The Indian Practitioner

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Study of Knowledge, Attitudes, Practices, and Perceptions of Primary Care Physicians in India towards Dietary Intervention in Management of Patients with Type 2 Diabetes Mellitus


Affiliations
1 Scientific & Medical Affairs Department, Abbott Nutrition International, India
     

   Subscribe/Renew Journal


Background: Family physicians have a primary role in detecting, diagnosing, and managing diseases especially in a country burdened with Type 2 Diabetes mellitus (T2DM) cases. Unfortunately, the data on their knowledge about nutrition; one of the cornerstones for T2DM management, is missing from India.

Aims: We aimed to assess the knowledge (K), attitude (A), practices (P), and perceptions (Pr) (KAPP) of Primary Care Physicians (PCPs) in India on nutrition management in patients with T2DM.

Method: A self-administered 7 questions-based survey was conducted amongst PCPs to gather from the period of December 2018- January 2019.

Findings: A total of 496 PCPs from metros (47%) and non-metro (57%) cities shared their responses. More than 90% (n=488) of the PCPs recommend dietary changes for patients on the diagnosis of T2DM with similar trends across regions. 402 PCPs (81%) recommended ≥2 dietary modifications which include; avoidance of sugars (83%), avoidance of foods with high carbohydrates (81%), and increase protein intake (58%), being the common ones. About 93% (n=463) PCPs actively discussed dietary recommendations even during follow-up visits. In terms of knowledge, Glycemic Index (GI)/Glycemic Load (GL), n=429; was the most familiar nutrition-related term known by the PCPs followed by soluble fibre and Glucagon Like Peptide-1 (GLP-1). Products promoted as Diabetes Specific Nutrition (DSN) and multivitamins came as the most preferred nutritional supplements with almost 70% and 47% PCPs recommendations, respectively. While majority of the PCPs (>50%) reported giddiness (a symptom of hypoglycaemia) as a complaint in <10% of their patients on oral anti-diabetic drugs, almost 90% PCPs felt DSN could help manage such cases if occurred.

Conclusion: PCPs in India do believe strongly in recommending dietary modifications and are keen to implement lifestyle interventions for patients with T2DM, however, they face challenges in doing so. The observed inclination of PCPs towards nutrition calls for further continuous and evidence-based awareness programs on nutrition to empower them on the way of better outcomes among patients with T2DM.


Keywords

Diabetes mellitus, Diabetes Management, Medical Nutrition Therapy, Lifestyle Intervention, Diabetes NutritionDiabetes mellitus, Diabetes Management, Medical Nutrition Therapy, Lifestyle Intervention, Diabetes Nutrition.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Pandey S and V Sharma. Indian J Ophthalmol. 2018 Nov; 66(11): 1652-1653.

  • International Diabetes Federation. IDF Diabetes Atlas. 8th Edition. Available at: http://diabetesasia.org/content/diabetes_guidelines/IDF_guidelines.pdf. Accessed on 12 May, 2019.

  • Viswanathan, V., Krishnan, D., Kalra, S. et al. Adv Ther (2019) 36: 520.

  • Anjana RM et al. Lancet Diabetes Endocrinol. 2017 Aug; 5(8):585-596

  • Rajadhyaksha V. Perspect Clin Res 2018;9:1-3 6. Nyenwe E et al. Metabolism. 2011 Jan; 60(1): 1-23.

  • Academy of Nutrition and Dietetics. How an RDN Can Help with Diabetes, 2018. https://www.eatright.org/health/diseases-and-conditions/diabetes/how-an-rdn-can-help-with-diabetesexternal icon

  • Kay S et al. Arch Fam Med. 1995; 4:589-593.

  • Harris S et al. Can Fam Physician. 2004 Sep; 50: 1235-1243.

  • Jansink et al. BMC Family Practice 2010, 11:414.

  • Kolasa K et al. Nutr Clin Pract. 2010; 25:502-509.

  • Kushner R. Prev Med. 1995 Nov;24(6):546-52.

  • Levine B et al. Am J Clin Nutr 1993;57: 115-9.

  • Eaton C et al. Am J Prev Med 2002;23(3):174-179.

  • Nicholas L et al. European Journal of Clinical Nutrition (2005) 59, Suppl 1, S140-S146.

  • Poskiparta M , Kasila K , Kiuru P. Scandinavian Journal of Primary Health Care, 2006; 24: 206-210.

  • Saslow LR, Daubenmier JJ, Moskowitz JT, et al. Nutr Diabetes 2017; 7:304.

  • Hallberg SJ, McKenzie AL, Williams PT, et al. Diabetes Ther 2018; 9:583-612.

  • Sainsbury E, Kizirian NV, Partridge SR, Gill T, Colagiuri S, Gibson AA. Diabetes Res Clin Pract 2018; 139: 239-252.

  • Jeannie Tay et al. The American Journal of Clinical Nutrition, Volume 102, Issue 4, October 2015, Pages 780-790..

