iwo, Osun State, Nigeria

Date of Submission16-May-2022
Date of Decision13-Oct-2022
Date of Acceptance09-Nov-2022
Date of Web Publication26-Dec-2022

Correspondence Address:
Matthew Idowu Olatubi
Department of Nursing Science, Bowen University, Iwo, Osun State
Nigeria
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jin.jin_47_22

Rights and Permissions
  Abstract 


Objective: The objective of this study is to assess the knowledge and self-care practices of people living with type 2 diabetes mellitus (T2DM).
Materials and Methods: The study was conducted in a clinic in Southwestern Nigeria. It adopted a cross-sectional design. The sample consists of 107 people living with T2DM. Data were collected using Diabetes Knowledge Questionnaire and Revised Self-care Inventory Scale.
Results: The mean diabetes knowledge of the participants was 16.2 ± 3.0 and 70.1% had inadequate knowledge of T2DM. The mean diabetes self-care practice score among the participants was 49.9 ± 4.9, and 89.7% reported poor diabetes self-care practice. There is no significant difference in the knowledge of diabetes between male (16.42 ± 3.42) and female (16.12 ± 2.8) participants (t = 0.45; P = 0.65), and no significant difference in self-care practice of male (49.23 ± 4.51) and female (50.06 ± 5.07) participants (t = 0.75, P = 0.46). In addition, there is no correlation between age and knowledge of diabetes (r = -0.18, P = 0.07) and self-care practices (r = 0.08, P = 0.38) of participants. No significant relationship was found between knowledge of diabetes and diabetes selfcare practices (χ2 = 1.605, P = 0.448)
Conclusion: Knowledge of diabetes and self-care practices of people living with T2DM in this study were poor. Effort should be directed at improving their diabetes knowledge and self-care practices.

Keywords: Adherence, clinic, knowledge, self-care practices, type 2 diabetes mellitus, type 2 diabetes


How to cite this article:
Famakinwa TT, Oluwatosin OA, Faronbi JO, Faremi FA, Ogunleye A, Adereti CS, Olatubi MI. Diabetes knowledge and self-care practices among people living with type 2 diabetes mellitus in a diabetes clinic in Southwestern Nigeria. J Integr Nurs 2022;4:239-44

How to cite this URL:
Famakinwa TT, Oluwatosin OA, Faronbi JO, Faremi FA, Ogunleye A, Adereti CS, Olatubi MI. Diabetes knowledge and self-care practices among people living with type 2 diabetes mellitus in a diabetes clinic in Southwestern Nigeria. J Integr Nurs [serial online] 2022 [cited 2023 Jan 29];4:239-44. Available from: https://www.journalin.org/text.asp?2022/4/4/239/365322




  Introduction Top


Diabetes mellitus is a chronic noncommunicable metabolic disorder that is of great concern to world health leaders due to its fast-growing prevalence worldwide. Globally an estimated 425 million adults between 20 and 79 years of age were living with diabetes in 2017, and by 2045, this may increase to 629 million.[1] In 2021, Nigeria has a diabetes prevalence of 3.6% among adults aged 20–79 years.[2] The increasing morbidity and mortality associated with diabetes lead to physical disabilities and social and economic losses with adverse consequences on the individual, family, and society. Minimizing these consequences largely depends on adequate management of type 2 diabetes mellitus (T2DM) to achieve glycemic control.

The management of T2DM requires lifestyle modification through self-care practices. Similarly, adherence to self-care practices depends on the patients' knowledge and understanding of T2DM and its diabetes management.[3] Patients' inadequate knowledge about T2DM control targets and self-care practices had been documented to be associated with poor glycemic control.[3],[4] Furthermore, good knowledge of T2DM is known to be associated with better management outcomes in terms of decreases in glycated hemoglobin values and adherence to T2DM self-care behaviors.[5],[6]

However, poor glycemic control among people living with T2DM remains a challenge.[7],[8],[9] The American Diabetes Association in 2016, reported that an estimated 30%–49% of diabetic patients do not have adequate control of blood sugar, blood pressure, or blood cholesterol and that only 14% have adequate control of these three factors.[10] In Nigeria, scholars had also documented poor glycemic control among people living with T2DM.[7]

