A Community Based Study-Effectiveness of nurse directed interventions on knowledge and health-promotion behavior of patients with Type-2 Diabetes Mellitus

A Community Based Study-Effectiveness of nurse directed interventions on knowledge and health-promotion behavior of patients with Type-2 Diabetes Mellitus | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Community Based Study-Effectiveness of nurse directed interventions on knowledge and health-promotion behavior of patients with Type-2 Diabetes Mellitus abhay Pattan, Milankumar Chauhan, Jahnvi Patel, Priyanka Baria This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8665478/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Historically, national health policies have primarily focused on communicable diseases and malnutrition. While these issues remain relevant in many low- and middle-income countries, recent changes in lifestyle patterns have contributed to a rising prevalence of non-communicable diseases (NCDs). These include diabetes, cardiovascular disorders, obesity, and joint diseases. Developing nations are experiencing an epidemiological transition, driven by sedentary behavior, unhealthy dietary habits, and increased substance use. As a result, they are increasingly vulnerable to NCD epidemics in the coming years. Methods : A quasi-experimental study was conducted in selected rural communities of Vadodara. The study was based on Nola Pender’s Health Promotion Model and focused on individual characteristics, behavior-specific cognitions, and behavioral outcomes. Nurse-directed interventions were implemented to improve knowledge and health-promotion behaviors among patients with Type 2 Diabetes Mellitus (T2DM). Results :The mean pre-test health-promotion behavior score was 14.26 ± 5.824. This significantly increased to 38.55 ± 4.908 in the post-test. The mean difference was 24.29, with a t-value of 38.04 (df = 147) and a highly significant p-value of 0.001 (p < 0.05). These results indicated that nurse-directed interventions were highly effective in improving health- promotion behaviors among T2DM patients. Conclusion : Nurse-directed interventions played a vital role in enhancing knowledge and promoting positive health behaviors in patients with T2DM. Incorporating such interventions into community healthcare programs may improve diabetes management and help reduce the long-term burden of NCDs in developing nations. Nurse-Directed-Intervention Knowledge Health-promotion-behaviour model Type-2-diabetes- mellitus Introduction Historically, a national health policy was primarily based on the issues of infectious diseases and malnutrition. Even though many low- and middle-income countries continue to face these issues, health care and community promotion can address the problems to a certain degree. Conversely, in various countries, swift alterations in dietary habits and a scarcity of physical activities have occurred alongside shifts in the prevalence of non-communicable diseases such as diabetes, osteoporosis, cardiovascular diseases, obesity, and numerous malignant conditions. Developing countries are undergoing an epidemiologic transition and the emergence of what is termed new world syndrome, characterized by unhealthy dietary habits, a sedentary lifestyle, and the consumption of junk. Diabetes-mellitus is characterized by the set of endocrinal-related-disorder where in there is an increased blood-sugar-level (Hyperglycemia) causing from faults in body insulin- production, insulin activity. Insulin is a hormone which aids body cells to absorb glucose so it can be utilized as a base of energy. In individuals with diabetes-mellitus glucose level structures up in the blood and pee, causing unreasonable pee, thirst and issues with fat and protein digestion. Diabetes is a common shorthand for diabetes mellitus. The "pancreas" in this refers to the gland that produces the hormone Insulin, which permits body cells to consume glucose and convert it into energy. If the body's cells fail to absorb the glucose, the glucose builds up in the body ("Hyperglycemia"), which could lead to a variety of unanticipated complications. 