  • M. E. J. Lean and L. Te Morenga, Sugar and Type 2 Diabetes. British Medical Bulletin, 2016, 120:43-53

  • Kalra, et al.: Hypoglycemia: The neglected complication. Indian Journal of Endocrinology and Metabolism/Sep-Oct 2013 Vol 17 | Issue 5

  • Shriraam, et al.: Knowledge of hypoglycemia among diabetic patients. Indian Journal of Endocrinology and Metabolism / May-Jun 2015 / Vol 19 | Issue 3

  • M. Gonza´ lez-Ortiz et al. Diabetes, Obesity and Metabolism, 8, 2006, 331-335

  • Craig L et al. Nutrition 1998; 14:529-534.

  • Alish CJ. Diabetes Technol Ther. 2010 Jun; 12(6):419-25.

  • Mesejo A et al. Crit Care. 2015 Nov 9; 19:390. doi: 10.1186/s13054-015-1108-1.

  • Van Steen et al. JPEN J Parenter Enteral Nutr. 2018 Aug; 42 (6):1035-1045.

  • https://foodinsight.org/wp-content/uploads/2018/05/2018-FHS-Report-FINAL.pdf as accessed on 15th May, 2019

  • Parker WA et al. Public Health Nutrition: 14(8), 1429-1438 31. American Diabetes Association. Diabetes Care 2019; 42 (Suppl. 1):S46-S60

  • http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/understanding-carbohydrates/glycemic-index-and-diabetes.html as accessed on 14th May, 2019

  • Devitt A et al. J. Diabetes Res. Clin. Metab. 2012; 1:20.

  • Mechanick et al. Curr Diab Rep (2012) 12:180-194.

  • Hamdy et al. Curr Diab Rep (2011) 11:111-119.

  • Tatti et al. Mediterr J Nutr Metab DOI 10.1007/s12349-0100034-7

  • Briggsearly et al. February 2018 Volume 118 Number 2.


Abstract Views: 290

PDF Views: 1




  • Study of Knowledge, Attitudes, Practices, and Perceptions of Primary Care Physicians in India towards Dietary Intervention in Management of Patients with Type 2 Diabetes Mellitus

Abstract Views: 290  |  PDF Views: 1

Authors

Ankita Deora
Scientific & Medical Affairs Department, Abbott Nutrition International, India
Gunjan Lath
Scientific & Medical Affairs Department, Abbott Nutrition International, India
Anshu Joshi
Scientific & Medical Affairs Department, Abbott Nutrition International, India
Anand Vijayan
Scientific & Medical Affairs Department, Abbott Nutrition International, India
Sameer Rao
Scientific & Medical Affairs Department, Abbott Nutrition International, India
Ganesh Kadhe
Scientific & Medical Affairs Department, Abbott Nutrition International, India

Abstract


Background: Family physicians have a primary role in detecting, diagnosing, and managing diseases especially in a country burdened with Type 2 Diabetes mellitus (T2DM) cases. Unfortunately, the data on their knowledge about nutrition; one of the cornerstones for T2DM management, is missing from India.

Aims: We aimed to assess the knowledge (K), attitude (A), practices (P), and perceptions (Pr) (KAPP) of Primary Care Physicians (PCPs) in India on nutrition management in patients with T2DM.

Method: A self-administered 7 questions-based survey was conducted amongst PCPs to gather from the period of December 2018- January 2019.

Findings: A total of 496 PCPs from metros (47%) and non-metro (57%) cities shared their responses. More than 90% (n=488) of the PCPs recommend dietary changes for patients on the diagnosis of T2DM with similar trends across regions. 402 PCPs (81%) recommended ≥2 dietary modifications which include; avoidance of sugars (83%), avoidance of foods with high carbohydrates (81%), and increase protein intake (58%), being the common ones. About 93% (n=463) PCPs actively discussed dietary recommendations even during follow-up visits. In terms of knowledge, Glycemic Index (GI)/Glycemic Load (GL), n=429; was the most familiar nutrition-related term known by the PCPs followed by soluble fibre and Glucagon Like Peptide-1 (GLP-1). Products promoted as Diabetes Specific Nutrition (DSN) and multivitamins came as the most preferred nutritional supplements with almost 70% and 47% PCPs recommendations, respectively. While majority of the PCPs (>50%) reported giddiness (a symptom of hypoglycaemia) as a complaint in <10% of their patients on oral anti-diabetic drugs, almost 90% PCPs felt DSN could help manage such cases if occurred.

Conclusion: PCPs in India do believe strongly in recommending dietary modifications and are keen to implement lifestyle interventions for patients with T2DM, however, they face challenges in doing so. The observed inclination of PCPs towards nutrition calls for further continuous and evidence-based awareness programs on nutrition to empower them on the way of better outcomes among patients with T2DM.


Keywords


Diabetes mellitus, Diabetes Management, Medical Nutrition Therapy, Lifestyle Intervention, Diabetes NutritionDiabetes mellitus, Diabetes Management, Medical Nutrition Therapy, Lifestyle Intervention, Diabetes Nutrition.

References