Assessment of the Awareness of Risk Factors and Current Behavior Among Individuals With Type 2 Diabetes Mellitus in India: A Cross-Sectional Study

Background The burden of type 2 diabetes mellitus (T2D) is compounded by serious complications, including cardiovascular and microvascular diseases, with significant healthcare costs associated with these complications. Engaging in self-care practices can enhance glycemic control and empower individuals to make informed health decisions. The present study aims to assess the existing levels of awareness and understanding of diabetes, focusing on the perception of its risk factors and associated complications. Methodology This prospective, cross-sectional study involved 2,468 individuals with T2DM recruited from 26 sites across India. Data underwent aggregate-level analysis using Python and were assessed for statistical significance using the chi-square test. Continuous variables (means and standard deviations) were analyzed, and differences among groups were evaluated using analysis of variance. To assess the understanding of diabetes, including its symptoms and complications, all knowledge-related questions were aggregated into a composite score. Participants were categorized into three groups (high, medium, and low) based on their knowledge levels. The participant's variables across five dimensions, namely, diabetes causes and symptoms, medication usage, diet and lifestyle, hypoglycemia, and complications from diabetes, were assessed. The highest achievable score was 26, while the lowest was 0. Based on the knowledge score, individuals were classified into the following three groups: high for participants who scored 80% or more correct answers (score >20); medium for those scoring between 40% and 80% (score between 11 and 20); and low for participants with a score between 0 and 10, indicating fewer than 40% correct responses. Results The average participant age was 54.1 years, with a male-to-female ratio of 60:40. The average hemoglobin A1c level was 8.2%, with 629 (28%) maintaining levels within the target range (≤7%), and 497 (22%) having levels above 9%. Overall, 655 (26.50%) individuals were classified as high knowledge, 1,179 (47.77%) as medium knowledge, and 634 (25.68%) as low knowledge. Scores were 22.4 (1.2) for high knowledge, 15.9 (2.9) for medium, and 6.2 (3.0) for low. Diabetic complications were significantly higher in the high-knowledge group. Adherence to diabetes medication was higher in the high (509 (78.5%)) and medium (917 (81.6%)) knowledge groups (p < 0.001) compared to the low (363 (60.3%)) knowledge group. Participants with high and medium knowledge levels demonstrated significantly greater ownership and use of glucometers compared to those with lower knowledge levels. Conclusions Individuals with T2DM who experience complications tend to have a greater understanding of diabetes and its risk factors than those without complications. This suggests that facing health issues motivates individuals to seek information, improving their knowledge and influencing better medication adherence and lifestyle choices. The findings of this study, coupled with existing data, underscore the urgent need for innovative approaches to engage and motivate individuals through targeted educational initiatives, comprehensive counseling, regular monitoring, and strategies to improve adherence to recommended diabetes management practices.