1 For a considerable amount of time, diabetes-mellitus has been known to worsen and ultimately result in death. In the first period, a Greek-physician ‘Aristaeus’ labelled the disease's harmfulness and named it "diabetes," which is derived from a Greek word (Siphon). Health professionals such as Aerates recorded the symptoms of hypoglycemia. Ancient times but were unable to treat it. 2 Preceding to the detection of insulin, very little was completed for patients with increased blood-glucose level. Low-calorie diets lengthened their lives while making them weak and hungry. In 1921, Canadian physicians began using insulin to treat dying diabetic patients, bringing their blood sugar level back to normal. Since that point forward, advances in medicine made life easier for diabetic patients. 3 Dr. Thomas Willis, a 17th-century London physician, determined whether individual had diabetes by scrutinizing their urine. If it is noticed sweet, he knew they had diabetes mellitus-"honeyed" diabetes. This technique was used to until the twentieth century. During 50s, Diabetes was found of two sorts: insulin-sensitive and insulin-insensitive. Diabetes mellitus was depicted as "the secretive infection" 2,000 years before ‘Aristaeus’. It is a long and difficult process to find because many specialists and analysts frequently put more information was identify the one solution. That time when information success led to a disclosure about pancreatic hormone at a Canadian research Centre. Since then, clinical advances have continued to make life easier for individual with type 2 diabetes. In the 21st century, diabetes mellitus specialists kept on covering the street heading across to being stagnant. Now, it has been ensuring the form of which is street may acquire; maybe some other theoretical disclosure was made which showed potentially specialists should be content which is the drowsy granulate of improvement (Satley, 2008). 4 Every cell in the human body needs vitality must work. The body's primary vitality source of glucose, a simple sugar produced by the breakdown of starches-containing the food (sugars and starches). Glucose from digested food circulate in the blood as a composed vitality hotspot for any cells that required. Insulin is a hormone that is delivered to the pancreas by cells, which are located behind the stomach. Insulin binds to a receptor site outside the cell like a key, transforms to open a passage through into the cell which glucose can enter. 5 In order to save part of the glucose for later, some of it can be converted into concentrated energy sources like glycogen or unsaturated lipids. Glucose does not enter the cells when insulin delivery is inadequate or when the insulin key is no longer recognized by the entranceway. 6 It is a narrowing, lengthened structure located in back of the stomach across the posterior to the abdomen. The pancreas consists of a head, body, and tail. The adjacent organ the right, known as "the head," is the broadest part is in the bend of the duodenum (the beginning segment of the small digestive tract). The tail of the pancreas is the narrowing left side that the stretches marginally ascendant and finishes close to the spleen. 7 The pancreas is made up of two types: Exocrine tissue secretes digestive enzymes. These are released into the main pancreatic duct, which leads to a network of ducts close to the pancreas. Endocrine tissue is made up of the "islets of Langerhans," which produce hormones and release them into the bloodstream. 2 There are several forms of diabetes mellitus, the most known are: Type-1-Diabetes: It is caused because of the pancreas inability to secrete insulin, and it is essential for patient to administer “insulin”. Type-2-Diabetes: It results to insulin tolerance, it conditions where in cells give up to utilize insulin appropriately, on the occasions of accompanying with a complete insulin shortage. It is found that female in the period between conception and giving birth have increase the blood glucose level. It might be led to progress of diabetes-mellitus-Type-2. The pancreas performs two functions: digestive and hormonal. Exocrine tissues secrete enzymes that aid digestion to duodenum by breaking down carbohydrates, fats, proteins, and acids. Those enzymes tend to flow slowly down the pancreatic duct into bile duct. They are triggered as soon as they reach duodenum. Bicarbonate is secreted by exocrine tissue in the duodenum to defuse the stomach acid. The endocrine tissues of the pancreas secrete two hormones: insulin and glucagon (which regulates blood glucose level) and somatostatin (preventing the secretion of the above hormones). 