JDM Journal of Diabetes Mellitus 2160-5831 Scientific Research Publishing 10.4236/jdm.2023.132011 JDM-124743 Articles Medicine&Healthcare Diabetes Treatment-Related Myths and the Impact of COVID-19 on Diabetes Knowledge—An Indian Survey-Based Study Anjali Vijaya 1 Subhash Kumar 2 * Jaipur National University Medical College, Jaipur, Rajasthan Diabetes and Obesity Care Center Boring Canal Road, Patna, Bihar 11 04 2023 13 02 130 141 14, February 2023 3, May 2023 6, May 2023 © Copyright 2014 by authors and Scientific Research Publishing Inc. 2014 This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/

Objective: The main aim of the survey was to assess diabetes treatment-related myths prevalent in the Indian population and if COVID-19 pandemic improved their knowledge about diabetes. Results: The survey was completed by 309 participants; 66% did not have diabetes. The responses of people with diabetes and those without diabetes were similar. Survey results of the total population showed that the majority believed that diabetes treatment should start early (92.6%); 87.4% believed that the treatment should start within three months of diagnosis with modern medicines; 67.3% of the participants felt that allopathic medicines for diabetes were safe, 69.6% believed that if started these medications continue lifelong, and 40.5% thought they damaged all major organs. Insulin was thought to be safe by 65% of the surveyed population; 60.8% believed that if they started insulin, they would need it life-long; 51.5% thought that insulin was started at the last stage of diabetes; and 58.6% believed that insulin caused kidney damage. A total of 58.6% believed that herbal medicines for diabetes were safer than allopathic; 76.4% did not believe that the “diabetic cure” shown through television/newspapers was safe and effective; 67.3% did not believe that ayurvedic medicines cured diabetes. Of the surveyed population, 67% felt that their knowledge about diabetes improved during the pandemic and 89.3% knew that PWDs have more serious problems with covid infection. Conclusions: Our survey shows that many diabetes treatment-related myths are prevalent in the Indian population even though the COVID-19 pandemic improved their knowledge about diabetes.

Diabetes Myths Misconceptions Survey Insulin Treatment COVID-19 Barriers 1. Introduction

Diabetes is a global pandemic [1] [2] . One in seven of all adult people with diabetes (PWD) in the world is an Indian [1] . The global PWD number is predicted to increase by 69% to 152 million by 2045 [1] .

The diabetes pandemic is preventable if diabetes is diagnosed and treated properly in time [1] [2] . However, diabetes treatment is complicated by various treatment opinions/myths prevalent in the general public and also in PWD [3] [4] . Myths or misconceptions are stories or beliefs shared by a group of people and passed from generation to generation as a part of their deeply ingrained cultural identity [4] [5] . Since the Indian culture is very diverse, these myths and misconceptions may vary with the region.

With diabetes reaching pandemic proportions in India, many Indians without diabetes have a high lifetime risk of developing diabetes in the coming years [1] [6] . Further, when people develop diabetes, they often consult their friends or relatives with diabetes or elders in the family about diabetes-related precautions and treatments. Hence, both PWDs and people without diabetes contribute to the spread of myths. Importantly, with many PWD relying on herbs, foods, and various other traditional medicines as their principal diabetes treatment, these myths influence health-care-seeking behavior and develop resistance to insulin use [3] [4] [5] [7] . This behavior often complicates the diabetes disease scenario and leads to hyperglycemia and its complications [3] [5] .

Survey-based studies on the myths about diabetes are few and none are focused only on diabetes treatment-related myths. No study, to the best of our knowledge, compared diabetes treatment-related myths between PWD and those without diabetes. Hence, we designed this survey-based study to understand the diabetes treatment-related myths prevalent across India and to compare them between PWD and those without diabetes. The correct understanding of diabetes treatment-related misconceptions and myths prevalent across India is important for designing and providing the correct health education for healthy individuals by busting these myths in a culturally sensitive and acceptable way.

Additionally, no survey-based study covered the impact of COVID-19 on diabetes-related information, nor compared the impact of COVID-19 on diabetes-related information in PWD and those without diabetes. There was a lot of media coverage about the worsening of COVID-19 symptoms in people with diabetes (PWD). Though PWD was anxious about getting COVID-19, only 28% of were regularly checking their blood glucose levels during the pandemic [8] . However, the majority were following diet control and doing some exercise during the pandemic [8] . Hence, we also aimed to understand whether a pandemic like COVID-19, which had serious implications for PWD, improved diabetes-related information amongst the public and compared the impact of COVID-19 on diabetes-related information between PWD and those without diabetes.

2. Material and Methods

This was a cross-sectional digital survey-based study conducted across 5 cities in India March 2022 to May 2022.

The main aim of the survey was to assess the myths about diabetes treatment that are prevalent in the Indian population. The questions of the survey were included after a detailed discussion with the team and after a detailed literature search to assess the myths associated with diabetes treatment in the world.

The survey questions were originally designed in English language and then translated into the local language with the help of medical experts. The survey was designed such that it could be filled in both online (on a tablet/computer) and offline paper mode.

The surveys were filled during routine clinic visits, either by the patients themselves or the patients were assisted by the designated clinic staff. The staff only read out the questions and filled in the response given, and ensured that the patient’s response was not influenced in any way. Each study subject was allowed to fill out the survey only after the subject was explained the aims and protocol of the study and, willingly gave consent to participate. All filled surveys were immediately cross-checked for completion.

Within a week of completing the survey, the data was uploaded on a Microsoft excel sheet and descriptively analyzed as percentages.

 3. Results 3.1. Baseline Characteristics

A total of 312 people were approached to fill out the survey, of which, 309 consented to fill out the survey. The surveyed population was largely educated; 104 of them were students, 22 were housewives, and others (n = 223) were working across 67 different job sectors. The majority (80%) of the surveys were filled online and all the surveys were largely filled by the patients themselves.

 3.2. Survey Outcomes Total Population

The average age of the survey participants was 36.63 ± 18.32 years.

The majority believed that diabetes treatment should start early (92.6%), and if modern medicines (allopathic) were to be used, then 87.4% (Figure 1(a)) believed that the treatment should start within three months of diagnosis.

A total of 67.3% of the participants felt that allopathic or English medicines for diabetes were safe and 69.6% believed that if started these medications have to continue lifelong. A total of 40.5% thought that allopathic or English medicines damaged all major organs (eyes, heart, kidney, and liver) while 29.1% believed that these medicines caused no organ damage (Figure 2(a)).

Insulin was thought to be safe for the treatment of diabetes by 65% of the surveyed population; 60.8% believed that if they started insulin, they would need it life-long to control their blood sugar; 51.5% thought that insulin was started at the last stage of diabetes; and 58.6% believed that insulin caused kidney damage.

A total of 58.6% believed that herbal medicines for diabetes were safer than allopathic. The “diabetic cure” shown on television or advertised in newspapers was not thought to be safe and effective by 76.4% of the surveyed population; 67.3% did not believe that ayurvedic medicines (as advertised by the media) cured diabetes.

Of the surveyed population, 67% felt that their knowledge about diabetes improved during the pandemic and 89.3% knew that PWDs have more serious problems with covid infection.

The survey questionnaire and the responses of the participants are detailed in Table 1.

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