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Self-care practices and barriers to compliance among patients with diabetes in a community in rural Bangladesh

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Abstract

Diabetes is an emerging health threat in Bangladesh. The study objectives were to evaluate self-management practices among a population with diabetes in rural Bangladesh and to identify barriers to complying with prescriptions for diet, physical activity and drug use. In this cross-sectional study, 220 patients with diabetes were recruited from logs of diabetes clinics in Mirzapur, Bangladesh. Participants were asked about self-care practices and health complications and comorbidities associated with diabetes. Participants were also asked about treatments costs, barriers to diabetes treatment and socio-demographic characteristics. Almost half of the participants (49 %) were taking oral hypoglycemic agents (OHA), and 47 % were taking a combination of OHA and insulin; however, 30 % of those using insulin were not confident in their ability to self-administer the medication. The majority of participants (86 %) had complications that they attributed to diabetes, including vision impairments, poor wound healing and dizziness. The median monthly cost of diabetes maintenance was 725 taka (~US$9), approximately 8 % of the median monthly income. Common barriers to treatment included the high cost of medication, access and proximity to services, and feeling unwell as a result of prescribed treatments. Although the vast majority of participants managed their diabetes using OHA and insulin, there were common barriers that prevented patients with diabetes from complying with doctor’s recommendations for diabetes management. Given the high incidence of self-reported diabetic complications among this population, addressing these barriers may improve self-care practices and overall quality of life among those with diabetes in rural areas in Bangladesh.

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Acknowledgments

This research study was funded by core donors which provide unrestricted support to icddr,b for its operations and research. Current donors providing unrestricted support include the Government of the People’s Republic of Bangladesh; the Department of Foreign Affairs, Trade and Development (DFATD), Canada; the Swedish International Development Cooperation Agency (Sida) and the Department for International Development (UK Aid). We gratefully acknowledge these donors for their support and commitment to icddr,b’s research efforts. We would like to extend our thanks to the participants for their invaluable participation in the study. The study was supported with funds provided by a Canadian Institutes of Health Research (CIHR) Vanier Canada Graduate Scholarship (LV), the CIHR Training Grant in Population Intervention for Chronic Disease Prevention: A Pan-Canadian Program (Grant No. 53893) (LV), a David Johnston International Experience Award (LV), a CIHR New Investigator Award (DH) and a Canadian Cancer Society Research Institute Junior Investigator Award (DH).

Authors’ contributions

The study was conceptualized by LV, ASGF, SKD and DH. Study design was developed equally by all authors. Data collection was conducted by LV, FF, FDF, SA and ASGF. Data analysis, interpretation and writing were primarily conducted by LV. All authors contributed to writing and editing this paper, and have read and approved the final manuscript.

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Authors and Affiliations

  1. School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada

    Lana Vanderlee & David Hammond

  2. Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh

    Shahnawaz Ahmed, Fahmida Dil Farzana, Sumon Kumar das, Tahmeed Ahmed & Abu Syed Golam Faruque

  3. Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan

    Farzana Ferdous

  4. School of Public Health, The University of Queensland, Brisbane, Australia

    Sumon Kumar das

Authors
  1. Lana Vanderlee
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  2. Shahnawaz Ahmed
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  3. Farzana Ferdous
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  4. Fahmida Dil Farzana
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  5. Sumon Kumar das
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  6. Tahmeed Ahmed
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  7. David Hammond
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  8. Abu Syed Golam Faruque
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Corresponding author

Correspondence to Abu Syed Golam Faruque.

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The authors declare that they have no competing interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Vanderlee, L., Ahmed, S., Ferdous, F. et al. Self-care practices and barriers to compliance among patients with diabetes in a community in rural Bangladesh. Int J Diabetes Dev Ctries 36, 320–326 (2016). https://doi.org/10.1007/s13410-015-0460-7

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  • DOI: https://doi.org/10.1007/s13410-015-0460-7

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