Demographic stratification of Type 2 diabetes and comorbidities in district healthcare in KwaZulu-Natal

Knowledge, Attitudes, and Practice Regarding Physical Exercise in Type 2 Diabetic and Non-Diabetic Staff at a Tertiary Institution

Type 2 diabetes mellitus (T2DM) has become a global epidemic, where increasing urbanization encourages sedentary lifestyles. Persistent physical inactivity can lead to T2DM and increase the risk of T2DM in the general population. Therefore, the aim of this study was to explore the knowledge, attitudes, and practices (KAP) regarding exercise amongst T2DM and non-diabetic (ND) staff at a tertiary institution in KwaZulu Natal South Africa. A total of 166 responses were received: a total of 16 responses (9.6%) were T2DM, and 150 responses (90.0%) were non-diabetic (ND). The demographics included 66.3% females and 33.7% males who consented to taking part, 62.7% were black, 18.7% were Indian, 12% were white, 5.4% were colored, and 1.2% were other. A cross-sectional descriptive survey design, utilizing a modified validated online knowledge, attitudes, and practice questionnaire, was used to collect data. Descriptive statistics were used for the analysis: inferential statistics; the ordinal (1-5) Likert scale; t-tests; and chi-square tests. The level of statistical significance was set at p ≤ 0.05. No significant differences were found between the T2DM and ND groups except in their attitude towards exercise, which showed three items with significant differences. The ND group agreed significantly more than the T2DM group that they looked forward to exercising (p = 0.002), and even without company, they exercised regularly (p = 0.042). The T2DM group agreed significantly more with the statement that they had asked their doctor if there was medicine available to make them better without doing any exercise (p = 0.002). The overall KAP results of the current study found that both participants diagnosed with T2DM and those in the ND group know about exercise and have a good attitude toward exercise. However, both groups still have poor practice regarding physical activity.

Diabetes-Related Knowledge, Attitude, and Practice Towards Exercise and Its Benefits Among Individuals with Type 2 Diabetes Mellitus

Regular exercise has been shown to have a positive effect on the health outcomes of individuals with type 2 diabetes mellitus (T2DM); however, it is still underutilized in developing countries. This study investigated diabetes-related knowledge, attitudes, and practice toward exercise and its benefits among individuals with T2DM. A total of one hundred and ninety-nine participants (male = 21.6% and female = 78.4%) with T2DM, aged between 18 and 75, (43.77 SD± 14.78) years, participated in the study. A validated diabetes-related knowledge, attitude, and practice questionnaire, evaluated by true/false or unsure, was utilized in the study. Descriptive and inferential statistics analysis was used to analyze data with the significance set at p < 0.05. The results demonstrated poor diabetes-related knowledge of exercise (p < 0.001). The majority of the study participants, 163 (81.90%) with T2DM, did not know that physical activity and exercise are different. About 158 (70.40%) of the study participants felt that their regular work was an adequate substitution for exercise. More than 50% of the study participants demonstrated a positive practice towards exercise and its benefits towards T2DM (p < 0.001). The majority of the study participants reported poor knowledge and a negative attitude toward diabetes. However, their diabetes-related practices were satisfactory.

Regional prevalence of hypertension among people diagnosed with diabetes in Africa, a systematic review and meta-analysis

Hypertension and diabetes comorbidity can increase healthcare expenditure and the risk of coronary heart disease. We conducted a systematic review and meta-analysis to estimate the prevalence of hypertension among people with diabetes in African countries. We searched EMBASE, PubMed and HINARI databases from inception to March 2023. Cross-sectional studies reporting the prevalence of hypertension among people with diabetes and published in English in Africa were eligible for inclusion. The cross-sectional study design component of the mixed method appraisal tool was used to assess the quality of the included studies. We quantified the overall and regional prevalence of hypertension among people with diabetes using random-effects meta-analysis. We assessed heterogeneity and publication bias using I2 statistics and funnel plots. Out of 3815 articles retrieved from the various databases, 41 met the inclusion criteria with sample sizes ranging from 80 to 116726. The mean age was 58 years (± 11) and 56% were women. The pooled prevalence of hypertension in people diagnosed with diabetes was 58.1% [95% CI: 52.0% - 63.2%]. By region, Central Africa had the highest hypertension prevalence; 77.6% [95% CI: 53.0% - 91.4%], Southern Africa 69.1% [95% CI: 59.8% - 77.1%;], North Africa 63.4% [95% CI: 37.1% - 69.1%;], West Africa 51.5% [95% CI: 41.8% - 61.1%] and East Africa 53.0% [95% CI: 45.8% - 59.1%]. Increasing age, being overweight/obese, being employed, longer duration of diabetes, urban residence, and male sex were reported to be associated with a higher likelihood of developing hypertension. The high prevalence of hypertension among people with diabetes in Africa highlights the critical need for an integrated differentiated service delivery to improve and strengthen primary care and prevent cardiovascular disease. Findings from this meta-analysis may inform the delivery of interventions to prevent premature cardiovascular disease deaths among persons in the region.