Poor T2DM-related knowledge had been documented among people living with T2DM in India,[11] Ethiopia,[3] and Nigeria.[12] Furthermore, Bayem et al.[13] documented that the majority of people living with T2DM in Nigeria had issues with diabetes self-care practices. Opara et al.[14] further found out in a study among people living with T2DM in Enugu and Nigeria that adherence to diabetes self-care practices was very poor. It had also been documented in some settings that the state of glycemic control can be improved if patients' knowledge of diabetes and self-care behaviors improved.[5],[13],[15]

A significant relationship had been found to exist between T2DM knowledge and self-care practice among people living with T2DM in Malta,[16] India,[17] Malaysia,[18] and Ethiopia.[15] However, little is known about the relationship between T2DM-related knowledge and self-care among people living with T2DM in Southwestern Nigeria. Therefore, the purpose of this study was to assess the knowledge of diabetes management and self-care practices among people living with T2DM and determine the relationship between respondents' knowledge and reported self-care practices.


  Materials and Methods Top


Study design

The study adopted a cross-sectional design.

Setting

Data were collected from March to June 2019 in the diabetes clinic of State Specialist Hospital, Ondo, Ondo State. The hospital provides both in-patients and out-patients health services to individuals with diverse care needs including people living with T2DM. The diabetes clinic essentially provides follow-up care in the areas of medication, glucose monitoring, and patient education. Physicians, nurses, and nutritionists/dieticians work in the clinic which attends to the clients on Tuesday of every week.

Study population and sampling strategy

The study population consists of 107 patients with T2DM attending the diabetes clinic. The sample size was determined using Kirk and Sterne (2003) formula.[19] The power of the study was 0.983 with the level of significance set at 95%. Simple random sampling technique using the ballot system was employed to recruit participants for the study. Only people that had been diagnosed with T2DM for at least 2 years were recruited for the study.

Data collection

Information about participants' knowledge was obtained with a validated Diabetes Knowledge Questionnaire (DKQ).[20] The DKQ is a 24-item scale that evaluates diabetes knowledge in the areas of cause, diagnosis, glucose monitoring, diet, complications, and exercise. DKQ has a reliability value of alpha 0.74. Response variables in the DKQ were Yes, No, and I don't know. Diabetes-related knowledge was evaluated as a percentage of correct answers and the mean score was calculated. Scores above the mean score were categorized as good knowledge, whereas scores below the mean (16.2) were categorized as fair and poor knowledge, respectively. The DKQ has documented Cronbach's alpha coefficients (α) score of 0.78. In the pilot study, it has a score of 7.0.

Adherence to self-care practices was evaluated with revised Self-Care Inventory scale (SCI-R).[21] SCI-R is a self-report 15-item Likert-type scale with “Never = 1,” “Rarely = 2,” “Sometimes = 3,” “Usually = 4,” and “Always = 5.” The scale allows for the possibility of varying treatment and also evaluates the individual's perception. For analysis, the response variables on diabetes SCI-R were assigned numerical values of 1, 2, 3, 4, and 5, respectively, thus the score ranged from 15 to 75. Participants' performance was categorized as good practice (70% and above), fair practice (50%–69%), and poor practice (below 50%). The SCI-R scale has a documented α score of 0.87[21] and 0.82 in the pilot study.

The data were collected by two of the authors who are well-grounded in survey data collection. The questionnaire was administered to the prospective participants during their clinic appointments. The questionnaire was retrieved after satisfactory completion. Totally 120 questionnaires were administered but only 107 were retrieved and satisfactorily filled giving a response rate of 89.17%. Data were collected over 3 months.

Statistical analysis

Data analysis was done with SPSS version 20 manufactured by IBM Corporation, Armonk, New York, the USA[22] using descriptive (frequency counts and percentages) and inferential statistics (Correlation coefficient, Chi-square test, and Student's t-test). Student's t-test was used to ascertain differences in the knowledge of diabetes and self-care practices of male and female participants in the study while the correlation coefficient was used to establish relationship between the age of the participants and between knowledge of diabetes and self-care practices. Chi-square was used to test the relationship between knowledge of diabetes and self-care practices among the participants.

