Document Type : Original Article
Authors
- . Ahmed O. Almobarak
- . Safaa Badi 1
- . Wadie M. Elmadhoun 2
- . Samar B. Siddiq 3
- . Hanan Tahir 4
- . Mugtaba Osman 5
- . Sufian K. Noor 6
- . Mohamed Suliman 7
- . Mohamed H. Ahmed 8
1 Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Sudan
2 Faculty of Medicine, Sudan International University, Khartoum, Sudan
3 Department of Research and Training, Alsharg Ahlia College, Kassala, Sudan
4 Dean of graduate college, University of Medical Sciences and Technology, Sudan
5 Armed Forces Centre for Psychiatric Care, Taif, Saudi Arabia
6 Department of Medicine, Faculty of Medicine, Nile Valley University, Atbara, Sudan
7 Imperial College London Diabetes Centre, Al Ain, United Arab Emirates
8 Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eagelstone, Milton Keynes, Buckinghamshire, UK
Abstract
BACKGROUND: Inadequate lifestyle practices among individuals with diabetes may influence
the progression of diabetes and its complications. The aim of this study was to assess the lifestyle
practices among individuals with diabetes in Sudan.
METHODOLOGY: This was a descriptive, cross‑sectional, health facility‑based study conducted in
3 diabetes centers treating individuals with diabetes. The data were collected using a standardized
pretested metabolic questionnaire about lifestyle and were analyzed by performing descriptive and
inferential statistics through SPSS program version 23.
RESULTS: A total of 528 patients with diabetes answered the questionnaire. There were 52.1% of
female participants and 72.9% of urban residents. 23.9% were obese, regular exercise was reported
by 27.7%, and no exercise by 17%. There was a statistically significant association between
lifestyle practices and gender (P < 0.001), age (P < 0.001), educational level (P = 0.002), marital
status (P < 0.001), duration of diabetes (P < 0.001), hypertension (P < 0.001), high‑density
lipoprotein (P < 0.001), low‑density lipoprotein (P < 0.001), and HbA1c level (P < 0.001). Logistic
regression analysis showed male gender and education were significantly associated with lifestyle
changes. Men were more likely to engage in favorable lifestyle practices than women (P < 0.001),
while those with no formal education were less likely to engage in healthy lifestyle (P < 0.001).
CONCLUSIONS: Health authorities in Sudan will need to put more efforts into education for promoting
self‑awareness and good lifestyle practices in the population with diabetes.
Keywords
Unwin N, Colagiuri S, Guariguata L, Motala AA, Ogurtsova K,
Shaw JE, Bright D, Williams R; IDF Diabetes Atlas Committee
Global and regional diabetes prevalence estimates for 2019 and
projections for 2030 and 2045: Results from the International
Diabetes Federation Diabetes Atlas, 9th edition.Diabetes Res Clin
Pract. 2019 Nov; 157:107843. doi: 10.1016/j.diabres. 2019.107843.
Epub 2019 Sep 10.
2. ElmadhounWM, Noor SK, Ibrahim AA, Bushara SO, Ahmed MH.
Prevalence of diabetes mellitus and its risk factors in urban
communities of North Sudan: Population‑based study. J Diabetes
2016;8:839‑46.
3. Padma K, Bele SD, Bodhare TN, Valsangkar S, Pradesh A.
Evaluation of knowledge and self‑care practices in diabetic
patients and their role. Natl Med J India 2012;3:3‑6.
4. Awadalla H, Noor SK, Elmadhoun WM, Almobarak AO,
Elmak NE, Abdelaziz SI, et al. Diabetes complications in
Sudanese individuals with type 2 diabetes: Overlooked
problems in sub‑Saharan Africa? Diabetes Metab Syndr
2017;11 Suppl 2:S1047‑51.
5. Beran D, Yudkin JS. Diabetes care in sub‑Saharan Africa. Lancet
2006;368:1689‑95.
6. Shrivastava PS, Shrivastava SR, Ramasamy J. An Epidemiological Study to Assess the Knowledge and Self Care Practices among
Type 2 Diabetes Mellitus Patients Residing in Rural Areas of Tamil
Nadu. Biol Med 2015;S3:002. doi: 10.4172/0974-8369.S3-002.
7. Dinesh PV, Kulkarni AG, Gangadhar NK. Knowledge and
self‑care practices regarding diabetes among patients with
Type 2 diabetes in Rural Sullia, Karnataka: A community‑based,
cross‑sectional study. J Family Med Prim Care 2016;5:847‑52.
8. Badi S, Abdalla A, Altayeb L, Noma M, Ahmed MH. Adherence
to antidiabetic medications among Sudanese individuals with
type 2 diabetes mellitus : A cross‑sectional survey. Journal of
Patient Experience 2020;7:163-8. [doi: 10.1177/2374373519831073].
9. Okonta HI, Ikombele JB, Ogunbanjo GA, Health P. Knowledge,
attitude and practice regarding lifestyle modification in type 2
diabetic patients. Afr J Prm Heal Care Fam Med 2014;6:2‑7.
