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A cross-sectional study of diabetic knowledge in West Bengal, India: an analysis based on access to health care

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript


In India, the rising prevalence of diabetes is a major public health challenge. The purpose of this study was to measure the level of diabetes knowledge in West Bengal, India, and to assess for a gradient in knowledge among those with varying levels of access to health care in both urban and rural environments. A validated questionnaire on diabetes knowledge was developed and administered in two health care settings in West Bengal: community clinics in low-income rural and urban communities representing the low-access group and a multi-specialty outpatient department (OPD) in Kolkata, India, representing the high-access group. Of the respondents in the low-access community clinic group, (n = 198), less than half knew what diabetes was (42.9 %) compared to 89.9 % in the high-access OPD group (n = 275) (p < 0.001). Those in the urban community clinics knew what diabetes was more often than those in the rural community clinics (49.5 vs. 36.1 %, p = 0.058). Additional questions testing basic knowledge of diabetes, risk factors, and disease complications showed a similar trend that people in the low-access setting had limited knowledge regarding diabetes and significantly less knowledge when compared to those in the high-access setting. Multivariate regression analysis demonstrated that clinic setting (high-access vs. low-access, p < 0.0001) and formal education (p = 0.001) were independent predictors of diabetic knowledge, while age and sex were not. Diabetes knowledge among respondents with low access to health care in urban and rural community clinics was significantly poorer than those with higher access to health care in an urban hospital outpatient department. To help bridge this gap, diabetes education and prevention campaigns should be targeted towards populations with low access to health care in West Bengal.

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Authors’ contribution

PL designed the study, conducted the necessary literature review, gathered and analyzed data, and prepared, edited, and reviewed the manuscript. PL is the “guarantor” of the article, having seen the process through from inception to submission. KNGL helped to design the study and methodology, gathered and analyzed data, and thoroughly edited and reviewed the manuscript providing detailed corrections throughout the manuscript. She helped see the process through from inception to submission. AK helped to design the study and helped oversee the delivery of the questionnaires within each setting. He helped to gather data. He reviewed the manuscript giving valuable feedback. LHG played a significant role in data analysis. She helped to prepare, edit, and review the manuscript. She acted as a mentor in the analysis and manuscript writing process. AS provided mentorship on study design and delivery. He helped to edit and review the manuscript prior to submission. As an administrator at Mercy Hospital, JB helped to oversee the completion of this study. He reviewed the study design and delivery and gave valuable feedback on the feasibility of the study. He allowed for staff to be available to help the team collect and analyze data. He reviewed the manuscript prior to submission.

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Correspondence to Paul Long.

Appendix 1: Questionnaire

Appendix 1: Questionnaire

1. What is your age? ____ 2. Gender: __Male __Female

3. What district of Kolkata do you live in?____________________ __I do not live in Kolkata

4. When you are sick, are you able to purchase the medications you need?

__Always __Sometimes __Never

5. When you are sick, are you able to see a doctor?__Always __Sometimes __Never

6. How close is the nearest healthcare clinic/ hospital to where you live? ____km (approximately)

7. What is the highest level of education you have obtained?14

__Class 1 to 6 (Primary) __Class 7 to 10 (lower secondary) __Class 11 to 12 (upper secondary) __Graduate Studies/University __I did not attend school

8. What is your current profession? __________________________ __Currently unemployed

9. Do you know what diabetes is?13 __Yes __No

If yes, how did you learn about the disease?

__Medical Personnel __School __TV __Street Advertisement __Family __Other:_________

10. When a person has diabetes, the sugar level in their blood is…14

__Low __Normal __High __Unsure

11. Have you been tested for diabetes before? __Yes __No

12. Do you have diabetes? __Yes __No

If yes, how often can you afford the diabetic medications & labs prescribed by the doctor?

__Always __Most of the time __Sometimes __Never

13. In general, do you think more people are getting diabetes?13 __Yes __No

14. Of the factors listed below, which can contribute to diabetes?13 (More than one answer is possible)

__Obesity __Lack of physical exercise __Family History of Diabetes __Diet __Smoking __Other:________________ __None of the above

15. If a person with diabetes is not treated, it can cause…

problems with the kidneys? __True __False __Unsure

problems with the eyes? __True __False __Unsure

problems with the heart? __True __False __Unsure

16. Are you fearful of getting diabetes more than you are of infectious diseases like Malaria or Tuberculosis?

__Yes __No

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Long, P., Long, K.N.G., Kedia, A. et al. A cross-sectional study of diabetic knowledge in West Bengal, India: an analysis based on access to health care. Int J Diabetes Dev Ctries 35, 614–619 (2015).

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