Survey Data on the Knowledge, Attitudes, and Practices of Patients Attending the Diabetes Control Program in a Network of Health Institutions in Cali, Colombia

Abstract

Diabetes is a global and local epidemic, with an exponential growth trend in prevalence rates. This article presents data collected through a survey administered to a probabilistic sample of patients enrolled in a diabetes control program within a network of health institutions in Cali, Colombia. The purpose of the survey was to explore knowledge, attitudes, and practices related to diabetes. The survey was designed as part of the quantitative component of a mixed methods macroproject, and the questionnaire was developed based on a review of the literature and the research team’s expertise in the field. The results of the article correspond to the description of the database and combine raw survey data with additional analytical variables derived from grouped response options or recoded items. The data provides a valuable source of information for further research and for decision-makers interested in diabetes risk management. In conclusion, this database enables other broader studies on factors related to adherence to conventional treatments and the use of nonconventional treatments for type 2 diabetes.

Dataset: 10.17632/4wwxz3hfgx.1

Dataset License: CC BY 4.0

1. Summary

Diabetes is an epidemic disease globally, regionally, and locally [1], with the majority of cases corresponding to type 2 diabetes mellitus (T2DM), accounting for approximately 90% of cases [2]. It is estimated that approximately 35 million people in Latin America live with this condition, and the number is expected to rise exponentially in the coming years owing to increased life expectancy, sedentary lifestyles, and changes in dietary patterns [2]. T2DM increases healthcare costs at all levels, leads to acute and chronic complications, disability, and premature death and negatively impacts the quality of life of patients and their families [3]. Because T2DM is closely linked to lifestyle, recognizing knowledge, attitudes, and practices and promoting changes in these areas are considered effective strategies for disease prevention and for delaying chronic complications [4]. Good self-care practices and adherence to treatment under the guidance of healthcare professionals remain major public health challenges in T2DM interventions.

The literature review identifies gaps in scientific knowledge regarding knowledge, attitudes, and practices (KAP) about T2DM. In Brazil, the study by Martins et al. showed the low prevalence of knowledge and positive attitudes towards T2DM, most participants had low understanding of self-care practices and disease management. Therefore, they did not have a positive attitude toward the expected lifestyle modifications essential for achieving metabolic control; and these findings were also demonstrated in other studies in Latin America [5]. In Honduras, the study by Castro shows that 62% of the population with T2DM is unaware of the cause of their disease, and they also do not know what hypoglycemia is or what the complications of diabetes are [6].

Another study conducted in Ecuador regarding the use of non-conventional medicine for the management of diabetes shows the use of herbal medicine and acupuncture with results of 39% of the patients surveyed opting for these practices due to family customs [7]. The study of social representations of people with T2DM by Andrade, published in 2021 and carried out in Colombia, highlights other relevant aspects of diabetic behavior, such as the importance of education on diabetes control and treatment adherence, and the importance of self-care and family support [8].

This article presents the database obtained from a probabilistic sample of 336 patients with T2DM [9] through a survey administered to patients enrolled in a diabetes control program within a network of health institutions in Cali, Colombia. The purpose of the survey was to explore knowledge, attitudes, and practices related to diabetes. This database is valuable because it contains a set of variables across three domains relevant to diabetes management: knowledge, attitudes, and health practices related to the disease, such as diet, physical activity, tobacco and alcohol use, use of conventional and nonconventional medicine, etc. Notably, the database is useful for broader studies on factors associated with adherence to conventional and nonconventional treatments, providing a valuable source of information for further research and for decision-makers concerned with diabetes risk management.

2. Data Description

Information on the specific characteristics and access to the database is presented in

Table 1. Specifications table.

Subject area	Health Sciences, Medical Sciences, and Pharmacology
More specific subject area	Diabetes and Metabolism, Public Health, and Health Policy
Type of data
How data was acquired	The survey data were collected in 2024 using a structured questionnaire administered through face-to-face interviews to a random sample of active patients enrolled in the diabetes control program within a network of health institutions in Cali, Colombia. The data collection instrument consisted of a 43-item questionnaire on knowledge, attitudes, and practices, developed based on the review of 15 previous studies and was refined through two pilot tests.
Data source Location	Country: Colombia, Universidad Santiago de Cali
Data accessibiity	Repository name: Mendeley Data Data identification number: DOI: 10.17632/4wwxz3hfgx.1 Direct URL: https://doi.org/10.17632/4wwxz3hfgx.1

.

