The available scientific knowledge concerning diabetes mellitus is an important resource to guide and educate diabetes patients concerning self-care. Self-care concepts that can benefit patients include adherence to diet, physical activity, blood glucose monitoring, and taking oral medication and insulin. Few studies regarding the relationship between knowledge and self-care practices among newly diagnosed diabetics are available in Bangladesh or elsewhere in the world. Studies have mostly involved the general population and type 2 diabetes patients who have had the disease for a significant period of time [5, 12, 14–17]. This study was undertaken in order to assess the relationships between knowledge and self-care practices among newly diagnosed type 2 diabetics attending different healthcare centers in Bangladesh.
In the present study, it is encouraging to note that the majority of respondents had average basic (66%) and technical (78%) knowledge regarding diabetes mellitus (DM). A study was conducted on members of the general public in Singapore to evaluate their level of knowledge about diabetes, and the results indicated that the respondents had an acceptable level of knowledge . Another study was done on knowledge and perceptions of diabetes in a semi-urban Omani population; it found that subjects’ level of knowledge was suboptimal . A study conducted on people with diabetes attending the Aga Khan University Hospital (AKUH)  in Pakistan found that 12%, 35%, and 53% of the patients had GAP knowledge of the symptoms, treatments, and complications of diabetes.
With regard to self-care practices, it was unfortunate to note that the majority (90%) of this study’s respondents from all three basic knowledge groups did not test their blood glucose regularly. However, the relationship was significant. Similar results were found in technical knowledge groups, and the relationship was not significant. These results revealed that the frequency of blood glucose monitoring increases gradually as the level of knowledge changes. The patients in this study showed higher rates of self-monitoring than those found in the study from Singapore .
Further findings indicated that a good number of the respondents in each basic knowledge group did exercise, and the rate of exercise rose with increasing levels of knowledge. Similar and significant results were found in this study’s technical knowledge groups. In Peshawar, it was found that 75% of subjects who had had diabetes for 9 years did exercise in order to control blood glucose . In the present study, many respondents in all three basic and technical knowledge groups did not take extra care of their feet regularly. Moreover, only 16%, 13%, and 12% of patients in GAP basic knowledge groups did not smoke. Almost the same rates of smoking were found in the technical knowledge groups. About 80% of respondents with good levels of basic knowledge consumed betel nuts; more than half of the respondents from the poor and average basic knowledge groups also had the same practice. Similar results were found in the three technical knowledge groups, and the relationship was significant both in basic and technical knowledge groups.
Diet plays an important role in the prevention and management of DM. The majority (90%) of the respondents in each basic and technical knowledge group did not follow dietary advice given by diabetes educators. Diabetes significantly changes the relationships between patients, their bodies, and the world around them, and restrictions on eating habits make them more aware of their limitations. This is why the conflict between the desire to eat and the imperious need to refrain from indulging such desire is always present in the daily lives of people with diabetes. This conflict might be an important element in understanding the respondents’ low rates of positive practices for coping with the disease. About 26%, 42%, and 51% of GAP basic knowledge groups were aware of the practice of following fixed times for eating their main meals, a significant relationship. Similar and significant results were found in the technical knowledge groups. Notably, about one-third of respondents in all basic and technical knowledge groups partially practiced the measurement of food before eating, a significant result.
Respondents of the present study were fairly informed about diabetes management and we have found an association between basic knowledge and practice. There is evidence that patient awareness is the most effective way to lessen the complications of diabetes . Business, one of the categories of occupations, has also been identified as determinant of good practice. We assume that this might have been due to their better access to goods and services as well their independence in availing the health care. Contrarily, rich people showed lower level of practice. The reason needs exploration.
In this study, several explanations were possible for the fact that respondents had average knowledge of DM but inappropriate self-care practices. First, the bulk of the respondents had family history of diabetes. It would be reasonable to assume that diabetic family members would share their knowledge with non-diabetics and newly diagnosed diabetics. Second, as the respondents in this study were newly diagnosed, they had not attended any structured diabetes education programs. Ignorance, high confidence level and lack of time may also be the reasons behind the scenario. Various issues need to be addressed in order to close the gaps between knowledge and practice. The results of this study encourage a positive outlook: all that is required is that a diabetes educator trained in diabetes management counsel patients during every visit and counseling may have an impact in improving the perception about disease, diet, and lifestyle changes and thereby on glycemic control and the complications of diabetes.