8 Diabetes mellitus are classified into 3 types: Type-1, Type 2, and pregnancy-induced diabetes. Other types are also mentioned. The term "diabetes" is commonly used to refer to diabetic mellitus, which means excessive sugar, delicious urine (glycosuria). Diabetes is likewise used to designate a few uncommon diseases. The utmost mutual is "Diabetes Insipidus," in which large amount of urine is excreted (Polyuria). The term "Type 2 diabetes" has substituted numerous earlier terms besides they are "obesity-related diabetes", "adult-onset diabetes", and "non-insulin-dependent diabetes mellitus". 7 Material & Methodology The conceptual framework of the study was based on the “Nola Pendar Health Promotion Behaviour Model. This theory consists of individual characteristics, Individual characteristics, and experiences, Behavior-specific cognitions, and affects Behavioral outcomes administration and validation between the research investigator and the nurse- directed interventions on knowledge and health promotion behavior of patients with type 2 diabetes mellitus in selected community rural areas of Vadodara. The study was conducted using a pre-experimental research design, one-group pre-test, and post-test design. The research variable was nurse-directed intervention on type-2 diabetes mellitus patients, while the demographic variables were Age in years, gender, Religion, Educational status of the participant, Medical suffering from Type 2 DM, Distance from residence to clinic /hospital, Any diabetic drugs, Family history of diabetes, Any other medical illness, Habits, Attended any training programs of Type-2 diabetes mellitus, Diet pattern, Income of the family and Occupation of the patient. The study was conducted on a sample of 296 (148 each in control and experimental groups) selected rural area of Vadodara, Type-2 diabetes mellitus patients using a non-probability convenience sampling technique from a selected rural area and type-2 diabetes mellitus patients from the rural community area of Vadodara, Gujarat, using a Convenience sampling technique. The instruments used for data collection were structured knowledge questionnaires. The data obtained were tabulated and analyzed in terms of the objectives of the study, using descriptive and inferential statistics. Results The demographic characteristics of the samples in the experimental and control groups were tested for homogeneity using the chi-square test. The result showed that the age of the patients with type 2 diabetes mellitus was found significant at p < 0.05 level and they were non-homogenous. The other demographic characteristics of the samples in the experimental and control group such as gender, educational status, religion, medical suffering with type 2 diabetes mellitus, distance from residence to clinic/hospital, are you on diabetic drugs, any other medical illness, family history of diabetes mellitus, habits, attended any training program and income of type 2 diabetes mellitus were found non- significant at p < 0.05 and they were homogenous and comparable. The results demonstrate a statistically significant improvement in knowledge scores following the nurse-directed interventions. The mean pre-test knowledge score was 7.97 ± 4.219, while the mean post-test knowledge score significantly increased to 19.75 ± 2.534. The mean difference in knowledge scores was 11.78. The obtained t-value of 32.75, with a degree of freedom (df) of 147, resulted in a p-value of 0.001. This indicates that the improvement in knowledge scores due to the nurse-directed interventions was highly significant at a p-value of less than 0.05. The results demonstrate a significant improvement in health promotion behavior scores following the nurse-directed interventions. The mean pre-test health promotion behavior score was 14.26 ± 5.824, while the mean post-test health promotion behavior score significantly increased to 38.55 ± 4.908. The mean difference in health promotion behavior scores was 24.29. The obtained t-value of 38.04, with a degree of freedom (df) of 147, resulted in a p-value of 0.001. This indicates that the improvement in health promotion behavior due to the nurse-directed interventions was highly significant at a p- value of less than 0.05. Table 1 Comparison of post-test level of knowledge and health promotion behavior of patients with type 2 diabetes mellitus in experimental group and control group. n = 296 Post-test Comparison Experimental group Control group Mean D t value df p value Knowledge 19.75 ± 2.534 9.07 ± 3.452 10.68 30.35 294 0.001* Health promotion