# A cross-sectional primary care study of knowledge, attitudes, and practices of type 2 diabetes self-care and their association with sociodemographic and sociocultural factors in Cali, Colombia

## TL;DR

This study examines how well people with type 2 diabetes in Cali, Colombia manage their condition, and how factors like age, gender, and socioeconomic status influence their self-care behaviors.

## Contribution

The study provides a culturally adapted assessment of diabetes self-care knowledge, attitudes, and practices in a Latin American urban setting.

## Key findings

- Most participants showed high knowledge and positive attitudes toward diabetes self-care.
- Gaps were found in meal planning and understanding blood-glucose monitoring.
- Sociocultural factors like socioeconomic stratum and household size significantly influenced self-care behaviors.

## Abstract

Type 2 diabetes mellitus (T2DM) represents a major and rising clinical and economic challenge in Latin America. Strengthening patients’ knowledge, attitudes, and practices (KAP) is essential to improve self-care behaviors and optimize primary care outcomes.

To assess self-care KAP among adults with T2DM in Cali, Colombia, and to examine their associations with sociodemographic and sociocultural factors.

A cross-sectional observational study was conducted among adults (≥18 years) with confirmed T2DM enrolled in a public primary-care network in Cali (January 2020–June 2024). Data were obtained through a 43-item structured questionnaire comprising the culturally adapted DKQ-24 (knowledge), Likert-type items (attitudes), and an adapted SDSCA incorporating traditional-medicine practices. KAP scores were categorized a priori. Descriptive statistics were used to characterize the sample, and chi-square tests examined associations between sociodemographic/sociocultural variables and KAP levels.

Of 336 participants, most were women (62.2%) and older adults (≥60 years, 65.7%). High knowledge was observed in 81.8%, positive attitudes in 99.0%, and frequent practices in 88.1%. Gaps emerged in daily meal planning (26.5% correct) and understanding the value of blood-glucose self-monitoring (31.8% correct). Strong behaviors included medication adherence and foot care (both 76.0% frequent); risk behaviors were uncommon (recent smoking 4.0%; dessert/sweet intake 19.0%). Knowledge was significantly associated with socioeconomic stratum (p = 0.003), with lower performance at extreme strata. Attitudes differed by marital status (p = 0.001), religion (p < 0.001), socioeconomic stratum (p < 0.001), and household size (p < 0.001), showing lower positivity among widowed individuals and households with more than five members.

Adults with T2DM in this urban primary-care setting demonstrate a favorable KAP profile, though persistent gaps remain in dietary planning and glycemic self-monitoring. Targeted, culturally sensitive educational strategies—integrating family and faith-based networks—should prioritize these areas while reinforcing adherence and foot care. Multivariable and longitudinal analyses are recommended to deepen understanding and evaluate tailored interventions.