Knowledge, attitudes and practices concerning diabetes self-management education among medical students: a cross-sectional study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20261029Keywords:
Medical students, Diabetes self-management education, Knowledge attitudes practices, Medical education, Diabetes careAbstract
Background: Diabetes self-management education (DSME) is crucial for optimal diabetes care, yet medical students' preparedness to provide such education remains poorly understood. This study has been done to assess knowledge, attitudes, and practices concerning diabetes self-management education among senior medical students and identify factors associated with competency levels.
Methods: This cross-sectional study enrolled 200 medical students (4th and 5th year) aged 22-25 years from Tertiary Care Hospital and Medical College of Maharashtra. A validated questionnaire assessed knowledge, attitudes, and practices regarding DSME across multiple domains. Scores were categorized as poor or good based on predetermined cutoffs. Associations between demographic factors and KAP scores were analyzed.
Results: Mean knowledge score was 6.51±1.39, attitude score was 3.17±0.83, and practice score was 4.03±0.89. Knowledge was classified as good in 74% of students, attitudes as good in 91%, and practices as good in 72%. Males comprised 55.5% of participants. Fourth-year students (51.5%) showed slightly better knowledge scores compared to fifth-year students (48.5%). Age distribution showed 37.5% were 23 years old. Significant associations were found between academic year and attitude scores, with fourth-year students demonstrating better attitudes toward DSME (p<0.05).
Conclusions: While most medical students demonstrated positive attitudes toward diabetes education, knowledge and practice domains showed concerning gaps. The study reveals a need for enhanced diabetes education curricula that bridge the gap between theoretical knowledge and practical application. Structured DSME training programs should be integrated into medical education to better prepare future physicians for comprehensive diabetes care.
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References
Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. 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;157:107843. DOI: https://doi.org/10.1016/j.diabres.2019.107843
International Diabetes Federation. IDF Diabetes Atlas. Brussels: International Diabetes Federation. 2021. Available at: https://diabetesatlas.org/. Accessed on 18 November 2025.
Powers MA, Bardsley J, Cypress M, Duker P, Funnell MM, Fischl AH, et al. Diabetes self-management education and support in type 2 diabetes: A joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Diabetes Care. 2015;38(7):1372-82. DOI: https://doi.org/10.2337/dc15-0730
American Diabetes Association Professional Practice Committee. Facilitating behavior change and well-being to improve health outcomes: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(1):S60-82. DOI: https://doi.org/10.2337/dc22-S005
Frank E, Breyan J, Elon L. Physician disclosure of healthy personal behaviors improves credibility and ability to motivate. Arch Fam Med. 2000;9(3):287-90. DOI: https://doi.org/10.1001/archfami.9.3.287
Oberg EB, Frank E. Physicians' health practices strongly influence patient health practices. J R Coll Physicians Edinb. 2009;39(4):290-1. DOI: https://doi.org/10.4997/JRCPE.2009.422
Kolasa KM, Rickett K. Barriers to providing nutrition counseling cited by physicians: A survey of primary care practitioners. Nutr Clin Pract. 2010;25(5):502-9. DOI: https://doi.org/10.1177/0884533610380057
Levinson W, Roter D, Mullooly JP, Dull VT, Frankel RM. Physician-patient communication: The relationship with malpractice claims among primary care physicians and surgeons. JAMA. 1997;277(7):553-9. DOI: https://doi.org/10.1001/jama.1997.03540310051034
Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, et al. National standards for diabetes self-management education. Diabetes Care. 2012;35(1):101-8. DOI: https://doi.org/10.2337/dc12-s101
Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179-211. DOI: https://doi.org/10.1016/0749-5978(91)90020-T
Berrios-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. 2017;152(8):784-91. DOI: https://doi.org/10.1001/jamasurg.2017.0904
Spencer EH, Frank E, Elon LK, Hertzberg VS, Serdula MK, Galuska DA. Predictors of nutrition counseling behaviors and attitudes in US medical students. Am J Clin Nutr. 2006;84(3):655-62. DOI: https://doi.org/10.1093/ajcn/84.3.655
Fitzgerald JT, Funnell MM, Hess GE, Barr PA, Anderson RM, Hiss RG, et al. The reliability and validity of a brief diabetes knowledge test. Diabetes Care. 1998;21(5):706-10. DOI: https://doi.org/10.2337/diacare.21.5.706
Garcia AA, Villagomez ET, Brown SA, Kouzekanani K, Hanis CL. The Starr County Diabetes Education Study: Development of the Spanish-language diabetes knowledge questionnaire. Diabetes Care. 2001;24(1):16-21. DOI: https://doi.org/10.2337/diacare.24.1.16
Chatterjee JS, Chakraborty C, Saha S, Ghosh A, Ghosh S, Dey D, et al. A study of knowledge-attitude-practice of diabetes among medical students in eastern India. J Family Med Prim Care. 2017;6(2):349-53.
Holt TA, Kumar S. Medical students' perspectives on learning and teaching about diabetes. Med Teach. 2010;32(6):e244-50.
Norris SL, Lau J, Smith SJ, Schmid CH, Engelgau MM. Self-management education for adults with type 2 diabetes: A meta-analysis of the effect on glycemic control. Diabetes Care. 2002;25(7):1159-71. DOI: https://doi.org/10.2337/diacare.25.7.1159
Eagly AH, Chaiken S. The Psychology of Attitudes. Fort Worth, TX: Harcourt Brace Jovanovich. 1993.
Beach MC, Keruly J, Cooper LA. Provider-patient communication among racial and ethnic minorities with diabetes: Impact of patient centered communication on adherence. J Gen Intern Med. 2006;21(7):693-5. DOI: https://doi.org/10.1111/j.1525-1497.2006.00399.x
Lewin SA, Skea ZC, Entwistle V, Zwarenstein M, Dick J. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database Syst Rev. 2001;(4):CD003267. DOI: https://doi.org/10.1002/14651858.CD003267
Roter D, Larson S. The Roter interaction analysis system (RIAS): Utility and flexibility for analysis of medical interactions. Patient Educ Couns. 2002;46(4):243-51. DOI: https://doi.org/10.1016/S0738-3991(02)00012-5
Wens J, Vermeire E, Royen PV, Sabbe B, Denekens J. GPs' perspectives of type 2 diabetes patients' adherence to treatment: A qualitative analysis of barriers and solutions. BMC Fam Pract. 2005;6:20. DOI: https://doi.org/10.1186/1471-2296-6-20
Nam S, Chesla C, Stotts NA, Kroon L, Janson SL. Barriers to diabetes management: Patient and provider factors. Diabetes Res Clin Pract. 2011;93(1):1-9. DOI: https://doi.org/10.1016/j.diabres.2011.02.002
Haidet P, Dains JE, Paterniti DA, Haidet P, Dains JE, Paterniti DA, et al. medical student attitudes toward the doctor-patient relationship. Med Educ. 2002;36(6):568-74. DOI: https://doi.org/10.1046/j.1365-2923.2002.01233.x
Burke SD, Sherr D, Lipman RD. Partnering with diabetes educators to improve patient outcomes. Diabetes Metab Syndr Obes. 2014;7:45-53. DOI: https://doi.org/10.2147/DMSO.S40036