behavior 38.55 ± 4.908 10.51 ± 5.162 28.04 47.90 294 0.001* *P < 0.05 level of significance NS-Non significance Table 1 . Illustrate that comparison of post-test level of knowledge and health promotion-behavior of patient’s with ‘Type-2 Diabetes Mellitus’ in ‘experimental group’ and control groups which was tested by using unpaired t-test. Regarding post-test knowledge score an experimental group mean-knowledge score was 19.75 ± 2.534 and in control set was 9.07 ± 3.452 with mean-difference of 10.68 with obtained t value (t = 30.35, df = 294, p = 0.001) was statistically highly-significant at p < 0.05 level of significance. Regarding health-promotion-behavior mean post-test knowledge score in experimental group was 38.55 ± 4.908 and in control group was 10.51 ± 5.162 with mean difference of 28.04 with obtained ‘t’ value (t = 47.90, df = 294, p = 0.001) was statistically highly significant at p < 0.05 level of significance. Findings revealed that nurse-directed-interventions was effective in improving the knowledge and health promotion behavior of patients with ‘Type-2 Diabetes Mellitus’ among elderly in ‘experimental group as compared to control group’. Conclusion The findings from this study demonstrate that nurse-directed interventions have a significant positive impact on the knowledge of patients with type 2 diabetes mellitus. The interventions resulted in a substantial improvement in knowledge levels, with the majority of participants attaining a good level of knowledge. These findings emphasize the importance of healthcare professionals in providing education and support to patients with type 2 diabetes mellitus to enhance their understanding of the condition and empower them to make informed decisions regarding their health. Abbreviations ADA American Diabetes Association DM Diabetes Mellitus NCDs Non-Communicable Diseases LMICs Low-and Middle-Income Countries T1DM Type 1 Diabetes Mellitus T2DM Type 2 Diabetes Mellitus NIDDM Non-Insulin-Dependent Diabetes Mellitus GDM Gestational Diabetes Mellitus IR Insulin Resistance ICMR Indian Council of Medical Research WHO World Health Organization NWS New World Syndrome DGCI Drugs Controller General of India PU IECHR-Parul University-Institutional Ethics Committee on Human Research Declarations Conflict of Interest The authors declare that they have no competing interests Ethical approval and consent to participant Ethical approval for the study was obtained from the Parul University–Institutional Ethics Committee on Human Research (PU-IECHR), which is registered with the Drugs Controller General of India (DGCI), Government of India (Registration No. ECR/102/Inst/GI/2025/RR-18) (Approval No. PU-IECHR/PIMSR/00/081734/3807). The committee reviewed, discussed, and approved the research proposal titled “Effectiveness of Nurse Directed Interventions on Knowledge and Health Promotion Behaviour of Patients with Type 2 Diabetes Mellitus in Selected Rural Community Areas of Vadodara – A Community-Based Study” during its 38th meeting held on 30 July 2021. Consent for publication Not applicable Competing Interest The authors declare that they have no competing interests Funding There is no any funding for the Study Design, Collection & analysis of data and drafting of the manuscript, this was the role of authors. The writing of this manuscript has not been funded. Author Contribution The study protocol is written by AP. Data collection was performed by the MC and PB. JP Prepared the manuscript. AP, MC, JP and PB provided the comments. Acknowledgement We would like to express our gratitude to the Chief District Health officer, Zilla Parishad, Vadodara, Gujrat, India for letting us conduct the study in rural areas. We would really appreciate participant for the cooperation without them, the study would be impossible conduct. Data Availability The datasets generated and/or analyzed during the current study are not publicly available due to ethical restrictions and to protect the confidentiality and privacy of the study participants. However, the data may be made available from the corresponding author upon reasonable request, subject to approval from the Parul University–Institutional Ethics Committee on Human Research (PU-IECHR). The research tool (structured questionnaire) used for data collection is available as a supplementary file with this manuscript. References Bhattamisra SK, Siang TC, Rong CY, Annan NC, Sean E, Xi LW. Type-3c Diabetes Mellitus, Diabetes of Exocrine Pancreas - An Update. Curr Diabetes Rev. 2019;15(5):382–94. Chu CK, Mazo AE, Sarmiento JM, Staley CA, Adsay NV, Umpierrez GE. Impact of Diabetes Mellitus on Perioperative Outcomes after Resection for Pancreatic Adenocarcinoma. J Am Coll Surg. 2010;210(4):463–73. French K, Donihi E, Korytkowski AC. Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic Syndrome: Review of Acute Decompensated Diabetes in Adult Patients. BMJ 2019, 365 . Han HS, Kang G, Kim JS, Choi BH, Koo SH. Regulation of Glucose Metabolism from a Liver-Centric Perspective. Exp Mol Med 2016, 48 (3). Inaishi J, Saisho Y. Beta-Cell Mass in Obesity and Type 2 Diabetes, and Its Relation to Pancreas Fat: A Mini-Review. Nutrients 2020, 12 (12). Li W, Huang E, Gao S. Type 1 Diabetes Mellitus and Cognitive Impairments: A Systematic Review. J Alzheimers Dis. 2017;57(1):29–36. Rahman MS, Hossain KS, Das S, Kundu S, Adegoke EO, Rahman MA. Role of Insulin in Health and Disease: An Update. Int J Mol Sci 2021, 22 (12). Unnikrishnan AG, Kalra S, Purandare V, Vasnawala H. Genital Infections with Sodium Glucose Cotransporter-2 Inhibitors: Occurrence and Management in Patients with Type 2 Diabetes Mellitus. Indian J Endocrinol Metab. 2018;22(6):837–42. https://doi.org/10.4103/ijem.IJEM_159_17 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8665478","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":589419504,"identity":"de254e6f-9814-41b7-af8b-9151905ad230","order_by":0,"name":"abhay Pattan","email":"data:image/png;base64,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","orcid":"","institution":"Parul University","correspondingAuthor":true,"prefix":"","firstName":"abhay","middleName":"","lastName":"Pattan","suffix":""},{"id":589419506,"identity":"7f5caa32-f58d-417c-96a1-5396e02d4de1","order_by":1,"name":"Milankumar Chauhan","email":"","orcid":"","institution":"Parul University","correspondingAuthor":false,"prefix":"","firstName":"Milankumar","middleName":"","lastName":"Chauhan","suffix":""},{"id":589419507,"identity":"1e816807-d03f-4435-bb09-4c6eca566291","order_by":2,"name":"Jahnvi Patel","email":"","orcid":"","institution":"Parul University","correspondingAuthor":false,"prefix":"","firstName":"Jahnvi","middleName":"","lastName":"Patel","suffix":""},{"id":589419508,"identity":"da4e9d55-f85c-4c9b-87df-75528888da9a","order_by":3,"name":"Priyanka Baria","email":"","orcid":"","institution":"Parul University","correspondingAuthor":false,"prefix":"","firstName":"Priyanka","middleName":"","lastName":"Baria","suffix":""}],"badges":[],"createdAt":"2026-01-22 05:24:34","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8665478/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8665478/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105277468,"identity":"b87b3432-890a-4c88-8ef4-9eaedef4d619","added_by":"auto","created_at":"2026-03-24 09:44:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":465911,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8665478/v1/0b4fe432-e158-48d4-a23b-a48131d7be49.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A Community Based Study-Effectiveness of nurse directed interventions on knowledge and health-promotion behavior of patients with Type-2 Diabetes Mellitus","fulltext":[{"header":"Introduction","content":"\u003cp\u003eHistorically, a national health policy was primarily based on the issues of infectious diseases and malnutrition. Even though many low- and middle-income countries continue to face these issues, health care and community promotion can address the problems to a certain degree. Conversely, in various countries, swift alterations in dietary habits and a scarcity of physical activities have occurred alongside shifts in the prevalence of non-communicable diseases such as diabetes, osteoporosis, cardiovascular diseases, obesity, and numerous malignant conditions. Developing countries are undergoing an epidemiologic transition and the emergence of what is termed new world syndrome, characterized by unhealthy dietary habits, a sedentary lifestyle, and the consumption of junk.\u003c/p\u003e \u003cp\u003eDiabetes-mellitus is characterized by the set of endocrinal-related-disorder where in there is an increased blood-sugar-level (Hyperglycemia) causing from faults in body insulin- production, insulin activity. Insulin is a hormone which aids body cells to absorb glucose so it can be utilized as a base of energy. In individuals with diabetes-mellitus glucose level structures up in the blood and pee, causing unreasonable pee, thirst and issues with fat and protein digestion.