PHARMACY STUDENTS’ KNOWLEDGE, ATTITUDE, AND PRACTICE CONCERNING DIABETES AND ITS LONG-TERM COMPLICATIONS - A CROSS-SECTIONAL STUDY

SMRUTIMALLIKA DUTTA; PRABHUDATTA MOHAPATRA; KARMAJEET RATH; DURGA MADHAB KAR

doi:10.22159/ajpcr.2025v18i6.54549

Authors

SMRUTIMALLIKA DUTTA Department of Pharmacology, School of Pharmaceutical Sciences, Siksha ‘O’ Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India https://orcid.org/0009-0004-1454-3118
PRABHUDATTA MOHAPATRA Department of Pharmacology, Sri Jayadev College of Pharmaceutical Sciences, Naharkanta, Bhubaneswar, Odisha, India https://orcid.org/0000-0002-4943-4649
KARMAJEET RATH Department of Pharmacology, Institute of Medical Science and SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India.
DURGA MADHAB KAR Department of Pharmacology, School of Pharmaceutical Sciences, Siksha ‘O’ Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India

DOI:

https://doi.org/10.22159/ajpcr.2025v18i6.54549

Keywords:

Diabetes, Pharmacy Students, Complications, Knowledge, Attitude, Practice

Abstract

Objectives: The purpose of the study is to examine pharmacy students’ attitudes, knowledge, and behaviors related to diabetes mellitus, pinpoint any knowledge gaps, and evaluate their preparedness for patient education and effective treatment.

Methods: Their knowledge, attitudes, and practices (KAPs) on diabetes and its long-term effects were evaluated by a cross-sectional, questionnaire-based study. A validated self-administered questionnaire was used to collect data, which was then analyzed using Statistical Package for the Social Sciences at a significance level of p<0.05.

Results: The study involved 310 pharmacy students, including D. Pharm (n=48), B. Pharm (n=239), and M. Pharm (n=23) students. The survey found that the majority of pharmacy students had academic exposure to diabetes, with 91.29% having studied the topic. But there are still gaps in our understanding, especially when it comes to diabetic complications, dietary misunderstandings, and medication use (p<0.000). Attitudinal studies revealed considerable recognition of the pharmacist’s function but little support for counseling training. Students lacked practical experience, particularly in drug interaction monitoring, counseling, and adhering to rules.

Conclusion: Pharmacy students demonstrated strong support for the pharmacist’s role in management, statistically significant results (p<0.05) in the majority of knowledge categories, and good knowledge and favorable attitudes toward diabetes care. However, major gaps in practical experience, such as patient counseling and guideline adherence, underscore the importance of hands-on training, workshops, and community engagement in improving clinical competence.

Downloads

Download data is not yet available.

References

Banday MZ, Sameer AS, Nissar S. Pathophysiology of diabetes: An overview. Avicenna J Med. 2020;10(4):174-88. doi: 10.4103/ajm. ajm_53_20, PMID 33437689

Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, et al. Pathophysiology of type 2 diabetes mellitus. Int J Mol Sci. 2020;21(17):6275. doi: 10.3390/ijms21176275, PMID 32872570

Antar SA, Ashour NA, Sharaky M, Khattab M, Ashour NA, Zaid RT, et al. Diabetes mellitus: Classification, mediators, and complications; A gate to identify potential targets for the development of new effective treatments. Biomed Pharmacother. 2023;168:115734. doi: 10.1016/j. biopha.2023.115734. PMID 37857245

Pradeepa R, Mohan V. Epidemiology of type 2 diabetes in India. Indian J Ophthalmol. 2021;69(11):2932-8. doi: 10.4103/ijo.IJO_1627_21, PMID 34708726

Mohapatra P, Kar DM, Rath K, Pal A. Effectiveness assessment of dapagliflozin as an add on to sitagliptin, vildagliptin and metformin in patients with different demographic parameters in Type II DM. Indian J Pharm Educ Res. 2025;59(2):544-9. doi: 10.5530/ijper.20255779

Punyamurthy C, Bheenaveni R. Urbanization in India: An overview of trends, causes, and challenges. Int J Asian Econ Light. 2023;11:9-20. doi: 10.36713/epra12473

