Abstract

The main objective of this study was to assess knowledge on diabetes and its associated health risks among individuals 18 years and above in the Ndongo community. The study used the descriptive cross sectional design where data was collected from 150 participants in the Ndongo community.

A structured questionnaire was used as the main instrument for data collection. Data collected was analysed and presented on frequency tables and descriptive charts with the help of Microsoft excel 2010. The study lasted for a period of 3 months that is from June to august 2021.

This study showed that 5.3% of the participants were diabetic, 52.7% were not diabetic and 42.0% did not know their diabetic status (fig 5). Results also showed that 56.0%participants had a family member living with diabetes while 44.0% did not have a family member living with diabetes (fig6).

From the study, 76.0% of the participants stated that diabetes could be cured, 76.0% of the participants agreed that eating too much sugar and other sweet things is a cause of diabetes while 24% did not know whether or not eating too much sugar or sweet things could cause diabetes. On the complications, 84.0% correctly identified the damage (leading to blindness) while 73.3% correctly identified heart problems.

However, 50.7% did not know that hearing impairments is a complication of diabetes. Concerning the signs and symptoms of diabetes,68.7%, 75.3% and 76.7% could identify increased thirst, frequent urination, frequent hunger, and unexplained weight loss respectively.(.table 1).59.1% of the respondents had adequate knowledge while 40.9% have inadequate knowledge (fig 7).

To prevent diabetes, an individual should consume a healthy diet, do regular exercise control weight, and quit smoking as postulated by 81.3% of the respondents while 18.7% said diabetes cannot be prevented (fig 9). Thus from the study, we could see that the population of Ndongo community know of the associated risk factors of diabetes mellitus, which is a great step towards prevention of diabetes.

CHAPTER ONE

BACKGROUND OF THE STUDY

1.0 Introduction;

This chapter specifically gives an introduction to the study, background of the study, problem statement, research objectives, research questions, and the scope of the study significance of the study, operational and conceptual definition of terms.

1.1BACKGROUND OF STUDY

Diabetes mellitus is a group of metabolic diseases involving carbohydrate, lipid, and protein metabolism. It is characterized by persistent hyperglycaemia, as a result of defects in insulin secretion, insulin action or a combination of both, defective secretion and incorrect action.Diabetes mellitus has been known since antiquity (Karamanouet al., 2016)

There are two main types of diabetes mellitus: Type 1 (insulin-dependent), and type 2 (non-insulin-dependent). Type 1 diabetes results by the autoimmune destruction of the β-cells of the pancreatic islets and type 2 diabetes is caused from impaired insulin secretion and resistance to the action of insulin (Kahn et al., 2015). Epidemiological data reveal that 9% of adults, 18 years of age and older, has diabetes mellitus while it was estimated that in 2012, 1.5 million people died due to the disease (CDC, 2012).

According to the World Health Organization, diabetes will be the 7th leading cause of death in 2030(WHO, 2012). Clinical features similar to diabetes mellitus were described 3000 years ago by the ancient Egyptians. The term “diabetes” was first coined by Araetus of Cappadocia (81130AD) Later, the word mellitus (honey sweet) was added by Thomas Willis (Britain) in 1675 after rediscovering the sweetness of urine and blood of patients (first noticed by the ancient Indians). It was only in 1776 that Dobson (a British scientist) firstly confirmed the presence of excess sugar in urine and blood as a cause of their sweetness. In modern time, the history of diabetes coincided with the emergence of experimental medicine (Iskeandar, 2012)

Origins, Symptoms and Signs of a disease characterized by the ‘too great emptying of urine finds its place in antiquity through Egyptian manuscripts dating back to 1500 B.C (McCracken and Hoel, 1997).Indian physicians called it madhumeha (‘honey urine’) because it attracted ants. (Ritu, 2013). The ancient Indian physician, Sushruta and the surgeon Charaka (400-500 A.D.) were able to identify the two types, later to be named Type I and Type II diabetes. To Aretaeus the Cappadocian, who coined the word diabetes (Greek, ‘siphon’) and dramatically stated “No essential part of the drink is absorbed by the body while great masses of the flesh are liquefied into urine”.