The database is subdivided into five sections: (i) Sociodemographic Data, (ii) Knowledge of T2DM, (iii) Attitudes, (iv) Practices related to the disease, and (v) Nonconventional treatments.

2.1. Sociodemographic Data

The database includes nine variables related to the sociodemographic characteristics of the respondents, distributed across a wide range of categories, as shown in

Table 2. Sociodemographic data of participants in the survey on knowledge, attitudes, and practices of patients attending the diabetes control program in a network of health institutions in Cali (n = 336).

Variable	Category	n	(%)
Marital status	Single	143	42.56
	Married	90	26.79
	Common-law marriage	50	14.88
	Widower	49	14.58
	Separated/Divorced	4	1.19
Religion	Catholic	233	69.35
	Christian	72	21.43
	Other	23	6.85
	Jehovah’s Witness	7	2.08
	Mormon	1	0.3
Socioeconomic stratum	0	7	2.08
	1	67	19.94
	2	172	51.19
	3	83	24.7
	4	6	1.79
	5	1	0.3
Level of education	Incomplete elementary school	117	34.82
	Completed primary school	73	21.73
	Incomplete high school	67	19.94
	Complete high school	53	15.77
	Technicians	18	5.36
	University students	8	2.38
Cohabiting with family members	Yes	288	85.71
	No	48	14.29
Number of cohabitants	Alone	38	11.31
	1	77	22.92
	2	71	21.13
	3	53	15.77
	4	47	13.99
	5	26	7.74
	>5	24	7.14
Relationship with their cohabitants	Bad	3	0.89
	Regular	24	7.14
	Good	270	80.36
	Not applicable	38	11.31
	No response	1	0.3
Belongs to a social group	No	293	87.2
	Yes	43	12.8
Someone supports you in your treatment and your illness	Yes	240	71.43
	No	96	28.57

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Additionally, the database includes two variables with open-text responses corresponding to (i) The city of residence, and (ii) The person who supports patients with T2DM.

2.2. Knowledge Data

The knowledge section of the database includes nine variables, and an additional summary variable that classifies the level of knowledge (low, medium, or high). These are described in

Table 3. Knowledge of patients attending the diabetes control program in a network of health institutions in Cali (n = 336).

Variable	Category	Frequency (%)
How long ago were you diagnosed with type 2 diabetes mellitus?	More than five years ago	154 (45.83%)
	Between one and five years ago	140 (41.67%)
	Less than one year ago	42 (12.50%)
If you have diabetes, how often should you see your doctor?	Every three–six months	225 (66.96%)
	Once a month	100 (29.76%)
	Once a year	11 (3.27%)
Testing your blood sugar level helps you:	Feel better because your blood sugar is better controlled	187 (55.65%)
	Change your meals, physical activity, or medications to keep your blood sugar levels in the right range	179 (53.27%)
	Identify high and low blood sugar levels before you have serious problems	173 (51.49%)
	Prevent diabetes complications	149 (44.35%)
How often should you test your blood sugar?	Once or twice a day	156 (46.43%)
	Never	78 (23.21%)
	Four or five times a week	62 (18.45%)
	Three times or more per day	40 (11.90%)
Frequent urination and thirst are signs of low blood sugar	No	192 (57.14%)
	Yes	144 (42.86%)
If you notice increased thirst, more frequent urination, weight loss, sugar in your urine or loss of appetite, what do you think is wrong?	High blood sugar (or glucose)	154 (45.83%)
	Does not know/does not answer	97 (28.87%)
	Normal blood sugar (or glucose) levels	43 (12.80%)
	Low blood sugar (or glucose) levels	42 (12.50%)
What do you know about alternative treatments to improve diabetes (herbs, acupuncture, homeopathy, and/or supplements)?	They can be used in addition to medications or pills prescribed by your physician	179 (53.27%)
	Never used them	51 (15.18%)
	Does not know/does not answer	49 (14.58%)
	They can replace the drug therapy you were sent if you notice that you are feeling better	40 (11.90%)
	They are prohibited because they alter sugar levels	17 (5.06%)
Have you used alternative treatments?	Yes	223 (66.37%)
	No	113 (33.63%)
How many meals a day does a patient with diabetes eat?	Three: breakfast, lunch, and dinner	201 (59.82%)
	Five: breakfast, lunch, lunch, snack, and dinner	89 (26.49%)
	Eat whenever you are hungry	37 (11.01%)
	Does not know/does not answer	9 (2.68%)
Level of knowledge	Low	24 (7.1%) 37 (11.0%) 275 (81.8%)
	Medium
	High

.

