Assessment of the knowledge of community health workers about type 1 diabetes mellitus: a cross-sectional study from rural Karnataka

Background: Type 1 diabetes mellitus (T1DM) is a chronic autoimmune condition primarily affecting children and young adults, requiring lifelong insulin management. Optimum management and early diagnosis are essential to prevent further health complications. In rural India, accredited social health activists (ASHAs), as frontline community health workers, play a key role in health education and early intervention. However, their knowledge regarding T1DM is less explored. Thus, this study aimed to assess the baseline knowledge of ASHA workers and community health workers (CHWs) about T1DM in rural and urban primary health centres of Bengaluru rural district, Karnataka, India. Methods: A cross-sectional study was conducted in Karnataka, over a time-period of 3 months in 2024, among 156 ASHA workers selected through systematic random sampling from primary health centres (PHCs) attached to the medical institution. A pretested, semi-structured questionnaire was used to assess knowledge on T1DM and its definition, symptoms, risk factors, complications, and management. Knowledge levels were categorized as good, adequate, or poor based on the number of correct responses. Results: According to the survey, only 14.1% of the participants had heard of type 1 diabetes, and only 11.5% had received training on the condition. 64.7% of participants were unable to distinguish between type 1 and type 2 diabetes, and the majority (64.1%) were not aware of its usual pediatric onset. There were many misconceptions, as 55.1% of individuals believed that consuming excessive sugar was the cause of T1DM. Just 25% of respondents correctly identified each significant symptom. 90.4% of the study participants fell under the poor knowledge category as they answered only 1-5 questions correctly. Conclusions: The study revealed a significant knowledge gap among CHWs and ASHA workers regarding T1DM. This underscores the urgent requirement to include focused T1DM education in ASHA educational modules. Improving ASHA knowledge can help children with T1DM in underserved rural settings by empowering early diagnosis, raising community awareness, and enabling timely management. This can minimise complications and improve outcomes.