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
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.
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