Integrative Obesity and Diabetes Research Article ISSN: 2056-8827 Knowledge and practice on prevention of hypoglycemia among diabetic patients in South Gondar, Northwest Ethiopia: Institution based cross-sectional study Girma Nega Gezie1*, Getahun Asres Alemie2 and Tadesse Awoke Ayele2 1Department of Applied Human nutrition, Faculty of chemical and Food Engineering, Bahir Dar Institute of technology, Bahir Dar University, Bahirdar, Ethiopia 2Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Ethiopia Abstract Hypoglycemia is an emergency life threatening condition for diabetic patients who take their medication. Proper hypoglycemia prevention relies on knowledge and self care practice. The objective of this study was to assess knowledge and practice of hypoglycemia prevention and associated factors among diabetic patients in South Gondar, Northwest Ethiopia, 2012. Institution based cross-sectional study was conducted from June-October, 2012 at governmental health institutions in South Gondar. Four hundred sixteen diabetic patients were involved in the study. A pre-tested, structured and interview administered questionnaire was used to collect data and analysis was done using SPSS version 16. Logistic regression was fitted and 95% CI and odds ratio were presented to identify associated factors and to assess the strength of the association. For all statistical significance, the cut- off value was P ≤ 0.05. From the total study participants 105(25.5%) were found to have good knowledge about hypoglycemia prevention. Eighty nine (21.4%) had good practice in hypoglycemia prevention. Educational status and being a member of diabetic association were found to be positively associated with knowledge and practice. Respondents who attained primary education (AOR=2.14, 95%CI: 1.19, 3.84), secondary education (AOR 3.02, 95%CI: 1.53, 5.98), college and above (AOR=2.35, 95%CI: 1.08, 5.13) were found to be more likely to have good knowledge compared with respondents who did not have formal education. Those who were members of Ethiopian diabetic association were about four times more likely to be knowledgeable (AOR=3.91, 95%CI: 2.26, 6.77) and six times more likely to practice hypoglycemia prevention (AOR=6.08, 95%CI: 3.34, 11.05). Knowledge and practice on hypoglycemia prevention are poor. Members of Ethiopian Diabetic Association are very low in this study. Thus the association should design and provide information tailored to patient education level. Introduction require hospitalization [9]. Majority of hospitalized diabetic patients and their relatives had inadequate understanding of diabetes and its Hypoglycemia is an acute medical situation that occurs when blood consequences or complications, and they had lack of confidence in own sugar falls below the recommended level. Individuals taking diabetic ability to manage diabetes effectively [10]. Patients knowledge about medications are at increased risk of experiencing low blood sugar [1,2]. various aspect of the disease together with the understanding of the An estimated 2-4% of people with type 1 diabetes mellitus die from aims and objectives of various treatment outcomes have tremendous hypoglycemia each year. It might explain the “dead in bed syndrome” impact on patients self care practice, skills necessary to control of self unexplained death of a person with type 1 diabetes occurring during blood glucose (SMBG) [11,12]. night time [3]. The symptoms of low blood sugar vary from person to person, and can change over time. During the early stages a person Despite the abundance of studies on self-care practice and with low blood sugar level may have sweating, trembling, feeling knowledge about hypoglycemia, there are no available studies done hungry and feeling anxious. The symptoms can become more severe, on knowledge and practice regarding hypoglycemia prevention and can include difficulty of walking, weakness, visual disturbance; among diabetic patients. But this study tried to identify determinants bizarre behavior, personality changes, confusion and unconsciousness of knowledge and practice regarding hypoglycemia among diabetic or seizure may be observed [4] . patients. Knowledge about these symptoms is an important step to self care Materials and methods practice, because informed people are more likely to have better self care practice [5]. It is important for patients with diabetes especially, Institution based cross-sectional study was conducted on public those receiving insulin to learn about hypoglycemia, and to carry some form of simple sugar with them at all times. Self care practice in diabetes management also includes dietary regulation, medication, physical Correspondence to: Girma Nega Gezie, Department of Applied Human activity and