Investigating knowledge deficit in diabetes mellitus type 2 amongst young Australian adolescents, aged 18-25-A cross-sectional study

Introduction

The purpose of this preliminary study Is to identify a deficit in knowledge amongst Australian adolescents about type 2 DM.

Australian institute of health & welfare ^[1] states, among young people, the risk of type 2 DM rose from an average annual rate of new cases of 16 per 100,000 for those aged 20-24. Given this prevalence among young adults, the study focused on type 2 DM knowledge deficit among young Australian adults aged between 18 to 25 in Australia.

This age group are likely to engage in unhealthy lifestyle behaviors, such as consuming excessive alcohol, increased sugar intake and consuming processed foods and being physically inactive, which can increase their risk of developing type 2 DM. This is largely due to the legal drinking age being 18 and these adolescents moving out of their homes for the first time. These circumstances make this target population more exposed to diabetic risk factors.

Additionally, the adolescents are likely to fail to recognise the early warning signs of type 2 DM, such as fatigue, increased thirst, and blurred vision. By promoting type 2 DM awareness among young Australian adults, we can empower them to make informed decisions about their health and improve their quality of life. ^[2] Early detection is critical as it helps prevent or delay the onset of complications associated with type 2 DM, such as heart disease, nephropathy, neuropathy, and retinopathy.

An existing study carried out in Kuwait, on this subject, found that the knowledge of type 2 DM amongst 15 to 20 years olds were at average.^[3] Despite this previous study, a gap exists in the literature regarding the deficit of knowledge regarding type 2 DM among young adults aged 18 to 25 in Australia. This preliminary study aims to fill the existing gap in the literature regarding the knowledge deficit of type 2 DM in young Australian adults.

The words adolescents and young adults were used interchangeably in this study.

Aims and Objectives

The aim of the study is to investigate the level of knowledge that young adults in Australia have about type 2 DM. The study aims to identify areas where there is a knowledge deficit among this demographic, such as understanding risk factors, prevention, management, and complications of type 2 DM. The objective is to use the findings of this study to develop possible targeted interventions to improve knowledge and awareness of type 2 DM among young adults in Australia.

Materials and Methods

The study employed a cross-sectional study to investigate the knowledge deficit among young Australian adults aged 18-25 regarding Type 2 DM to inform efforts to mitigate potential future health implications. The study was conducted in the suburbs of Sydney, Australia, with a sample size of 108 participants.

Data collection involved the distribution of a self-completed questionnaire through Rotary members. The questionnaire consisted of a combination of closed-ended questions and multiple-choice questions, administered via an online survey. Questions were focused on general knowledge, knowledge of risk factors, knowledge of symptoms, knowledge on complications and knowledge about lifestyle modifications.

The questionnaire consisted of 15 questions, of which 10 had yes or no options. Of the responses if the participants had gotten 8 or more questions correct out of 10, then they were deemed to have a good knowledge of DM and I gave them a score of 1. Otherwise, they got a score of zero.

Statistical Analysis and Results

A total of 108 participants, 38 men and 70 women, aged between 18 -25 were questioned in the study. The skew towards female participants in the sample was due to the random nature of the selective process. To overcome any bias the analysis was done on the basis of percentages- percentage of males who were knowledgeable and females who were knowledgeable.

[Table 1] the comparison of male and female knowledge about type 2DM in which it was observed that 46 (65.7%) of female study participants stated that type 2 DM is a genetic disease, p- value was 0.28. In [Table 1] it was noted that the comparison of male and female knowledge about type 2DM in which, 57 (81.4%) of female study participants stated that high blood pressure is a risk factor for DM as compared to the male participants 28 (73.7%). P-value was found to be insignificant.

[Table 2], demonstrates the comparison of male and female knowledge about type 2DM in which it was observed that the percentage of female study participants 50 (71.4%) was higher who thought that the type 2 DM can be prevented or managed through lifestyle changes such as healthy eating patterns and exercise as compared to the percentage of male participants 17 (44.7%) and the p-value show a significant result. Whilst [Table 1], showed the comparison of male and female knowledge about type 2DM in which the percentage of female study participants 62(88.6%) was higher, who thought that the untreated type 2 DM led to increased sugar in the blood as compared to the percentage of male participants 29 (76.3%) and the p-value shows an insignificant result.

[Table 3] indicate the comparison of male and female knowledge about type 2DM, in which it was observed that the percentage of female study participants 63(90%) was higher who thought that the obesity led to type 2 DM as compared to the percentage of male participants 35(92.1%) and the p-value shows an insignificant result. Table number 6displays the comparison of male and female knowledge about type 2DM in which it was observed that the percentage of female study participants 62 (88.6%) was higher who thought that there is more than one type of DM as compared to the percentage of male participants 29(76.3%) and the p-value shows an insignificant result.

