Date of Award
Doctor of Nursing Practice (DNP)
Jochebed Bea Ade-Oshifogun
Type II diabetes mellitus (T2DM) is a common chronic metabolic disease affecting millions of people globally, which causes many long-term complications such as high blood pressure, chronic kidney disease, improper wound healing and loss of sight. Literature supports that most people, in general and diabetic patients specifically, in Africa, including Kenya are currently not taught about the importance of proper management of their disease. Therefore, many have difficulty following treatment plans, resulting in improper eating, poor glucose control, and diabetic complications. The limited knowledge concerning T2DM contributes to the negative impact this serious disease has on those who live with it. This global trend is significantly problematic for the efforts to manage and prevent diabetes complications. Lack of diabetic knowledge leads to poor glucose control and, consequently, increased morbidity and motility. In the past, T2DM was regarded as a disease of the affluent. It is now evident that the disease’s prevalence is increasing alarmingly in low income countries of Sub-Saharan Africa. The burden caused by diabetic complications is worse in these developing countries compared to the developed world.
The purpose of this project was to determine if a structured diabetes education intervention for patients in an urban-rural hospital in Eldoret, Kenya would increase their diabetic knowledge, self-efficacy, hence reduce their HbA1c level. Literature supports that diabetes education has a measurable positive effect in mitigating diabetes complications by reducing the Glycosylated hemoglobin A1c (HbA1c) levels, weight, and blood glucose levels. The phenomenon of structured diabetes education is a novelty in Kenya; diabetes educators and their work are yet to be recognized. Diabetes education is offered only sporadically in hospitals and is usually delivered by providers with limited resources in dissemination of methods hindering expertise in treating the disorder.
After obtaining ethical approvals, 143 participants, both male and female, were screened and placed into the control or the experimental groups. Consent from both groups was obtained. The experimental group was given lessons on a structured diabetes education once every week for three weeks and then followed up for three months. All the participants were given diabetic knowledge test (DKT) and self-efficacy test at the beginning and at the end of the project. In addition, each participant’s HbA1c was collected before and after the intervention.
At the end of the three months' intervention 123 out of 143 (86%) had completed the project (60 control and 63 experimental). The results showed that the experimental group had significantly reduced their levels of HbA1c compared to the control group (F(1, 122)= 9.989, p=0.002). Also, the experimental group improved their diabetic knowledge (t=7.218, p=<0.001) and self-efficacy (F(1, 117)= 14.342, p<0.001) significantly compared to the control group.
Structured diabetes education is an important step in reducing HbA1c thus, controlling diabetic complications and that diabetes education increases the patients’ self efficacy, which is crucial in adjusting lifestyles such as diet intake in managing diabetes. This project highlighted the importance of structured diabetes education by to not only the patients but also the diabetes management practitioners, the caregivers and the community at large.
Bett, Sabina Jeruto, "Effectiveness of Educational Intervention on Diabetic Knowledge & HbA1c Levels on Kenyan Adults with T2DM" (2019). Doctor of Nursing Practice Projects. 6.
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