Avicenna (980–1037 A.D) the great Persian physician, in the Canon of Medicine not only referred to abnormal appetite and observed diabetic gangrene but also concocted a mixture of seeds (lupine, fenugreek, zedoary) as a panacea. The term mellitus (Latin, ‘sweet like honey’) was coined by the British Surgeon-General, John Rollo in 1798, to distinguish this diabetes from the other diabetes (Insipidus) in which the urine was tasteless (Lakhtakia, 2013

Diabetes has been around for centuries. In fact, cases of diabetes can be traced as far back as the ancient Egyptians. In the 1800s, dogs helped scientist study and determine how the pancreas and lack of the hormone insulin revealed signs of diabetes. In the 1930s up through the 1970s, society commonly referred to individuals with diabetes as having “sugar,” but the correct medical term for diabetes is ‘diabetes mellitus’. Today, healthcare teams most commonly refer to it as ‘diabetes’. The words “diabetes” and “mellitus” have two very separate meanings. They are, however, linked together and have a meaningful connection.

Mellitus means, “pleasant tasting, like honey. Ancient Chinese and Japanese physicians noticed dogs were particularly drawn to some people’s urine. When the urine was examined they found the urine had a sweet taste. What made the urine sweet were high levels of glucose, or sugar. That is how this discovery of sweet urine became part of the name, diabetes mellitus (Mandall, 2019) Diabetes is an ancient Greek word meaning “passing though; a large discharge of urine.” The meaning is associated with frequent urination, which is a symptom of diabetes. Both frequent urination and excess, sweet glucoses levels expelled in our urine can be signs of diabetes. (Daniels, 2010).

The term diabetes was probably coined by Apollonius of Memphis around 250 BC. Diabetes is first recorded in English, in the form diabetes, in a medical text written around 1425. It was in 1675 that Thomas Willis added the word “mellitus” to the word diabetes. This was because of the sweet taste of the urine. This sweet taste had been noticed in urine by the ancient Greeks, Chinese, Egyptians, Indians, and Persians as is evident fromtheirliterature (Anaya, 2016).

In the world, Diabetes mellitus affects millions of people worldwide and it related complications continue to be of great concern. The condition is rapidly spreading in developing countries and particularly affecting poor population in sub- Saharan Africa (International Diabetes Federation, 2015).

The prevalence of diabetes among blacks has increased during the past 30 years and blacks are .7 times as likely to develop diabetes as White. Among blacks age 20 and older, about 2.3 million have diabetes. Black with diabetes are more likely than non- Hispanic White to develop diabetes and to experience greater disability from diabetes related complication such as amputation, adult blindness, kidney failure and increase risk of heart disease and stroke. Death rate for blacks with diabetes are 27% higher than for white (Sobngwi, 2011)

In the U.S There are 30.3 million people with diabetes (9.4% of the US population) including 23.1 million people who are diagnosed and 7.2 million people (23.8%) undiagnosed. The numbers for pre diabetes indicate that 84.1 million adults (33.9% of the adult U.S. population) have pre diabetes, including 23.1 million adults aged 65 years or older (the age group with highest rate). The estimated percentage of individuals with type 1 diabetes remains at 5% among those with diabetes. The statistics are also provided by age, gender, ethnicity, and for each state/territory so you can search for these specifics. (C.D.C, 2017).

In Cameroon the prevalence of diabetes in adults in urban areas is currently estimated at 6 – 8%, with as much as 80% of people living with diabetes who are currently undiagnosed in the population. Further, according to data from Cameroon in 2002, only about a quarter of people with known diabetes actually had adequate control of their blood glucose levels.