Ethical considerations

Approval was obtained from the Research Ethics Committee of Ondo State Ministry of Health (AD.4693/315) on January 15, 2019. In addition, written consent was obtained from the participants. The instruments were given to the participants who could read and write while those who could not, were assisted by the research assistants who read and interpreted the items on the instruments to each client and their responses were documented accordingly.


  Results Top


[Table 1] presents the sociodemographic characteristics of the participants. All 107 participants duly completed and returned the questionnaire, representing a 100% response rate. Forty-two point one percent (42.1%) of the participants were within the age range of 60 and 69 years. The mean age of the participants in the study was observed to be 65.1 ± 9.4 years. The majority (75.7%) of the patients that participated in the study were females, 53.3% had no formal education, whereas 82.2% were employed.
Table 1: Participants' sociodemographic characteristics

Click here to view


Only 29.9% of the participants had good knowledge of diabetes, and 45.8% and 24.3% had fair and poor knowledge of diabetes, respectively [Table 2]. Better knowledge was demonstrated in the area of diabetes diagnosis (80.5%), diet management (83.2%), and clinical manifestations/complications (89.1%). The mean diabetes knowledge of the participants was 16.2 ± 3.0. No significant difference in the knowledge of diabetes between male (16.4 ± 3.4) and female (16.1 ± 2.8) participants with T2DM, (t = 0.45; P = 0.65). Furthermore, no correlation exists between the age of the participants and their knowledge of diabetes (r = −0.18, P = 0.07).
Table 2: Relationship between participants' knowledge and reported self-care practice

Click here to view


Self-care practices among the participants in this study showed that only few (10.3%) reported good diabetes self-care practices while the majority (89.7%) have fair diabetes self-care practices. The mean diabetes self-care practice score among the participants in the study was 49.9 ± 4.9. Furthermore, there is no significant difference in diabetes self-care practice of male (49.2 ± 4.5) and female (50.1 ± 5.1) participants in the study (t = 0.75, P = 0.46). There is no significant correlation between the age of the people living with T2DM that participated in this study and their diabetes self-care practices (r = 0.08, P = 0.38).

As regards the relationship between the participants' knowledge and reported self-care practices, findings from the Chi-square test showed no significant relationship between knowledge of diabetes and diabetes self-care practices [Table 2].


  Discussion Top


Adequate knowledge of diabetes and effective self-care practices are key factors in achieving glycemic control in people living with T2DM.[3],[23],[24],[25] The patients take daily decisions about their care, make choices concerning self-care behaviors, and ultimately take control of their care to promote well-being and prevent complications. In this study, results showed that 24.3% of the participants' demonstrated overall poor knowledge of diabetes and diabetes self-care. This implies that a good number of people living with T2DM that participated in this study were not knowledgeable about diabetes and diabetes self-care. This is similar to poor knowledge of diabetes documented among people attending outpatient diabetes clinics in Ethiopia,[3] India,[11] Nigeria,[12] and Zimbabwe.[26] In many developed nations, knowledge of diabetes among people living with T2DM is better than what was documented in this study.[27] However, another related study reported fair knowledge of diabetes among people living with T2DM in Ibadan, southwestern Nigeria.[28] The reason for this might be due to the fact that Ibadan is an urban city with better access to health care and health information compared to Ondo where this study was carried out.

While assessing the knowledge of people living with T2DM about different aspects of diabetes self-care, it was reported that only few of the participants in their study have good nutritional knowledge about diabetes.[29] Results of our study, however, showed good nutritional knowledge among patients that participated in the study. This is probably due to frequent education on the dietary management of diabetes that is provided in the clinic where our study was carried out. Also, this study documented good knowledge of clinical manifestations and complications of diabetes among the participants. This had also been documented among people living with T2DM in the Southeastern part of Nigeria.[30]

Participants' knowledge on the diagnosis of diabetes was also found to be very high. The participants' knowledge may be a result of adequate education provided by health-care providers to the patients. It is recommended that diabetes education should be made available to patients on diagnosis and on on-going basis. The findings about the overall knowledge of the participants about diabetes are similar to the findings of Dinesh et al. except their findings about knowledge of complications of diabetes.[31]

Ubajaka et al.[32] documented a significant relationship between gender and knowledge of diabetes in a study among secondary school teachers in the eastern part of Nigeria. However, this study found that there is no significant difference in the diabetes knowledge of male and female patients living with T2DM that participated in this study. This might be probably due to the fact that our study was carried out among people living with T2DM while Ubajaka et al.'s study was carried out among the general population. Furthermore, the weak insignificant relationship was found between age and knowledge of diabetes among participants in this study.