2.3. Attitude Data

The database in the attitudes section includes five variables, which are described in

Table 4. Attitude of patients attending the diabetes control program in a network of health institutions in Cali (n = 336).

Variable	Category	Frequency (%)
What was your attitude like when you were diagnosed with diabetes?	Acceptance because they felt unwell and this explained why	156 (46.43%)
	Fear and sorrow because it is an incurable disease	90 (26.79%)
	Disbelief about the diagnosis being true	72 (21.43%)
	Other	46 (13.69%)
	Anger and despair because it is a punishment	37 (11.01%)
Are you interested in learning how to do caregiving activities to prevent complications?	Yes	292 (86.90%)
	No	33 (9.82%)
	Does not know/does not answer	11 (3.27%)
Are you willing to change your lifestyle to manage your diabetes?	Yes	310 (92.26%)
	No	20 (5.95%)
	Does not know/does not answer	6 (1.79%)
Which of the following lifestyle changes has posed the most difficulty in managing your diabetes?	Diet	182 (54.17%)
	Exercise or physical activity	137 (40.77%)
	Weight control	88 (26.19%)
	Regular blood glucose monitoring	88 (26.19%)
	Attend medical checkups with a physician	72 (21.43%)
	None	36 (10.71%)
	Other	3 (0.89%)
	Does not know/does not answer	1 (0.30%)
What was your reaction like when you were prescribed treatment (pill or insulin)?	Fear	106 (31.55%)
	Other	80 (23.81%)
	Sadness, exhaustion	77 (22.92%)
	Apathy, discouragement	69 (20.54%)
	Neglect and noncompliance	50 (14.88%)
	Feeling of being defeated	32 (9.52%)

.

2.4. Practices Data

The practices section of the database includes 12 questions and a summary variable that classifies the frequency level (infrequent or very frequent); these are described in

Table 5. Practices of patients attending the diabetes control program in a network of health institutions in Cali (n = 336).

Variable	Category	Frequency
On how many of the last 7 days did you eat five or more servings of fruits and vegetables?	0	36 (10.71%)
	1	24 (7.14%)
	2	44 (13.1%)
	3	68 (20.24%)
	4	26 (7.74%)
	5	26 (7.74%)
	6	12 (3.57%)
	7	100 (29.76%)
On how many of the last 7 Days did you include sweets or desserts in your meals?	0	144 (42.86%)
	1	70 (20.83%)
	2	40 (11.9%)
	3	17 (5.06%)
	4	13 (3.87%)
	5	9 (2.68%)
	6	9 (2.68%)
	7	34 (10.12%)
On how many of the last 7 days did you participate in at least 30 min of physical activity? (Total minutes of continuous activities, such as walking).	0	104 (30.95%)
	1	32 (9.52%)
	2	44 (13.1%)
	3	27 (8.04%)
	4	17 (5.06%)
	5	16 (4.76%)
	6	7 (2.08%)
	7	89 (26.49%)
On how many of the last 7 days did you engage in a specific exercise session (e.g., swimming, walking, or cycling) other than what you normally do at home or as part of your job?	0	135 (40.18)
	1	36 (10.71%)
	2	33 (9.82%)
	3	20 (5.95%)
	4	10 (2.98%)
	5	16 (4.76%)
	6	3 (0.89%)
	7	83 (24.7%)
On how many of the last 7 days did you test your blood glucose as many times as recommended by your treating physician?	0	120 (35.71%)
	1	34 (10.12%)
	2	31 (9.23%)
	3	32 (9.52%)
	4	15 (4.46%)
	5	8 (2.38%)
	6	7 (2.08%)
	7	89 (26.49%)
On how many of the last 7 days did you check your feet?	0	51 (15.18%)
	1	28 (8.33%)
	2	17 (5.06%)
	3	23 (6.85%)
	4	12 (3.57%)
	5	9 (2.68%)
	6	4 (1.19%)
	7	192 (57.14%)
On how many of the last 7 days did you dry your feet, including the spaces between the toes after washing your feet?	0	35 (10.42%)
	1	25 (7.44%)
	2	11 (3.27%)
	3	11 (3.27%)
	4	14 (4.17%)
	5	8 (2.38%)
	6	9 (2.68%)
	7	223 (66.37%)
On how many of the last 7 days did you take your recommended diabetes medications?	0	35 (10.42%)
	1	25 (7.44%)
	2	12 (3.57%)
	3	7 (2.08%)
	4	10 (2.98%)
	5	11 (3.27%)
	6	8 (2.38%)
	7	228 (67.86%)
On how many of the last 7 days did you take the recommended number of pills or insulin for diabetes?	0	34 (10.12%)
	1	25 (7.44%)
	2	16 (4.76%)
	3	12 (3.57%)
	4	9 (2.68%)
	5	5 (1.49%)
	6	12 (3.57%)
	7	223 (66.37%)
Have you smoked cigarettes, including up to one puff, during the past 7 days?	Yes	15 (4.46%)
	No	321 (95.54%)
	Total	336 (100%)
If yes, on average, how many cigarettes did you smoke per day? Write the number of cigarettes:	1	5 (1.49%)
	3	5 (1.49%)
	4	1 (0.3%)
	5	1 (0.3%)
	6	1 (0.3%)
	7	1 (0.3%)
	10	1 (0.3%)
	N.A.	321 (95.54%)
When was the last time you smoked a cigarette?	I have never smoked	256 (76.19%)
	More than two years ago	55 (16.37%)
	One or two years ago	5 (1.49%)
	Four–twelve months ago	4 (1.19%)
	One–three months ago	3 (0.89%)
	During the last month	7 (2.08%)
	Today	6 (1.79%)
Practice level	Infrequent	40 (11.9%)
	Very frequent	296 (88.1%)