\u003c/p\u003e \u003cp\u003eDiabetes is a common shorthand for diabetes mellitus. The \"pancreas\" in this refers to the gland that produces the hormone Insulin, which permits body cells to consume glucose and convert it into energy. If the body's cells fail to absorb the glucose, the glucose builds up in the body (\"Hyperglycemia\"), which could lead to a variety of unanticipated complications.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eFor a considerable amount of time, diabetes-mellitus has been known to worsen and ultimately result in death. In the first period, a Greek-physician \u0026lsquo;Aristaeus\u0026rsquo; labelled the disease's harmfulness and named it \"diabetes,\" which is derived from a Greek word (Siphon). Health professionals such as Aerates recorded the symptoms of hypoglycemia. Ancient times but were unable to treat it.\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003cp\u003ePreceding to the detection of insulin, very little was completed for patients with increased blood-glucose level. Low-calorie diets lengthened their lives while making them weak and hungry. In 1921, Canadian physicians began using insulin to treat dying diabetic patients, bringing their blood sugar level back to normal. Since that point forward, advances in medicine made life easier for diabetic patients.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eDr. Thomas Willis, a 17th-century London physician, determined whether individual had diabetes by scrutinizing their urine. If it is noticed sweet, he knew they had diabetes mellitus-\"honeyed\" diabetes. This technique was used to until the twentieth century.\u003c/p\u003e \u003cp\u003eDuring 50s, Diabetes was found of two sorts: insulin-sensitive and insulin-insensitive. Diabetes mellitus was depicted as \"the secretive infection\" 2,000 years before \u0026lsquo;Aristaeus\u0026rsquo;. It is a long and difficult process to find because many specialists and analysts frequently put more information was identify the one solution. That time when information success led to a disclosure about pancreatic hormone at a Canadian research Centre. Since then, clinical advances have continued to make life easier for individual with type 2 diabetes. In the 21st century, diabetes mellitus specialists kept on covering the street heading across to being stagnant. Now, it has been ensuring the form of which is street may acquire; maybe some other theoretical disclosure was made which showed potentially specialists should be content which is the drowsy granulate of improvement (Satley, 2008).\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eEvery cell in the human body needs vitality must work. The body's primary vitality source of glucose, a simple sugar produced by the breakdown of starches-containing the food (sugars and starches). Glucose from digested food circulate in the blood as a composed vitality hotspot for any cells that required. Insulin is a hormone that is delivered to the pancreas by cells, which are located behind the stomach. Insulin binds to a receptor site outside the cell like a key, transforms to open a passage through into the cell which glucose can enter.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn order to save part of the glucose for later, some of it can be converted into concentrated energy sources like glycogen or unsaturated lipids. Glucose does not enter the cells when insulin delivery is inadequate or when the insulin key is no longer recognized by the entranceway.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIt is a narrowing, lengthened structure located in back of the stomach across the posterior to the abdomen. The pancreas consists of a head, body, and tail. The adjacent organ the right, known as \"the head,\" is the broadest part is in the bend of the duodenum (the beginning segment of the small digestive tract). The tail of the pancreas is the narrowing left side that the stretches marginally ascendant and finishes close to the spleen.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe pancreas is made up of two types: Exocrine tissue secretes digestive enzymes. These are released into the main pancreatic duct, which leads to a network of ducts close to the pancreas.\u003c/p\u003e\u003cp\u003eEndocrine tissue is made up of the \"islets of Langerhans,\" which produce hormones and release them into the bloodstream.