Leon BM, Maddox TM. Diabetes and cardiovascular disease: epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015;6(13):1246-58. doi: 10.4239/ wjd.v6.i13.1246, PMID 26468341

Valliant SN, Burbage SC, Pathak S, Urick BY. Pharmacists as accessible health care providers: Quantifying the opportunity. J Manag Care Spec Pharm. 2022;28(1):85-90. doi: 10.18553/jmcp.2022.28.1.85, PMID 34949110

Tsuyuki RT, Beahm NP, Okada H, Al Hamarneh YN. Pharmacists as accessible primary health care providers: Review of the evidence. Can Pharm J (Ott). 2018;151(1):4-5. doi: 10.1177/1715163517745517, PMID 29317929

Mantzourani E, Desselle S, Le J, Lonie JM, Lucas C. The role of reflective practice in healthcare professions: Next steps for pharmacy education and practice. Res Social Adm Pharm. 2019;15(12):1476-9. doi: 10.1016/j.sapharm.2019.03.011. PMID 30926252

Bin Saleh GB, Rezk NL, Laika L, Ali A, El-Metwally A. Pharmacist, the pharmaceutical industry and pharmacy education in Saudi Arabia: A questionnaire-based study. Saudi Pharm J. 2015;23(5):573-80. doi: 10.1016/j.jsps.2015.02.019. PMID 26594125

Morris ME, Ren T, Asare-Nkansah S, Bilensoy E, Gatwood J, et al. Doctoral graduate programs in the pharmaceutical sciences: An international survey. J Pharm Sci. 2022;111:3196-205.

Almaghaslah D, Alsayari A, Almanasef M, Asiri A. A cross-sectional study on pharmacy students’ career choices in the light of Saudi vision 2030: will community pharmacy continue to be the most promising, but least preferred, sector? Int J Environ Res Public Health. 2021;18(9):4589. doi: 10.3390/ijerph18094589, PMID 33926047

Basak SC, Sathyanarayana D. Pharmacy education in India. Am J Pharm Educ. 2010;74(4):68. doi: 10.5688/aj740468, PMID 20585429

Dineshkumar B, Raghuram TC, Radhaiah G, Krishnaswamy K. Profile of drug use in urban and rural India. Pharmacoeconomics. 1995;7(4):332-46. doi: 10.2165/00019053-199507040-00007, PMID 10155322

Lawal M. Barriers to attendance in diabetes education: A systematic review. Diabetes Prim Care. 2014;16(6):299-306.

Mc Sharry J, Dinneen SF, Humphreys M, O’Donnell M, O’Hara MC, Smith SM, et al. Barriers and facilitators to attendance at type 2 diabetes structured education programmes: A qualitative study of educators and attendees. Diabet Med. 2019;36(1):70-9. doi: 10.1111/dme.13805, PMID 30156335

Wongwiwatthananukit S, Zeszotarski P, Thai A, Fuller R, Owusu Y, Tan C, et al. A training program for pharmacy students on providing diabetes care. Am J Pharm Educ. 2013;77(7):153. doi: 10.5688/ ajpe777153, PMID 24052656

Akhuemonkhan E, Lazo M. Association between family history of diabetes and cardiovascular disease and lifestyle risk factors in the United States population: The 2009-2012 National Health and Nutrition Examination Survey. Prev Med. 2017;96:129-34. doi: 10.1016/j. ypmed.2016.12.015, PMID 28007493

Das M, Pal S, Ghosh A. Family history of type 2 diabetes and prevalence of metabolic syndrome in adult Asian Indians. J Cardiovasc Dis Res. 2012;3(2):104-8. doi: 10.4103/0975-3583.95362, PMID 22629026

Katulanda P, Ranasinghe P, Jayawardena R, Sheriff R, Matthews DR. The influence of family history of diabetes on disease prevalence and associated metabolic risk factors among Sri Lankan adults. Diabet Med. 2015;32(3):314-23. doi: 10.1111/dme.12591, PMID 25251687