[Table 3] shows the comparison of male and female knowledge about type 2DM in which it was observed that the percentage of female study participants 54(77.1%) was higher who thought that smoking and alcohol risk factors for type 2 DM as compared to the percentage of male participants 22(57.9%) and the p-value shows significant result. In [Table 1] it highlights high incidence of type 2DM amongst the Aboriginal and Torres Strait Islanders.

Data analysis was done using the IBM SPSS v 23.0 and yielded a p value of 0.0244.

The study was approved by the Oceania University of Medicine Ethic Committee approval number- 20-0424VF.

Discussion

In terms of previous studies examining awareness of risk factors for type 2DMby Al Husiani & Mustafa ^[3] carried out a cross sectional study in Kuwait in the age group between 15 to 20. They discovered that the young people had good general information about diabetes except for a few areas. However, this preliminary study found that was not the case amongst Australian young adults. On the other hand, 91%ofthose surveyed correctly identified being overweight or obese as a risk factor for type 2DM, while 79% identified high blood pressure as a risk factor. This also study concluded that female study participants were more likely to believe that type 2 diabetes can be prevented or managed through lifestyle changes, with a significantly higher p-value than male participants, suggesting a knowledge disparity within the sexes.

Hossain et al ^[6] examined the awareness of risk factors for type 2 DM among people with pre-DM in rural Australia and found that while most participants were aware of the importance of diet and physical activity in preventing type 2DM, many were not aware of other important risk factors, such as family history, ethnicity, and age. However, this study found that 60% of participants were aware of the genetic factor but the study was not conducted in a rural setting.

In addition to smoking, excessive alcohol consumption has also been linked to the development of type 2DM. A study by Knott et al ^[7] found that heavy alcohol consumption was associated with an increased risk of type 2 DM, independent of other risk factors such as obesity and smoking. This study identified 70% of the young Australian adults identified smoking &alcohol as risk factors, this is a significant finding as the adolescents were able to relate type 2 DM to the these risk factors. This is supported by Meads et al. ^[8] who discovered that most Australian adults were aware of the link between smoking and type 2DM.

The outcome of this study is relevant to clinical practice, as clinicians can employ brief opportunistic interventions to encourage adolescents to improve their health behaviors. Early intervention, especially at the adolescent stage by advocating for lifestyle would help lower the burden of disease. This could be done as early as making adolescents aware of type 2DM in high schools. ^[9], ^[10] Results of this study could also benefit the community, particularly considering the significant number of young Australian adults in an 'obesogenic' environment, which, combined with other risk factors, substantially increases the risk of diabetes and related diseases. ^[11]

An extended goal is to alleviate the burden of diabetes in Australia and reduce the healthcare costs. In 2018, the economic cost of diabetes was estimated at $14 billion, encompassing direct healthcare costs and indirect costs such as reduced productivity, absenteeism, early retirement, and premature death, with costs being notably higher for people with diabetes complications. ^[12]

There are certain limitations associated with this study, which require careful consideration. One such limitation pertains to generalizability, for example, study only interviewed Rotarians also the sample size may be inadequate to reflect the true representation of the entire Australian youth. As such, the results are not be applicable to other regions or populations with varying demographics, socioeconomic statuses, or cultural backgrounds.

Further, the age group surveyed has a wide interval between 18 to 25, the future studies should concentrate on narrowing to a specific age group.

Moreover, this study was conducted in a suburban area of Sydney, which raises questions regarding the representatives of the sample and its applicability to other parts of Australia. It is worth noting that the prevalence of certain health conditions such as type 2DM can vary significantly across different regions and ethnic groups in Australia, with Aboriginal and Torres Strait Islander people being more than three times as likely as non-Indigenous people to have type 2DM according to the Australian Bureau of Statistics. Efforts to reduce the high prevalence of type 2DM among Indigenous Australians require a multifaceted approach that addresses both the social determinants and genetic factors that contribute to the development of type 2DM. Improved access to healthy food options, education and awareness programs, and culturally appropriate healthcare services are essential to prevent and manage type 2DM among Indigenous Australians.^[13]

Another potential limitation to consider is that the study offered insights specific to a particular community or locality, potentially not reflecting the experiences and perspectives of youth from other parts of the country. Furthermore, the author feels that a longitudinal study would identify changes in the characteristics of the given population. It is imperative to acknowledge and address these limitations appropriately to ensure the validity and reliability of the study's results.

Conclusion

This study suggests that there is a deficit in knowledge amongst Australian adolescents about type 2DM. Further, the study found that there is a statistically significant difference in the knowledge about diabetes factors between the sexes, female participants were found to be more knowledgeable than their male counterparts.

Source of Funding

None.

Conflict of Interest

None.