Assessment of Knowledge, Attitudes, and Practices Related to Diabetes Mellitus among Patients in Primary Healthcare Settings: A Cross-Sectional Study

Abstract

Background: Diabetes mellitus is a major public health concern that requires active patient participation in treatment and self-management. Adequate knowledge and positive attitudes are essential for promoting appropriate self-care practices and preventing diabetes-related complications. However, evidence regarding diabetes-related knowledge, attitudes, and practices among patients receiving care at primary healthcare facilities in Pakistan remains limited. Objective: To assess knowledge, attitudes, and practices regarding diabetes mellitus and identify predictors of good self-care practices among patients attending primary healthcare settings in Lahore, Pakistan. Methods: A cross-sectional observational study was conducted among 180 adult patients with diabetes attending primary healthcare facilities in Lahore. Data were collected using a structured, interviewer-administered questionnaire covering sociodemographic characteristics, diabetes-related knowledge, attitudes toward disease management, and self-care practices. Descriptive statistics, chi-square tests, and multivariable logistic regression were used for data analysis. A p-value of <0.05 was considered statistically significant. Results: Of the 180 participants, 54.4% had adequate knowledge of diabetes, 62.8% demonstrated positive attitudes toward diabetes management, and 41.7% reported good self-care practices. Higher educational attainment was significantly associated with adequate knowledge (OR 3.12; 95% CI 1.46–6.66; p=0.003). Participants with adequate knowledge (OR 3.47; 95% CI 1.84–6.55; p<0.001) and positive attitudes (OR 4.18; 95% CI 2.17–8.05; p<0.001) were more likely to demonstrate good practices. Medication adherence was reported by 68.9% of participants, whereas adherence to a recommended diabetic diet and regular physical activity was reported by only 39.4% and 36.1%, respectively. In the adjusted analysis, adequate knowledge (adjusted OR 2.96; 95% CI 1.49–5.89; p=0.002), positive attitudes (adjusted OR 3.41; 95% CI 1.72–6.77; p<0.001), and higher education (adjusted OR 2.18; 95% CI 1.07–4.45; p=0.031) independently predicted good self-care practices. Conclusion: Although more than half of the participants had adequate diabetes-related knowledge and positive attitudes, self-care practices remained suboptimal, particularly regarding diet and physical activity. Structured diabetes education, behavioural counseling, and patient-centered support should be integrated into primary healthcare services to improve diabetes self-management.