Mansell K, Mansell H, Neubeker W, Drake H. Students’ perceptions of and amount of diabetes education in Canadian schools of pharmacy. Curr Pharm Teach Learn. 2017;9(3):376-82. doi: 10.1016/j. cptl.2017.02.003, PMID 29233274

Sterrett J, Croom M, Phillips CM, Shrader S. Incorporating a diabetes certificate program in a pharmacy curriculum. Am J Pharm Educ. 2012;76(5):89. doi: 10.5688/ajpe76589, PMID 22761530

Bakshi S, Bera S, Mehta DK, Joshi S, Das R. Assessment of pharmacy students knowledge regarding diabetes mellitus and its prevention. J Young Pharm. 2021;13(3):285-90. doi: 10.5530/jyp.2021.13.58

Wajid S, Al-Arifi M, Babelghaith SD, Naqvi AA, Althagfan S, Mahmoud MA. Pharmacy students’ knowledge and attitudes towards diabetes: A cross-sectional study. Biomed Res. 2018;29(19). doi: 10.4066/biomedicalresearch.29-18-1074

Hu J, Zhang R, Zou H, Xie L, Zhou Z, Xiao Y. Latent autoimmune diabetes in adults (LADA): from immunopathogenesis to immunotherapy. Front Endocrinol. 2022;13:917169. doi: 10.3389/ fendo.2022.917169, PMID 35937817

Ahmad A, Alshammari AA, Aldhafeeri AM, Alharbi AL, Aldhafeeri OH, Aldhafeere TH, et al. Awareness, knowledge, attitudes, and practices of diabetic nephropathy among the general population in Hafr Al Batin, Saudi Arabia: A cross-sectional study. Cureus. 2024;16(10):e71987. doi: 10.7759/cureus.71987, PMID 39569233

Sękowski K, Grudziąż-Sękowska J, Pinkas J, Jankowski M. Public knowledge and awareness of diabetes mellitus, its risk factors, complications, and prevention methods among adults in Poland-A 2022 nationwide cross-sectional survey. Front Public Health. 2022;10:1029358. doi: 10.3389/fpubh.2022.1029358, PMID 36620244

Mubaraki AA, Alotaibi NM, Alshaer AA, Alhamayani MH, Althobaiti MF, Alqurashi AM, et al. Awareness level of diabetic neuropathy and its complications among Taif city population in Saudi Arabia. Int J Gen Med. 2023;16:4207-13. doi: 10.2147/IJGM.S426573, PMID 37731898

Elsiraj SE. Knowledge, attitudes and practices regarding diabetic neuropathy among Type-II diabetics in Jabra locality, Khartoum, Sudan, in 2022. Int J Med Stud. 2023;10:S223. doi: 10.5195/ijms.2022.1806

AlHargan MH, AlBaker KM, AlFadhel AA, AlGhamdi MA, AlMuammar SM, AlDawood HA. Awareness, knowledge, and practices related to diabetic retinopathy among diabetic patients in primary healthcare centers at Riyadh, Saudi Arabia. J Fam Med Prim Care. 2019;8(2):373-7. doi: 10.4103/jfmpc.jfmpc_422_18, PMID 30984641

Singh A, Tripathi A, Kharya P, Agarwal R. Awareness of diabetic retinopathy among diabetes mellitus patients visiting a hospital of North India. J Fam Med Prim Care. 2022;11(4):1292-8. doi: 10.4103/ jfmpc.jfmpc_977_21, PMID 35516672

Ganesan K, Rana MB, Sultan S. Oral hypoglycemic medications. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2023 May 1. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482386

Howard-Thompson A, Khan M, Jones M, George CM. Type 2 diabetes mellitus: outpatient insulin management. Am Fam Physician. 2018;97(1):29-37. PMID 29365240

Nalavadey S, Baliga SS. Misconceptions about diabetes mellitus among diabetes patients: A cross-sectional study. Indian J Health Sci Biomed Res (KLEU). September-December 2022;15(3):230-4. doi: 10.4103/ kleuhsj.kleuhsj_383_21

Kumar S. Knowledge, attitude and awareness of diabetes nutrition in physicians: A dietary survey. Int J Med Sci Diagn Res. 2019;3(7):451.

