Abstract
BACKGROUND AND AIMS: Diabetes Mellitus (DM) is a chronic metabolic disease and a major global health issue that has reached alarming levels. Developing countries including Nepal face particular challenges due to financial constraints in disease management. This study aimed to assess the knowledge, attitude, and practice (KAP) of diabetes management among patients aged above 40 years attending a tertiary care outpatient department in Nepal. METHODS: An institutional-based, hospital cross-sectional study was conducted on 407 diabetic patients at the Medicine Outpatient Department (MOPD) of Bir Hospital, Kathmandu, Nepal, from November 2022 to February 2023. Patients were selected by simple random sampling. KAP regarding diabetes mellitus was assessed using a validated structured questionnaire (Cronbach's alpha = 0.808). Data were analysed using SPSS version 20. Chi-square tests were used for associations at a significance level of α = 0.05 (two-sided). RESULTS: This study involved 407 participants, with most being female (63.6%) and literate (84%). Nearly 41% identified agriculture as their primary occupation. Among participants, 88.7% had diabetes (HbA1c-confirmed), with a median age of 65 years (range: 41-84 years). The findings reveal significant gaps in knowledge, attitudes, and practices related to diabetes management. Nearly 29% of patients had highly insufficient knowledge, and only 16% had satisfactory knowledge. About 25% demonstrated a negative attitude towards diabetes care, and a similar proportion showed highly insufficient practices. Gender and occupation were significantly linked to knowledge levels (p < 0.001), while HbA1c levels were associated with attitudes (p = 0.001) and practice (p = 0.031). Knowledge and practice levels (p < 0.001), as well as attitude and practice levels (p = 0.003), were significantly correlated. Socio-demographic and clinical factors did not show significant associations with HbA1c levels (all p > 0.05). CONCLUSION: The study reveals significant gaps in diabetes management, with approximately one-third of participants showing insufficient knowledge and practices. Gender, occupation, and HbA1c levels were linked to knowledge and attitudes. These findings emphasize the need for targeted education and interventions, which can guide training programs and policies to improve diabetes outcomes in Nepal.