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Influence of Diabetes Education on Blood Glucose Monitoring Practices among Adults with Diabetes in Nigeria

Abstract

Diabetes mellitus is a major public health concern in Nigeria and is associated with significant morbidity, mortality, disability, and healthcare costs when poorly controlled. Effective diabetes management requires individuals to understand their condition and adopt appropriate self-management practices, including monitoring blood glucose as recommended by qualified healthcare professionals. Blood glucose monitoring can provide useful information for assessing glycaemic control, identifying abnormal glucose levels, supporting treatment decisions, and recognizing patterns that may require medical attention. Diabetes education provides adults with information about the nature of diabetes, blood glucose control, appropriate monitoring methods, recommended monitoring frequency, interpretation of results, medication adherence, nutrition, physical activity, recognition of symptoms associated with abnormal blood glucose levels, and appropriate healthcare seeking. Blood glucose monitoring practices refer to behaviours related to the appropriate and consistent monitoring of blood glucose using recommended methods and responding appropriately to monitoring results. In Nigeria, inadequate diabetes knowledge, cost of monitoring equipment and supplies, limited access to healthcare services, inadequate self-management support, misconceptions, and difficulties maintaining regular monitoring may affect blood glucose monitoring practices among adults with diabetes. Effective diabetes education may improve patients' knowledge, self-efficacy, and confidence in monitoring their blood glucose and may encourage appropriate self-management practices. Against this background, this study investigates the influence of diabetes education on blood glucose monitoring practices among adults with diabetes in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding individuals' decisions to engage in appropriate blood glucose monitoring. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping diabetes self-management behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from diabetes education may influence blood glucose monitoring practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how diabetes education may influence blood glucose monitoring practices among adults with diabetes in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from adults receiving diabetes care at selected healthcare facilities in Nigeria using a structured interviewer-administered questionnaire and, where appropriate, a validated self-management or blood glucose monitoring practice assessment tool. A multistage sampling technique will be employed to select states, local government areas, healthcare facilities, diabetes clinics, and eligible adults with diabetes. Where feasible, selected participant groups or healthcare facilities will be assigned to intervention and comparison groups. Participants in the intervention group will receive structured diabetes education covering diabetes management, the importance of blood glucose monitoring, appropriate monitoring techniques, recommended monitoring schedules based on individual treatment plans, interpretation of results, recording and reporting glucose readings, medication adherence, dietary management, physical activity, recognition of abnormal glucose levels, and appropriate healthcare seeking. Blood glucose monitoring practices will be assessed using indicators such as frequency of monitoring according to individual clinical recommendations, correct use of glucose-monitoring equipment, recording of results, proper storage and handling of monitoring supplies, response to abnormal readings, and communication of relevant results to healthcare professionals. Descriptive statistics will be used to summarize participants' sociodemographic and clinical characteristics, diabetes knowledge, exposure to education, and blood glucose monitoring practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the influence of diabetes education on blood glucose monitoring practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that diabetes education has a significant positive influence on blood glucose monitoring practices among adults with diabetes in Nigeria. Adults exposed to structured diabetes education are expected to demonstrate improved understanding of diabetes management and greater adherence to appropriate blood glucose monitoring practices. Education may improve knowledge of the importance of monitoring, increase confidence in using monitoring devices, improve interpretation and recording of results, encourage appropriate responses to abnormal readings, and strengthen communication with healthcare providers. However, diabetes education alone may not guarantee consistent monitoring because adults may continue to face barriers such as the cost of glucometers and test strips, limited access to healthcare services, lack of electricity or suitable storage conditions in some settings, competing household responsibilities, discomfort associated with testing, and limited availability of ongoing diabetes self-management support. Consequently, diabetes education is expected to be most effective when supported by affordable monitoring supplies, accessible diabetes care, regular clinical follow-up, trained healthcare professionals, and continuous self-management support. The study is expected to contribute to the literature on diabetes self-management, chronic disease education, blood glucose monitoring, non-communicable disease prevention and control, patient education, and public health in Nigeria by providing empirical evidence on the influence of diabetes education on blood glucose monitoring practices among adults with diabetes. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), state ministries of health, diabetes clinics, primary healthcare facilities, healthcare professionals, diabetes educators, community health workers, development partners, and policymakers regarding strategies for improving diabetes self-management. The study will also provide evidence-based recommendations for strengthening diabetes education programmes, improving access to affordable blood glucose monitoring supplies, enhancing patient counselling, strengthening follow-up and self-management support, and promoting appropriate blood glucose monitoring practices among adults with diabetes across Nigeria.

Keywords: Diabetes education, blood glucose monitoring practices, adults with diabetes, diabetes mellitus, diabetes self-management, glycaemic control, patient education, chronic disease management, self-care practices, non-communicable diseases, public health, Nigeria.