A study at awareness and self-care practices among diabetes type 2 patient in rural areas of India Punjab and Urban areas of Delhi.
Introduction: Diabetes is a disease that has closest links to lifestyle and living practices of a patient. Behavior and awareness of patient about personal care programs at diabetics play a vital role in terms of recovery.
Need is to start efforts in order to increase health care practices among patients regarding his or her own attitude and dealings towards Diabetics. When we talk about Diabetic Mellitus, it is a not transmissible disease. It is the disease of poor and those who are living in financially stretched situations especially in third world countries and India is one of those countries. India is among top 3 high diabetic patients around the world. [A. Mascarenhas, 2016, The Indian express]
 Scarcity of health care facilities and living style of masses leave them in the hands of diabetes. Diabetes requires patient to stay conscious about health issues so that complications can be avoided. Patient needs to live an active life with daily exercise routine, eat healthy and proper foot care practices are required to handle it and keep a sound control on hypoglycemic periods. So, the aim of this research is to evaluate basic knowledge and health care routine among diabetic populations especially in rural areas. Search strategy:This study is conducted among the patients of type 2 diabetics mellitus in Punjab And Delhi to know the level of awareness among patients about their disease.
Basically, the behavior of people toward diabetic is so casual and they don’t consider it a serious threat to their healthy existence. Around 40% population has awareness about health care practices. Patients were residents of different areas of Punjab and Delhi and sampling technique was on random bases. People were asked questions regarding their health care routine and they were advised to give their honest opinion that also in the premises of question. Questions were designed under the guideline of health experts and Diabetologist to stay relevant and targeted in approach. Research questions were in Hindi so that people can understand and respond accordingly.
Questions were tested on some selected persons first so that its validity and clarity can be checked. All of them were close ended with different categories of people who were good or bad at their knowledge about diabetics. Data was collected with all is precisions. Questions were regarding daily exercise, blood pressure monitoring, looking inside foot, medicine intake, smoking or drinking habits and eating habits. People were categorized as per their bad, average and good approach about their own health. Discussion of research evidences Research was conducted in rural population first; people were not found to be that much aware of health facilities provided even inside India. Also rural population don’t have capital for the treatment of disease.
Research proposed that in both male and female have trends to be caught in this disease in early stages of their age. Research shows that Indians get trapped in the clutches of Diabetes 10-15 years earlier than non-Indians. [cardiresearch]  In order to get wider image of the picture in research, a comparison of rural and urban population was also conducted to know the difference between rural and urban population about the statistics of this diseases.
People in urban areas are more aware about their health problems but vulnerability about diabetics is more in urban population as compared to rural population. Overall community takes diabetics not as serious as other diseases like cancer, AIDS and a lot more. That’s why India has a lot of population trapped in this.
According to latest figures more than 50 million people are suffering from this disease in India only. [R Malik, 2016, Times of India]  One basic factor is that people are least aware that their traditional eating habits are further airing this disease. Indian traditional foods are full of fat and sugar which people should be warned about. Situation is even alarming because of lack of awareness in people. Number of patients are even increasing with a fast rat.
According to International Diabetic federation estimates, number of diabetic patients in India were 69.1 million in 2015. There is one other factor about which people are not aware of; it’s depression that exists with DM (Diabetics Mellitus). Unfortunately, patients don’t take depression as serious as it should be.
There are 40% urban population in India who have depression and DM at the same time. [E.Mendenhall 1, G Narayanan , D Prabhakaran , 2017, national institute of health. ] Moreover, urbanization is also a factor of diabetic being widespread in urban population.
According to United Nations recognition, one of the causes of increasing diabetic patients is urbanization. Urbanization becomes a burden on health care facilities in urban areas where there are already less hospitals and medical care centers in India. Migrating people make the situation even worse and more and more population starts going away of health care facilities.
Delhi is among the most urbanized cities in India; it has maximum number of DM patients [B. Shaja,2016, the Hindu]. . Diabetes is among the top health threats in India and it should be tackled on immediate bases. Furthermore, most patients get diagnosed about diabetics when it gets complicated. [A. Misra,2017] . They keep on ignoring or/ and stay unaware that they are sick. It further complicates the issue. Blood sugar level becomes uncontrolled causing serious damage in body.
When they become aware of their sickness it’s already too late to start a treatment. These delayed diagnoses are more prevalent in rural population then in urban population of India. Urban population is still aware of their health problems and they have comparatively better financial condition to treat their health problems but rural population considers it a wastage of money unless they get trapped in some immediate life threatening disease.