self monitoring of blood glucose (SMBG) [6]. Additionally, nutrition, Faculty of chemical and Food Engineering, Bahir Dar Institute of these patients should always wear an identification bracelet or tag [7,8]. technology, Bahir Dar University, Bahirdar, Ethiopia, Tel: +251-582-205925; E-mail: [email protected] Several retrospective studies indicate that risk factors for Key words: hypoglycemia, Ethiopia, diabetes hypoglycemia in 1,418 type2 diabetes mellitus are of drug- induced and fasting as the major risk factors for sever hypoglycemia and Received: April 15, 2015; Accepted: May 23, 2015; Published: May 25, 2015 Integr Obesity Diabetes, 2015 doi: 10.15761/IOD.1000113 Volume 1(3): 56-60 Gezie GN (2015) Knowledge and practice on prevention of hypoglycemia among diabetic patients in South Gondar, Northwest Ethiopia: Institution based cross- sectional study health facilities which provide chronic illness follow-up for diabetic Table 1. Socio demographic Characteristic of participants, South Gondar, Northwest- patients from June to October 2012 in South Gondar. There is only one Ethiopia, October, 2012. zonal hospital and 90 health centers giving medical service for a total of 2,238,737 people in the zone. Diabetes patients aged 18 years and above Variable Frequency (n=416) Percent (%) Age who were attending government health institutions in south Gondar 18-34 208 50 zone were included in the study. Study subjects were recruited with proportional allocation from 1 Hospital and 9 Health centers. Then 35-64 196 47.1 final sample was taken by simple random sampling technique from ≥65 12 2.9 their registration book. Total 416 100 Sex A structured questionnaire was developed and prepared originally Male 259 62.3 in English and translated to Amharic and then translated to English Female 157 37.7 to check consistency. For administering the interview, 10 diploma Total 416 100 nurses and 4 trained BSC Nurses were recruited for data collection and Residence supervision respectively. Training was given for data collectors and Rural 220 52.9 supervisors for two days about the objective, relevance, confidentiality, Urban 196 47.1 respondent’s right, informed consent and techniques of interview for Total 416 100 the study. Religion Orthodox 367 88.2 Data analysis was made by using SPSS version 16 statistical package. Muslim 49 11.8 For all statistical significance tests, the cut- off value was p-value ≤ Total 416 100 0.05. Multivariate logistic regression was used to check the effect of Ethnicity each explanatory variable on the dependent variable. Odds ratio and Amhara 412 99.0 95% confidence interval were computed to assess the strength of the Tigrie 4 1.0 association and statistical significance. Total 416 100 Marital status Knowledge on hypoglycemia is defined as good glycemic control Single 114 27.4 when respondents answered equal to or above the mean score of Married 221 53.1 knowledge questions. Practice on hypoglycemia is defined as good self Divorced 81 19.5 care practice when respondents answered equal to or above the mean Total 416 100 score of practice questions. Educational status Regular exercise means a 30 minute fast walk or riding bicycle No formal education 154 37.0 Primary 145 34.9 daily. Member of Ethiopian diabetic association is diabetic patient who are voluntary to be member of the association and governed on the rule Secondary 69 16.6 College and above 48 11.5 and the regulation of the association. Total 416 100 Ethical clearance was obtained from University of Gondar and Occupation permission letter was taken from Amhara Regional Health Bureau and Unemployed 144 34.6 South Gondar zone health department. Government 99 23.8 Private 173 41.6 Results Total 416 100 Socio demographic characteristics of participants Economical status ≤ 400 Eth birr 117 28.1 A total of 416 diabetes mellitus patients were included in the study 401-700 106 25.5 with response rate of 98.6%. The mean age of the respondents was 39.1 701-999 42 10.1 with S.D of ± 1.4 years. One hundred ninety six (47.1%) of them were ≥1000 151 36.3 urban residents. One hundred fifty four (37%) participants did not have Total 416 100 formal education; 307 (88.2%) respondents were Orthodox Christian Membership of diabetic in religion. One hundred forty four (34.6%) of the respondents were association No 346 83.2 unemployed, 201 (53.1%) of respondents were married. From the Yes 70 16.8 total participants only 70 (16.8%) were found to be members of the Total 416 100 Ethiopian diabetic association (Table1). Knowledge regarding hypoglycemia Practice regarding hypoglycemia From all knowledge questions, 105 (25.5%) respondents had good knowledge in hypoglycemia prevention; however in specific question From the total respondents eighty