.

2.5. Nonconventional Treatment Data

The nonconventional treatment section of the database includes seven questions, which are described in

Table 6. Nonconventional treatment of patients attending the diabetes control program in a network of health institutions in Cali (n = 336).

Variable	Category	Frequency (%)
Uses nonconventional medicine (waters, herbs, acupuncture, drinks, supplements, fruits, and other substances).	Yes	221 (65.77%)
	No	115 (34.23%)
How often do you use nonconventional medicine?	Every day	91 (27.08%)
	Some days	130 (38.69%)
	Never	115 (34.23%)
Have you received guidance in using nonconventional medicine?	Yes	276 (82.14%)
	No	60 (17.86%)
How did you receive guidance in the use of nonconventional medicine?	Through friends	164 (48.81%)
	Through a neighbor	91 (27.08%)
	Has not received orientation	60 (17.86%)
	You tube	46 (13.69%)
	Doctor	37 (11.01%)
	Other	32 (9.52%)
	TV/Radio	31 (9.23%)
	WhatsApp	8 (2.38%)
Do you feel that nonconventional medicine can help you treat diabetes?	Yes	228 (67.86%)
	No	33 (9.82%)
	Does not know/Does not answer	75 (22.325)
What is the current state of your diabetes?	Controlled	264 (78.57%)
	Uncontrolled	38 (11.31%)
	Does not know	34 (10.12%)
How do you feel your diabetes is controlled? Regardless of how you currently feel.	I don’t feel dizzy	216 (64.29%)
	I don’t feel weak	209 (62.20%)
	I don’t get hungry or crave food	130 (38.69%)
	My urge to drink water or go to the bathroom decreases	107 (31.85%)
	Other	35 (10.42%)

.

3. Methods

The database was collected using the framework of a mixed-methods macroproject and constitutes a product of quantitative component with an observational, cross-sectional design, developed using the survey method to explore health-related knowledge, attitudes, and practices (KAP) regarding T2DM.

The unit of observation for the target population was individuals diagnosed with diabetes (

Table 7. Population and sample of the KAP survey of patients with diabetes in Cali, Colombia, 2024.

Population Universe	Study Population	Sampling Frame	Study Sample
Patients with diabetes in Cali in 2024	Patients with type 2 diabetes mellitus enrolled in the diabetes control program in the Red de Salud del Norte de Cali (Northern Cali Health Network) years 2020–2024.	Patients with type 2 diabetes mellitus enrolled in the diabetes control program in the Red de Salud del Norte de Cali who met the inclusion criteria.	Study sample of patients calculated for the study.
112.136 *	3416	1465	336

* Source: Statistical data from Red de Salud Norte (Northern Cali Health Network), ESE, 2024. Estimated according to the prevalence document in the Cali Health Situation Analysis, 2023.