10. Karimi F, Abedini S, Mohseni S, Abbas B, Abbas B, Sciences M,
et al. Self‑carebehavior of type 2diabetesmellituspatients in Bandar
Abbas in 2015. Electron Phys 2017;9:5863‑7.
11. Tabong PT, Bawontuo V, Dumah DN, Kyilleh JM, Yempabe T.
Premorbid risk perception, lifestyle, adherence and coping
strategies of people with diabetes mellitus: A phenomenological
study in the Brong Ahafo Region of Ghana. PLoS One
2018;13:e0198915.
12. Gato WE, Acquah S, Apenteng BA, Opoku ST, Boakye BK.
Diabetes in the Cape Coast metropolis of Ghana: An assessment of
risk factors, nutritional practices and lifestyle changes. Int Health
2017;9:310‑6.
13. Assah FK, Ekelund U, Brage S, Mbanya JC, Wareham NJ.
Urbanization, physical activity, and metabolic health in
sub‑Saharan Africa. Diabetes Care 2011;34:491‑6.
14. Fezeu LK, Assah FK, Balkau B, Mbanya DS, Kengne AP, Awah PK,
et al. Ten‑year changes in central obesity and BMI in rural and
urban Cameroon. Obesity (Silver Spring) 2008;16:1144‑7.
15. Mbanya JC, Motala AA, Sobngwi E, Assah FK, Enoru ST. Diabetes
in sub‑Saharan Africa. Lancet 2010;375:2254‑66.
16. Khalil S, Almobarak AO, Awadalla H, Elmadhoun WM, Noor SK,
Sulaiman AA, et al. Low levels of physical activity in Sudanese
individuals with some features of metabolic syndrome: Population
based study. Diabetes Metab Syndr 2017;11 Suppl 2:S551‑4.
17. Ahmed MH, Ali YA, Awadalla H, Elmadhoun WM, Noor SK,
Almobarak AO. Prevalence and trends of obesity among adult
Sudanese individuals: Population based study. Diabetes Metab
Syndr 2017;11 Suppl 2:S963‑7.
18. Awadalla H, Almobarak AO, Ahmed MH. Prevalence of
smoking in Sudanese individuals with diabetes and associated
complications: Population‑based study. Diabetes Metab Syndr
2018;12:749‑51.
19. Zhong X, Tanasugarn C, Fisher EB, Krudsood S, Nityasuddhi D.
Awareness and practices of self‑management and influence
factors among individuals with type 2 diabetes in urban
community settings in Anhui Province, China. Southeast Asian
J Trop Med Public Health 2011;42:185‑6, 184, 187‑96.
20. Mehta NV, Trivedi M, Maldonado LE, Saxena D, Humphries DL.
Diabetes knowledge and self‑efficacy among rural women in
Gujarat, India. Rural Remote Health 2016;16:3629. Available from:
http://www.rrh.org.au/journal/article/3629. [Last accessed on
2020 Jan 02].
21. Ku GM, Kegels G. Knowledge, attitudes and perceptions of people
with type 2 diabetes as related to self‑management practices:
Results of a cross‑sectional study conducted in Luzon, Philippines.
Chronic Illn 2015;11:93‑107.
22. American Diabetes Association. 5. Facilitating behaviour change
and well‑being to improve health outcomes” Standards of Medical
Care in Diabetes‑2020. Diabetes Care 2020;43 Suppl 1:S48‑65.
23. 2018 Physical Activity Guidelines Advisory Committee Scientific
Report. Washington, DC, U.S. Department of Health and Human
Services; 2018.
24. Bazargan‑Hejazi S, Arroyo J, Hisa S, Brojeni N, Pan D. A racial
comparison of differences between self‑reported and objectively
measured physical activity among US adults with diabetes. Ethn
Dis 2017;27:403‑10.
25. Tewahido D, Berhane Y. Self‑care practices among diabetes
patients in Addis Ababa: A qualitative study. PLoS One
2017;12:e0169062.
26. Adil MM, Alam AY, Jaffery T. Knowledge of type 2 diabetic
patients about their illness: Pilot project. J Pak Med Assoc
2005;55:221‑4.
27. Saleh F, Mumu SJ, Ara F, Begum HA, Ali L. Knowledge and
self‑care practices regarding diabetes among newly diagnosed
type 2 diabetics in Bangladesh: A cross‑sectional study. BMC
Public Health 2012;12:1112.
28. Yang S, Hsue C, Lou Q. Does patient empowerment predict
self‑care behavior and glycosylated hemoglobin in Chinese
patients with type 2 diabetes? Diabetes Technol Ther 2015;17:343‑8.
29. Al‑Khawaldeh OA, Al‑Hassan MA, Froelicher ES. Self‑efficacy,
self‑management, and glycemic control in adults with type 2
diabetes mellitus. J Diabetes Complications 2012;26:10‑6.
30. Yuan X, Wang F, Fish AF, Xue C, Chen T, Liu C, et al. Effect of
case management on glycemic control and behavioral outcomes
for Chinese people with type 2 diabetes: A 2‑year study. Patient
Educ Couns 2016;99:1382‑8.
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