South Asian diabetic patients need more education about their illnessBMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7092.1486 (Published 17 May 1997) Cite this as: BMJ 1997;314:1486
- Kamila Hawthorne, General practitionera
Editor—I hope that Veena Soni Raleigh's article on the necessity to plan now for the future health needs of Britain's South Asians is read and understood by the people who matter (Britain's health planners and the holders of the health budgets).1 We are certainly facing a serious problem for the South Asian community in the next few decades. The article quotes a study from Nottingham in 1990 on the knowledge of diabetes and its complications among South Asians attending a hospital diabetic clinic, which compared them with matched white diabetic patients.2 A more recent study, of 200 randomly selected South Asian patients attending Manchester Diabetes Centre in 1993-4, found similar results: 168 patients could not name any diabetic complications, 99 were unsure of the reasons for monitoring and controlling glucose concentrations, 175 did not know the purpose of attendances at the clinic to screen for early complications, and 183 did not know what a chiropodist did or how to see one. In addition, a hard core, consisting of older women with no experience of formal education, was found to have poorer diabetic control than the rest as well as less knowledge of diabetes (the average glycated haemoglobin concentration for the 107 women in the study was 8.79%, compared with 8.14% for the 94 men (P=0.04)). These patients' educational requirements need to be urgently addressed if we are to prevent further morbidity, improve quality of life, and use resources effectively.
The patients reported on in the Nottingham and Manchester studies were largely Pakistani Moslems. British South Asian communities vary enormously in terms of language, culture, religion, diet, and degree of Westernisation. In addition, this variation is dynamic: it changes from year to year as the younger generations grow up in a British environment. Any educational interventions or health service programmes for South Asians need cultural assessment in the environment of the target community and also careful audit by the community itself to avoid irrelevance and to promote optimal uptake.