Ren Y, Sun S, Su Y, Ying C, Luo H. Effect of fruit on glucose control in diabetes mellitus: A meta-analysis of nineteen randomized controlled trials. Front Endocrinol. 2023;14:1174545. doi: 10.3389/ fendo.2023.1174545, PMID 37214237

Pourkazemi A, Ghanbari A, Khojamli M, Balo H, Hemmati H, Jafaryparvar Z, et al. Diabetic foot care: Knowledge and practice. BMC Endocr Disord. 2020;20(1):40. doi: 10.1186/s12902-020-0512-y, PMID 32192488

Shriraam V, Mahadevan S, Anitharani M, Jagadeesh NS, Kurup SB, Vidya TA, et al. Knowledge of hypoglycemia and its associated factors among type 2 diabetes mellitus patients in a Tertiary Care Hospital in South India. Indian J Endocrinol Metab. 2015;19(3):378-82. doi: 10.4103/2230-8210.152779, PMID 25932394

Campbell RK. Role of the pharmacist in diabetes management. Am J Health Syst Pharm. 2002;59 Suppl 9:S18-21. doi: 10.1093/ajhp/59. suppl_9.S18, PMID 12489383

Badi S, Suliman SZ, Almahdi R, Aldomah MA, Marzouq ME, Ibrahim EE, et al. The impact of clinical pharmacist diabetes education on medication adherence in patients with type 2 diabetes mellitus: An interventional study from Khartoum, Sudan. J Pers Med. 2024;14(1):74. doi: 10.3390/jpm14010074, PMID 38248775

Axon DR, Alamer A, Almatruk Z, Fazel MT. Assessing student pharmacists’ confidence and knowledge of basic diabetes self-management skills. Curr Pharm Teach Learn. 2022;14(8):982-9. doi: 10.1016/j.cptl.2022.07.017, PMID 36055707

Katangwe T, Bhattacharya D, Twigg MJ. A systematic review exploring characteristics of lifestyle modification interventions in newly diagnosed type 2 diabetes for delivery in community pharmacy. Int J Pharm Pract. 2019;27(1):3-16. doi: 10.1111/ijpp.12512, PMID 30697864

Akoskar S, Jha D, Hangargekar P, Kulkarni D, Joshi A, Jain A. Pharmacy Student’s knowledge of diabetes and obesity: A cross-sectional study in Dharashiv, India. Ind J Pharm Pract. 2024;17(3):226-32. doi: 10.5530/ ijopp.17.3.37

Kharono B, Nabisere R, Kiddu Persis N, Nakakeeto J, Openy A, Bakeera Kitaka S. Knowledge, attitudes, and perceived risks related to diabetes mellitus among university students in Uganda: A cross-sectional study. East Afr Health Res J. 2017;1(2):105-12. doi: 10.24248/ EAHRJ-D-16-00371, PMID 29250612

Malathy R, Narmadha M, Ramesh S, Alvin JM, Dinesh BN. Effect of a diabetes counseling programme on knowledge, attitude and practice among diabetic patients in Erode district of South India. J Young Pharm JYP. 2011;3(1):65-72. doi: 10.4103/0975-1483.76422, PMID 21607057

Farahani I, Farahani S, Deters MA, Schwender H, Laeer S. Efficacy of an objective structured clinical examination training approach for training pharmacy students in diabetes mellitus counseling: A randomized controlled trial. Pharmacy (Basel). 2020;8(4):229. doi: 10.3390/pharmacy8040229, PMID 33255975

Al-Maskari F, El-Sadig M, Al-Kaabi JM, Afandi B, Nagelkerke N, Yeatts KB. Knowledge, attitude and practices of diabetic patients in the United Arab Emirates. PLOS One. 2013;8(1):e52857. doi: 10.1371/ journal.pone.0052857, PMID 23341913

Saber HJ, Daoud AS. Knowledge and practice about the foot care and the prevalence of the neuropathy among a sample of type 2 diabetic patients in Erbil, Iraq. J Fam Med Prim Care. 2018;7(5):967-74. doi: 10.4103/jfmpc.jfmpc_163_18, PMID 30598942