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Effect of Diabetes Self-Care Education on Self-Care Practices among Adults Living with Diabetes in Nigeria

Abstract

Diabetes mellitus is a major public health concern and a chronic condition that requires continuous self-management to reduce the risk of complications and improve quality of life. Effective diabetes self-care involves a range of daily practices, including appropriate dietary management, regular physical activity, adherence to prescribed medications, blood glucose monitoring where indicated, foot care, regular medical follow-up, recognition of warning signs, and appropriate management of illness. Diabetes self-care education is an important component of diabetes management because it provides individuals with the knowledge, practical skills, and confidence required to manage their condition effectively. In Nigeria, adults living with diabetes may experience challenges in maintaining appropriate self-care practices because of inadequate diabetes knowledge, high healthcare and medication costs, limited access to diabetes education, dietary and cultural influences, misconceptions about the disease, limited access to glucose-monitoring equipment, and difficulties maintaining regular healthcare appointments. Effective self-care education may improve patients' understanding of diabetes management and encourage consistent adoption of recommended self-care practices. Against this background, this study investigates the effect of diabetes self-care education on self-care practices among adults living with diabetes in Nigeria. The study is anchored on the Health Belief Model (HBM), Social Cognitive Theory (SCT), and Self-Efficacy Theory. The Health Belief Model explains health-related behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding patients' decisions to adopt recommended diabetes self-care practices. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, behavioural capabilities, social influences, and environmental conditions in shaping self-management behaviour. Self-Efficacy Theory emphasizes individuals' confidence in their ability to perform specific health behaviours and maintain them despite challenges, making it particularly relevant to diabetes self-management. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how diabetes self-care education may influence self-care practices among adults living with diabetes in Nigeria. The study adopts a quantitative quasi-experimental research design. Primary data will be collected from adults living with diabetes who attend selected public and private healthcare facilities in Nigeria using a structured interviewer-administered questionnaire and, where appropriate, a validated diabetes self-care assessment instrument. A multistage sampling technique will be employed to select states, local government areas, healthcare facilities, and eligible participants. Where feasible, selected participants or healthcare facilities will be assigned to intervention and comparison groups. Participants in the intervention group will receive structured diabetes self-care education covering diabetes management, healthy dietary practices, physical activity, medication adherence, blood glucose monitoring where indicated, foot-care practices, recognition of hypo- and hyperglycaemia warning signs, sick-day management, regular clinical follow-up, and appropriate healthcare-seeking behaviour. Self-care practices will be assessed using indicators such as medication adherence, dietary adherence, physical activity, blood glucose monitoring where indicated, foot care, attendance at scheduled clinical appointments, and appropriate management of diabetes-related symptoms. Descriptive statistics will be used to summarize participants' sociodemographic and clinical characteristics, exposure to diabetes self-care education, and self-care practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be employed to determine the effect of diabetes self-care education on self-care practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and the robustness of the findings. The study anticipates that diabetes self-care education will have a significant positive effect on self-care practices among adults living with diabetes in Nigeria. Participants exposed to structured self-care education are expected to demonstrate improved knowledge of diabetes management and greater adherence to recommended self-care behaviours. Education may improve medication adherence, dietary management, physical activity, glucose monitoring where appropriate, foot-care practices, recognition of warning signs, and regular utilization of healthcare services. However, education alone may not guarantee sustained self-care because individuals may face barriers such as medication costs, limited access to healthy foods, inadequate access to glucose-monitoring equipment, transportation challenges, competing household responsibilities, cultural beliefs, and limited availability of diabetes educators and specialist services. Consequently, diabetes self-care education is expected to be most effective when supported by affordable treatment, accessible healthcare services, regular clinical follow-up, appropriate monitoring resources, family support, and continuous patient education. This study is expected to contribute to the literature on diabetes management, chronic disease prevention, self-care, patient education, health promotion, and public health in Nigeria by providing empirical evidence on the effect of diabetes self-care education on self-care practices among adults living with diabetes. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, state ministries of health, hospitals, primary healthcare facilities, diabetes clinics, endocrinologists, nurses, nutrition professionals, community health workers, diabetes educators, patient-support organizations, development partners, and policymakers regarding strategies for improving diabetes self-management. The study will also provide evidence-based recommendations for strengthening diabetes self-care education, integrating structured diabetes education into routine clinical care, improving access to affordable diabetes management resources, strengthening follow-up services, promoting family-supported self-management, and expanding community-based diabetes education programmes across Nigeria.

Keywords: Diabetes self-care education, self-care practices, diabetes mellitus, adults living with diabetes, diabetes management, medication adherence, blood glucose monitoring, diabetes education, chronic disease management, health promotion, public health, Nigeria.