Publication:

Evaluation of clinicians’ perspectives and approaches to the challenges in the management of diabetes mellitus in tribal population: a cross-sectional, observational pilot study

Background Management of diabetes mellitus in tribal population poses unique challenges due to their distinct socio-cultural fabric. Understanding clinicians’ perspectives and their approach is crucial for effective management strategies. Objective was to study clinicians’ perspective and approach to managing the challenges in treatment of diabetes mellitus (DM) in tribal population.

Methods A cross-sectional observational pilot study was conducted with 50 clinicians treating minimum of 5% tribal patients. Data collected using a validated semi-structured questionnaire via Google forms, focusing on challenges related to comprehension, communication and compliance, alongside open-ended questions for potential solutions.

Results 50 clinicians participated, with median clinical experience of 4 years. The median estimated prevalence of diabetes was 20% with 15.2% patients attending regular follow-ups. Tribals preferred non-allopathic treatments, with Ayurveda being the most favoured (76%). Healthcare-workers (70%) were primary source of health-related information. Major challenges included lack of follow-ups (78.3%) and low awareness (66%). Language barrier (28%) leading to extended counselling time (26%) were predominant communication issues. Metformin and glimepiride were the most prescribed medications due to their free availability from government programs. Moderately positive correlation (0.515) was observed between follow-up and awareness. Clinicians suggested increased community health programs (32%), ensuring adequate drugs and glucometers (26%) as some solutions.

Conclusions The study highlighted various challenges faced in the management of diabetes in tribal population. Language barriers, low medication adherence, disease awareness and negligent approach are critical barriers. Community educational initiatives, improved diagnostic availability, and improving awareness may help in mitigating these challenges.