No significant difference in the knowledge of diabetes between male (16.42 ± 3.42) and female (16.12 ± 2.8) participants with T2DM that participated in the study (t = 0.45; P = 0.65). Furthermore, no correlation exists between the age of the participants and their knowledge of diabetes (r = −0.18, P = 0.07). However, Formosa and Muscat[16] found a positive correlation between the age of people living with T2DM and their knowledge of diabetes, which is not consistent with results of our study.

Findings from our study also showed that participants adhered poorly to blood glucose monitoring, which is similar to the findings of previous studies.[12],[13],[29] In a systematic review of adherence to diabetes self-care, adherence with blood glucose monitoring among people living with T2DM was reported to be between 17.0% and 77.45% depending on the setting where the study was carried out.[33] Mogre et al.'s review further showed that studies conducted in poor nations like our study, have poor adherence to blood glucose monitoring.[34] Therefore, poor adherence to blood glucose in our study might probably be due to the unavailability of glucometer for the personal use of many of the participants in this study.[12],[13]

Although participants in this study have good knowledge of dietary management of diabetes, dietary-related practices in the management of diabetes were found to be poor.[13],[30] This is at variance with moderate dietary self-care practices among people living with T2DM documented by Ketema et al.[35] Nearly all the participants reported taking the correct doses of diabetes pills and 82 of them take their medications at the right time corroborating submissions of previous studies.[30],[32]

Overall, participants reported adherence to self-care practices was fair. This is better than poor adherence to diabetes self-care practices reported among people living with T2DM in Enugu Nigeria,[14] and India.[36] A possible reason for the participants' better adherence to medication is their reported belief that untreated or poorly controlled diabetes would cause an increase in blood sugar levels and possible complications. This is, however, in contrast with the findings by Dinesh et al.,[31] where only 48% of their study participants take the recommended hypoglycemic agents and insulin daily. Results of our study showed that there is no relationship between gender, age, and self-care practices of people living with T2DM that participated in the study, contrary to findings of previous studies.[28],[32]

The participants' poor knowledge of diabetes and diabetes care reflected in their reported self-care practices which were fair. This shows the importance of diabetes patient education as an integral component of diabetes care to encourage effective self-care practices. On the relationship between participants' knowledge of diabetes and self-care practices, findings showed no statistically significant relationship them. Patients with adequate knowledge of diabetes are more likely to better engage in self-care than those with poor knowledge.

Assessing practice from participants' point of view is prone to bias. This study uses a standardized scale that had been used in previous studies to increase the correctness of the results. Similarly, this study was conducted in a single setting, multiple settings would have yielded broader findings and generalization.


  Conclusion Top


The participants in this study demonstrated inadequate knowledge of diabetes and diabetes self-care and their reported performance in self-care activities was below average. To minimize T2DM complications, there is a need for improved diabetes patient education. Similarly, no difference in the knowledge of diabetes and diabetes self-care among male and female participants in this study. This will help patients to engage better in self-care behaviors and thus prevent complications while experiencing good quality of life.

Acknowledgment

The authors appreciate the support of the following people Mr. Ogunleye A, Mrs. O. Araoyinbo, Mrs. O. Ezekiel, Mrs. B. O Adegoke, Rev. Sister Oluwole, and the entire staff of Diabetes Clinic, State Specialist Hospital, Ondo City, Ondo State.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Forouhi NG, Wareham NJ. Epidemiology of diabetes. Medicine (Baltimore) 2019;47:22-7.  Back to cited text no. 1
    
2.
World Data Atlas. Nigeria Diabetes Prevalence 1960-2021. Nigeria – Diabetes Prevalence as a Share of Population Aged 20-79 Years. New York: World Data Atlas; 2022.  Back to cited text no. 2
    
3.
Kassahun T, Gesesew H, Mwanri L, et al. Diabetes related knowledge, self-care behaviours and adherence to medications among diabetic patients in Southwest Ethiopia: A cross-sectional survey. BMC Endocr Disord 2016;16:28.  Back to cited text no. 3
    