Moreover, obesity is also a problem in rural and urban areas. People are least aware about their eating habits of junk food which is leading them to DM. Fast food and energy drinks increase blood sugar level and fat accumulation in body which leads to diabetics. So, the biggest problem is with basic health care system and awareness among masses. Patient should be aware of the nature of disease, medication process and above all actual knowledge against myths about that specific disease.
India is a place where myths are believed blindly. It is even common in rural population. People are an easy prey to anyone who says anything logical or illogical at any issue. Same is the case with diabetics. During our research we communicated with some people who listened from some ‘so called’ Herbalists that they can treat DM just in one day.
People are least aware these are nothing but noxious tactics to pull money out of innocent patience’ pocket. There is not a single scientific research or medicine who claims to treat DM just in a single day. So, lack of awareness is leading Indian population to be trapped in this disease in a rapid speed.
Another neglected area which gives space to Diabetes to attack a body is Blood Pressure (BP). And it is present in both rural and Indian population of India. People don’t think it even a disease. They treat a BP patient almost like a healthy person where they are not aware of the fact that that it can lead to serious health complications. Patients don’t get optimal treatment and become helpless in front of DM to trap them even badly.
Indian have high triglycerides and BP problems which stay unaddressed. [ S. Kalavalapalli, 2017, Times of India] Moreover, patients in urban and rural population in India are not punctual in taking their medicine and going for regular checkup. If once a patient starts feeling good, he or she will start thinking as if all is good now and health is back. But this attitude leads to father complications and disease comes back with even more intensity. Then they again start medication and do the same next time.
There is no trend of medical boxes or medication alters as masses are illiterate or less literate to understand latest inventions about health sciences. Our research revealed that urban people of Delhi are even more aware of their health issues as compared to rural population of Punjab. Then, while looking at total Indian population, there is an eye opening statistic about diabetic patient under 35-year-old. In FY16 it was seen that over Diabetes has been increased by 57% among those who are less than 35 years old.
Another ignored area is consumption of alcohol. Indians are although not that much alcoholic nation yet there are a number of people which are in alcohol and narcotic addiction. Specially, in Punjab, Sikh culture, people consume alcohol even more so they give a call to diabetes through their eating habits.
About alcohol and narcotics, things are not as much bad when we talk about awareness. Masses are comparably aware of it bad implication on their body still they consume it because of either addiction, peer group pressure or to stay away of their problems even they don’t know that It is an open call to various disease like Diabetes and heart disease which are obviously only a few instances of dangers of alcohol that it causes to a healthy existence of individuals. Both men and women consume it but statistics about its consumption for men are even high.
Our research revealed that women who are in diabetes are even more vulnerable when they get pregnant.
On one side, when there are less health facilities in India, on the other side women get pregnant that also with DM, situation becomes even more worse. Mostly, women in India stay dependent on their husbands who, most of the times, don’t show that much interest in their either being diabetic or pregnant. According to International Diabetic Foundation, one in 10 women are living with Diabetes and diabetes is also the ninth leading cause of women death around the world.
Conclusion and recommendations While comparing rural and urban population awareness, from the reference of diabetes, situation is far more unfortunate. Either it’s rural pop0ulation of Punjab or urban population of Delhi, patients or healthy masses are not well aware of Diabetes and health care facilities are also not meeting the needs of people for treatment or consultation about this disease.
During the research people cooperated to deliver ample knowledge so that conclusion can be derived. Lack of awareness, financial pressures, illiteracy, lack of healthcare facilities and unhealthy eating lifestyle are the top line causes which cause Diabetes in Booth rural and urban population of Punjab and Delhi.
All these factors want to be addressed to have a healthy population both in rural and urban areas of India. Facilities are there but they are unable to cover a big lot of diabetics which are even increasing with every passing day.
Everyone should have a healthy life style to follow. Exercise and eating most of raw foods and vegetables should be considered as the prime ingredient of daily meals.
Pregnant ladies should be given special attention if they are diabetic because a healthy mother can have a healthy offspring which leads the whole nation towards health and fitness. Fitness campaigns should be launched on national bases to make people aware of the harmful consequences that DM can cause in a healthy body. Regular patient checkup facility at door step is also need so that people who are unable to afford expensive treatment t can take advantage from them.
Kids should be raised with healthy eating habits to avoid obesity as healthy eating habits of childhood stay with a person throughout the life. People who can afford and all the charity organizations should work to make people more and more aware of this problem. Media campaigns area must in this regard, as media is pervasive in most of India states especially in Delhi.
Remote areas of Punjab should also be addressed. Need is to lunch campaign against diabetics or urgent bases so that nations should stay safe from the harmful clutches of Diabetes.