The burden of diabetes in Cameroon is not only high but is also rising data in Cameroonian adults based on three cross-sectional surveys over a 10-year period (1994–2004) showed an almost 10-fold increase in diabetes prevalence. (World diabetes foundation, 2016). Presently, Cameroon’s centre for diabetes and hypertension consults an average of 210 diabetic and hypertensive patients daily. Going by official statistics, about 6% of the population in Cameroon has the disease while over 6,500 diabetic related deaths were recorded in 2013.

Theoretically, theories such as self-deficit theory, and many more have been postulated by theorist to help in the management of diabetes and its associated health risks.

Conceptually According to Cypress (2015), an individual with diabetes the body either does not make enough insulin or cannot use its own insulin as well as it should. This causes sugar to build up in blood this explains why many people refer to diabetes as “sugar”. Diabetes usually present with signs and symptoms like frequent urination, excessive thirst, unexplained weight loss, extreme hunger, sudden vision change. Diabetes is the seventh leading cause of death.

Diabetes mellitus is a heterogeneous metabolic disorder characterized by the presence of hyperglycaemia due to impairment of insulin secretion, defective insulin action or both. The chronic hyperglycaemia of diabetes is associated with relatively specific long-term microvascular complications affecting the eyes, kidneys and nerves, as well as an increased risk for cardiovascular disease (CVD).

The diagnostic criteria for diabetes are based on thresholds of glycaemia that are associated with microvascular disease, especially retinopathy. (American diabetes Association, 2012).Lifestyle characteristics conferring risks for diabetes are; Diets poor in fibre, phytochemicals or plant food in general. (Jannaschet al.2013).

Regular consumption of sugar-sweetened beverages (relative risk increase by 20–30% compared to non-consumption (Lofvenbong et al., 2016). Contextually, The burden of diabetes in Cameroon is not only high but is also rising Data in Cameroonian adults based on three cross-sectional surveys over a 10-year period (1994–2004) showed an almost 10-fold increase in diabetes prevalence. (World diabetes foundation, 2016).

Presently, Cameroon’s centre for diabetes and hypertension consults an average of 210 diabetic and hypertensive patients daily. Going by official statistics, about 6% of the population in Cameroon has the disease while over 6,500 diabetic related deaths were recorded in (2013).

Edward et al. (2010), conducted a study in Cameroon titled knowledge, attitude and behaviour relating to diabetes and it main risk factors among urban resident in Cameroon. He reported that many participants during his studies lack awareness of diabetes and knowledge of its causes, clinical course, and complications.  However, people’s knowledge and attitude about diabetes mellitus have not been efficiently investigated in the Ndongo community.

1.2 Problem Statement

Diabetes is a major health problem and is a non- modifiable risk factor to stroke.it is also linked to hypertension. The worldwide increase in type two diabetes is becoming a major health problem in many communities.

The lack of many individual’s knowledge about how to live a healthy lifestyle to reduce the chances of having diabetes put many people at risk of developing diabetes hence, because of the lack of knowledge of many individuals and communities about what diabetes is all about makes many people to stand a greater risk of developing diabetes (especially type two diabetes) that has a lot to do with lifestyle modification which many individuals do not practice due to lack of knowledge.

Edward et al (2011) carried out a research titled knowledge, attitude and behaviour relating to diabetes and it main risk factors among urban resident in Cameroon. He reported that many participants during his studies lack awareness of diabetes and knowledge of its causes, clinical course, and complications. Many participants believed diabetes was caused by excessive sugar consumption rather than excessive energy in take, obesity or physical inactivity.

1.3 Objectives

1.3.1General objective. To assess knowledge on diabetes and its associated health risks among individuals 18 years and above in the Ndongo community.

1.3.2 Specific Objective

1. To assess individual’s knowledge on diabetes
2. To identify the associated risk factors to diabetes
3. To identify the dietary and lifestyle modifications in the prevention of diabetes.

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