• Vol. 48 No. 8, 247–263
  • 15 August 2019

Impact of Knowledge and Attitudes on Lifestyle Practices in Preventing Type 2 Diabetes Mellitus



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Diabetes mellitus is a major public health issue in Singapore. To shape healthcare policies for the primary prevention of diabetes, it is crucial to understand Singaporeans’ knowledge, attitudes and practices related to diabetes and its prevention. This study aimed to assess the knowledge, attitudes and lifestyles of individuals without diabetes. Materials and Methods: A cross-sectional household survey was performed between 31 January to 3 February 2019 to examine knowledge, attitudes and practices related to diabetes. Inclusion criteria of the participants included: 1) Singaporeans/permanent residents, 2) between 30 to 64 years old, and 3) who did not have a diagnosis of diabetes. Logistic and linear regression models were used to analyse the association of knowledge and attitudes with physical activity and diet habits, respectively. Results: Among 806 participants, 72.2% did not meet the Health Promotion Board’s physical activity recommendation. Physical activity was associated with better diabetes knowledge (odds ratio [OR] 5.38, 95% confidence interval [CI] = 1.65-17.53, P = 0.049), stronger beliefs in diabetes prevention (OR 3.36, 95% CI = 1.02-11.12, P = 0.047) and lower levels of worry about diabetes (OR 0.41, 95% CI 0.17-1.00, P = 0.049). Neither knowledge nor beliefs or worries about diabetes was associated with diet. Conclusion: There is a need to reinforce the importance of physical activity and healthy diet in preventing diabetes. Although improving the knowledge level of diabetes may increase physical activity of the population, it is unlikely to improve dietary choices without effective behaviour change interventions.

Diabetes mellitus is a chronic disease that affects the body’s metabolism of sugar. Type 2 diabetes involves insulin resistance and is preventable. Worldwide, type 2 diabetes accounts for the majority of diabetes cases.1 It is a disease of multifactorial pathogenesis2 and modifiable lifestyle factors include obesity,3 physical inactivity,4 diet5 and alcohol consumption.6 Diabetes leads to debilitating complications like chronic renal failure,7 acute myocardial infarction and stroke.8 It is a worldwide epidemic that affected 422 million adults (8.5% of the world’s population) in 20149 and is listed as 1 of 4 priority non-communicable diseases by the World Health Organization (WHO).

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