4.
International Diabetes Federation. IDF Diabetes Atlas. Brussels: International Diabetes Federation; 2017.  Back to cited text no. 4
    
5.
Nazir SU, Hassali MA, Saleem F, et al. Disease related knowledge, medication adherence and glycaemic control among patients with type 2 diabetes mellitus in Pakistan. Prim Care Diabetes 2016;10:136-41.  Back to cited text no. 5
    
6.
Martin D, Elie C, Dossier C, et al. Diabetes knowledge in adolescents with type 1 diabetes and their parents and glycemic control. Pediatr Diabetes 2017;18:559-65.  Back to cited text no. 6
    
7.
Iwuala SO, Olamoyegun MA, Sabir AA, et al. The relationship between self-monitoring of blood glucose and glycaemic control among patients attending an urban diabetes clinic in Nigeria. Ann Afr Med 2015;14:182-7.  Back to cited text no. 7
[PUBMED]  [Full text]  
8.
Viana LV, Leitão CB, Kramer CK, et al. Poor glycaemic control in Brazilian patients with type 2 diabetes attending the public healthcare system: A cross-sectional study. BMJ Open 2013;3:e003336.  Back to cited text no. 8
    
9.
Musenge EM, Michelo C, Mudenda B, et al. Glycaemic control and associated self-management behaviours in diabetic outpatients: A hospital based observation study in Lusaka, Zambia. J Diabetes Res 2016;2016:1-9.  Back to cited text no. 9
    
10.
American Diabetes Association. Diabetes care. J Clin Appl Res Educ 2016;39:1-5.  Back to cited text no. 10
    
11.
Eunyoung SY, Suh E. The level of diabetes knowledge and related factors among patients with diabetes mellitus in Hyderabad, India. Korean J Adult Nurs 2018;30:447-54.  Back to cited text no. 11
    
12.
Sabo SY, Moh'd AS, Emenike VI. Assessment of diabetic patient's knowledge and understanding of diabetes mellitus in a North-Eastern Nigeria Tertiary Hospital. SAJ Pharm Pharmacol 2019;6:1-9.  Back to cited text no. 12
    
13.
Bayem MV, Oriaran MB, Olugbade A, et al. Self-care challenges among diabetic patients in a South-Southern teaching self-care challenges among diabetic patients in a South-Southern Teaching Hospital, Nigeria. Int J Caring Sci 2019;12:906-15.  Back to cited text no. 13
    
14.
Opara HC, Anarado AN, Anetekhai CJ, et al. Non-adherence to selected self-care actions and its determinants among adults with type 2 diabetes mellitus in a tertiary hospital in Enugu State Nigeria. Int J Nurs Midwifery 2020;11:1-9.  Back to cited text no. 14
    
15.
Dedefo MG, Ejeta BM, Wakjira GB, et al. Self-care practices regarding diabetes among diabetic patients in West Ethiopia. BMC Res Notes 2019;12:212.  Back to cited text no. 15
    
16.
Formosa C, Muscat R. Improving diabetes knowledge and self-care practices. J Am Podiatr Med Assoc 2016;106:352-6.  Back to cited text no. 16
    
17.
Mehta NV, Trivedi M, Maldonado LE, et al. Diabetes knowledge and self-efficacy among rural women in Gujarat, India. Rural Remote Health 2016;16:3629.  Back to cited text no. 17
    
18.
Abbasi YF, See OG, Ping NY, et al. Diabetes knowledge, attitude, and practice among type 2 diabetes mellitus patients in Kuala Muda District, Malaysia – A cross-sectional study. Diabet Metab Syndr Clin Res Rev 2018;12:1057-63.  Back to cited text no. 18
    
19.
Kirkwood BR, Sterne JA. Essential Medical Statistics. Wiley-Blackwell: Blackwell Science; 2003.  Back to cited text no. 19
    
20.
Garcia AA, Villagomez ET, Brown SA, et al. The Starr County diabetes education study: Development of the Spanish-Language diabetes knowledge questionnaire. Diabetes Care 2001;24:16-21.  Back to cited text no. 20
    
21.
Weinger K, Butler HA, Welchi GW, et al. Measuring diabetes self-care. A psychometric analysis of the self-care inventory – Revised with adults. Diabet Care 2005;28:134-52.  Back to cited text no. 21
    
