This study has provided data about the knowledge of complications of diabetes mellitus among diabetic patients visiting the diabetic clinic at the Addis Zemen Hospital, northwest Ethiopia. Comprehensive assessment of the level of knowledge of 402 patients on DM complications showed that less than half of participants had a good knowledge. This finding is more or less similar with the study conducted in Ghana (40%) (12), Mongolia (33.3%) (13). On the contrary, it is not in line with other studies, India (74.2%) (14), Oman (55.5%) (15) and Pakistan (62%) (16), which showed that more than half of respondents had a good knowledge of DM complications. The reason for the difference may be because of a difference in socioeconomic conditions, cultural beliefs and habits, as studies showed that differences in such variables had an impact on the pattern of knowledge on diabetic complications(17).
In the current study, age, sex, educational level, occupation and family history of DM was found to be significantly associated with knowledge of DM complications. Those who were male were 4.6 times more knowledgeable than females. This finding is congruent with the study done in Pakistan (15). The justification for this finding may be because of the cultural practice in that community; females spent more of their time at home while performing their daily tasks. But males spent most of their time outside the home that gave them more chance to gain more information and to attend different meetings and conferences. In addition, when females spend their time at home, they will either follow different Medias or read books that help them know more about DM complications. Age was also found to have a highly significant association with knowledge of DM complications. Those 31-45 years old were 7.3 more knowledgeable than those with age 15-30 years old. It is because. as age increases, they will get more counseling and health education during their follow-up at the diabetic clinic and from formal and non-formal education.
A higher level of education were found to be positively associated with more knowledge, this finding coincides with other studies (15,18). Those with educational level of read and write, 1-8 and, high school and above were 3.7, 9.5 and 7.4 times more knowledgeable respectively than those who cannot read and write. This finding is in agreement with other studies (15,16). As individuals learn more, the chance of gaining information about DM complications from different sources will increase. In addition, those individuals with a high level of education can clearly communicate with the health care professionals and can gather a lot of information about DM complications by asking them and reading different medical books. Another interesting finding of this study was the association between occupation and patient knowledge of diabetic complications. NGO employees were 7 times more knowledgeable about diabetic complications when they are compared with those who were farmers. These results agree with findings by Obirikorang et al. (12). This is because NGO employees are mostly linked to different institution especially health institutions which create them a favorable condition to gain information about complication of DM. Even they have more chance to be involved in scientific conferences and training, making them aware of DM complications.
This study also found a significant association between income and the level of knowledge on diabetic Complication. Those patients with an income of greater than 2500 were found to be more knowledgeable than those with income of less than <500. Other studies support this finding (12,15). It is clear that as income increases, individuals can access or buy any electronic media like TV, which is one means of gaining information. Even individuals with low income may do not attend their follow up regularly, because of lack of money for transportation, which affect one major source of information from a health professional at the diabetic clinic.
Another important finding of this study was patients with a family history of DM were five times more likely to have knowledge on DM complications than the counterparts that have no family history of DM. It is supported by a study done in Oman (15). If their family were diabetic patients, they will have more information from their family and in addition, they may investigate a lot of information about the disease due to fear of losing their parent.
This study reveals that less than half of patients had a good knowledge of DM complications. This gives an evidence for officials and health professionals to include strategies to increase diabetes complication knowledge among diabetes patients. Diabetes education programs should be promoted by using mass media to create awareness at a community level. It should also be incorporated in the national curriculum of education to improve awareness of DM complication and finally this will help to minimize morbidity and mortality associated with DM complications.
Limitations of the study
During assessment of knowledge of patients on DM chronic complications, even though the interviewers carried out it carefully, respondents may have replied socially acceptable responses which may cause an overestimation of level of knowledge of study participants.