Type 2 diabetes care: knowledge and clinical practice among medical practitioners at Medical Teaching Institute Mardan, Pakistan - a cross-sectional study.

BACKGROUND

Type 2 Diabetes Mellitus (T2DM) poses a major health burden in Pakistan, where a shortage of endocrinologists places the responsibility of care on medical practitioners. Global studies reveal significant gaps in GP knowledge and practices. However, no such data exists for Pakistan, particularly in the Mardan region.

METHODS

This analytical cross-sectional study was conducted at Mardan Medical Complex, Pakistan, between January and March 2025, targeting licensed medical practitioners who had completed their MBBS and one-year internship. Participants were recruited using convenience sampling, and data were collected through a 34-item questionnaire covering demographics, T2DM knowledge, practices, barriers, confidence, and attitudes. Statistical analyses were performed in SPSS (IBM v27.0), using descriptive statistics and logistic regression, with a significance level of p < 0.05.

RESULTS

A total of 178 medical practitioners participated. The mean diabetes knowledge score was 9.05 ± 2.52 out of 14. Significant predictors of higher knowledge included managing >40 diabetic patients per week (p = 0.002), and working in medical rather than surgical specialties (p = 0.007). Years of practice was also a significant predictor (p = 0.043). Only 52.8% correctly identified the diagnostic HbA1c threshold (≥6.5%), 64.6% the fasting glucose cut-off (≥126 mg/dL), 74.72% the random glucose level (≥200 mg/dL). While Caring for Diabetes patients 97.8% advised lifestyle modification and 91% utilized HbA1c testing, only 51.1% routinely performed foot exams. Major reported barriers included high treatment costs (84.8%), poor patient compliance (81.5%), limited specialist access (52.8%), and absence of clinical protocols (50.6%). Importantly, 93.3% of practitioners expressed willingness to attend diabetes-focused CME programs.

CONCLUSION

Medical practitioners at public hospitals show moderate knowledge of type 2 diabetes, with good awareness of symptoms but notable gaps in diagnosis, guideline adherence, and complication screening.