22.
IBM Corp. IBM SPSS Statistics for Windows. United Kingdom: IBM Corp; 2011.  Back to cited text no. 22
    
23.
Chavan GM, Waghachavare VB, Gore AD, et al. Knowledge about diabetes and relationship between compliance to the management among the diabetic patients from Rural Area of Sangli District, Maharashtra, India. J Family Med Prim Care 2015;4:439-43.  Back to cited text no. 23
[PUBMED]  [Full text]  
24.
Oyetunde MO, Famakinwa TT. Nurses knowledge of contents of diabetes patient education in Ondo-State, Nigeria. J Nurs Educ Pract 2014;4:91-8.  Back to cited text no. 24
    
25.
Fabrizi D, Rebora P, Luciani M, et al. How do self-care maintenance, self-care monitoring, and self-care management affect glycated haemoglobin in adults with type 2 diabetes? A multicentre observational study. Endocrine 2020;69:542-52.  Back to cited text no. 25
    
26.
Mufunda E, Ernersson Å, Hjelm K. Limited knowledge of diabetes in patients attending an outpatient diabetes clinic at a referral hospital in Zimbabwe: A cross-sectional study. Pan Afr Med J 2018;29:144.  Back to cited text no. 26
    
27.
Zowgar AM, Siddiqui MI, Alattas KM. Level of diabetes knowledge among adult patients with diabetes using diabetes knowledge test. Saudi Med J 2018;39:161-8.  Back to cited text no. 27
    
28.
Oyelami FI, Oshiname F, Ekerete-udofia C, et al. Knowledge and factors associated with treatment compliance among diabetes mellitus patients in selected hospitals in Ibadan, Oyo State, Nigeria. J Adv Med Med Res 2017;23:1-8.  Back to cited text no. 28
    
29.
Olatona FA, Airede CA, Aderibigbe SA, et al. Nutritional knowledge, dietary habits and nutritional status of diabetic patients attending teaching hospitals in Lagos, Nigeria. J Community Med Prim Health Care 2019;31:90-103.  Back to cited text no. 29
    
30.
Iloh GU, Collins PI. Hypoglycemia in a resource – Poor Nigerian environment : A cross – Sectional study of knowledge ambulatory type 2 diabetic patients in. BLDE Univ J Health Sci 2017;2:29-37.  Back to cited text no. 30
  [Full text]  
31.
Dinesh PV, Kulkarni AG, Gangadhar NK. Knowledge and self-care practices regarding diabetes among patients with Type 2 diabetes in Rural Sullia, Karnataka: A community-based, cross-sectional study. J Family Med Prim Care 2016;5:847-52.  Back to cited text no. 31
[PUBMED]  [Full text]  
32.
Ubajaka CF, Olisa OC, Uchechukwu OP, et al. Knowledge and practice of preventive measures against diabetes mellitus amongst secondary school teachers in Awka. Int J Diabet Res 2019;2:50-6.  Back to cited text no. 32
    
33.
Mogre V, Johnson NA, Tzelepis F, et al. Barriers to diabetic self-care : A qualitative study of patients' and healthcare providers' perspectives. J Clin Nurs 2019;28:2296-308.  Back to cited text no. 33
    
34.
Mogre V, Johnson NA, Tzelepis F, et al. A systematic review of adherence to diabetes self-care behaviours: Evidence from low and middle-income countries. J Adv Nurs 2019;75:3374-89.  Back to cited text no. 34
    
35.
Ketema DB, Leshargie CT, Kibret GD, et al. Level of self-care practice among diabetic patients in Ethiopia: A systematic review and meta-analysis. BMC Public Health 2020;20:309.  Back to cited text no. 35
    
36.
Chinnappan J, Iqbal FV, Ashok P, et al. Assessment of self-care practices among type 2 diabetic patients in a secondary care teaching hospital. J Drug Deliv Ther 2020;10:119-24.  Back to cited text no. 36
    



 
 
    Tables

  [Table 1], [Table 2]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Materials and Me...
Results
Discussion
Conclusion
References
Article Tables

 Article Access Statistics
    Viewed174    
    Printed8    
    Emailed0    
    PDF Downloaded20    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]