). The study population consisted of patients who were receiving care or were registered in the database of a network of health institutions in Cali, Colombia. The inclusion criteria for the sampling framework were: Individuals >18 years of age, residing in Colombia, and enrolled in the control program with a diagnosis of T2DM. Exclusion criteria were: Individuals who did not sign the consent form to participate in the study, individuals with type 1 diabetes mellitus, and individuals with T2DM who had comorbidities such as cancer, hypothyroidism, chronic kidney disease, mental illness, or any severe disability. The CAP Diabetes Study (observational) was designed to describe adults in a primary healthcare program. The majority of these patients are diabetics with manageable underlying hypertension. The most complex patients are referred to another level of care not covered by the study. Exclusion criteria were defined to describe diabetic patients managed in primary care and to capture their attitudes and practices related to diabetes as accurately as possible. That is, other complex pathologies uncommon in primary care are excluded to prevent confounding bias that may arise in attitudes and practices related to other comorbidities.

Simple random sampling was used, calculated with 95% confidence and a 4.69% margin of error. For the selection of participants, a random number list was used until reaching a total of 336 individuals.

The data collection instrument consisted of a questionnaire of 43 questions grouped into five sections: Section 1, sociodemographic data; Section 2, knowledge; Section 3, attitudes; Section 4 practices; and Section 5, nonconventional treatment use. The questionnaire was developed through a process that included the review of 15 studies, focusing on Latin American KAP research [10,11,12,13,14,15,16,17,18,19,20,21,22,23], and was refined through two pilot tests.

For the knowledge section, validated questions from the Diabetes Knowledge Questionnaire (DKQ) 24 were included. This instrument was originally developed in Spanish by García et al. in 2001 [19] and later adapted to the Peruvian context by Guerrero in 2021 [20]. This module included nine questions related to T2DM, covering aspects such as symptoms, control measures, diet, and conventional and nonconventional medical treatment. This knowledge was classified into three levels: low, medium, and high knowledge. In the attitude section, five questions were established regarding the disease, care actions, lifestyle, and treatment. Finally, in the practice section, questions from the Summary of Diabetes Self-Care Activities questionnaire (SDSCA) were included as it is one of the most widely used instruments to measure self-care. The instrument was validated for Colombia in a 2015 study conducted in the city of Bogota. The practice questions are related to the self-care of patients with T2DM, and include 12 questions oriented to diet, exercise, alcohol intake and tobacco use. The final section includes questions regarding nonconventional medicine use and disease management.

To ensure the quality of the data collection process, surveyors were previously trained in the characteristics of the survey, the instruments, and the completion of the informed consent form. The survey was administered through face-to-face interviews, using a virtual format for online collection using Google Forms. Patients were selected randomly from the institutional list of the sampling frame and were contacted via telephone and summoned to the health institution near their residence. In addition, as a replacement strategy for those who did not attend the meeting, patients who attended the diabetes program control appointment were interviewed, verifying the inclusion and exclusion criteria.

Within the ethical considerations, and according to Colombian resolution 8430 of 4 October 1993, the study is classified in the category of minimal risk (Section 11) given that a survey of individuals was used to collect primary data. The international ethical principles of the Declaration of Helsinki and its updates were also followed, ensuring the autonomy, confidentiality, dignity, rights, and well-being of the participants. Therefore, informed consent was obtained to ensure participants’ autonomy in freely deciding whether to take part in the study, with the document explaining the study objectives, benefits, scope, risks, and their mitigation. Strategies to ensure the confidentiality of the information included the use of codes to protect personal data in the database and storage in a password-protected file accessible only to the researchers. The macroproject that generated the database, entitled “Knowledge, Attitudes, and Practices of Patients Attending the Diabetes Risk Control Program in the Red de Salud ESE Norte, Period 2020–2024”, was approved by the ethics committee of the Network of Health Institutions (Act No. 03, 7 June 2024) and the endorsement of the Research Directorate of the University where the researchers are affiliated (No. 094/2024 of 4 July 2024).