\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eThere are several forms of diabetes mellitus, the most known are: Type-1-Diabetes: It is caused because of the pancreas inability to secrete insulin, and it is essential for patient to administer \u0026ldquo;insulin\u0026rdquo;. Type-2-Diabetes: It results to insulin tolerance, it conditions where in cells give up to utilize insulin appropriately, on the occasions of accompanying with a complete insulin shortage.\u003c/p\u003e \u003cp\u003eIt is found that female in the period between conception and giving birth have increase the blood glucose level. It might be led to progress of diabetes-mellitus-Type-2.\u003c/p\u003e \u003cp\u003eThe pancreas performs two functions: digestive and hormonal. Exocrine tissues secrete enzymes that aid digestion to duodenum by breaking down carbohydrates, fats, proteins, and acids. Those enzymes tend to flow slowly down the pancreatic duct into bile duct. They are triggered as soon as they reach duodenum. Bicarbonate is secreted by exocrine tissue in the duodenum to defuse the stomach acid. The endocrine tissues of the pancreas secrete two hormones: insulin and glucagon (which regulates blood glucose level) and somatostatin (preventing the secretion of the above hormones).\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eDiabetes mellitus are classified into 3 types: Type-1, Type 2, and pregnancy-induced diabetes. Other types are also mentioned. The term \"diabetes\" is commonly used to refer to diabetic mellitus, which means excessive sugar, delicious urine (glycosuria). Diabetes is likewise used to designate a few uncommon diseases. The utmost mutual is \"Diabetes Insipidus,\" in which large amount of urine is excreted (Polyuria). The term \"Type 2 diabetes\" has substituted numerous earlier terms besides they are \"obesity-related diabetes\", \"adult-onset diabetes\", and \"non-insulin-dependent diabetes mellitus\".\u003csup\u003e7\u003c/sup\u003e\u003c/p\u003e"},{"header":"Material \u0026 Methodology","content":"\u003cp\u003eThe conceptual framework of the study was based on the \u0026ldquo;Nola Pendar Health Promotion Behaviour Model. This theory consists of individual characteristics, Individual characteristics, and experiences, Behavior-specific cognitions, and affects Behavioral outcomes administration and validation between the research investigator and the nurse-\u003c/p\u003e \u003cp\u003edirected interventions on knowledge and health promotion behavior of patients with type 2 diabetes mellitus in selected community rural areas of Vadodara.\u003c/p\u003e \u003cp\u003eThe study was conducted using a pre-experimental research design, one-group pre-test, and post-test design. The research variable was nurse-directed intervention on type-2 diabetes mellitus patients, while the demographic variables were Age in years, gender, Religion, Educational status of the participant, Medical suffering from Type 2 DM, Distance from residence to clinic /hospital, Any diabetic drugs, Family history of diabetes, Any other medical illness, Habits, Attended any training programs of Type-2 diabetes mellitus, Diet pattern, Income of the family and Occupation of the patient.\u003c/p\u003e \u003cp\u003eThe study was conducted on a sample of 296 (148 each in control and experimental groups) selected rural area of Vadodara, Type-2 diabetes mellitus patients using a non-probability convenience sampling technique from a selected rural area and type-2 diabetes mellitus patients from the rural community area of Vadodara, Gujarat, using a Convenience sampling technique. The instruments used for data collection were structured knowledge questionnaires. The data obtained were tabulated and analyzed in terms of the objectives of the study, using descriptive and inferential statistics.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe demographic characteristics of the samples in the experimental and control groups were tested for homogeneity using the chi-square test. The result showed that the age of the patients with type 2 diabetes mellitus was found significant at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 level and they were non-homogenous. The other demographic characteristics of the samples in the experimental and control group such as gender, educational status, religion, medical suffering with type 2 diabetes mellitus, distance from residence to clinic/hospital, are you on diabetic drugs, any other medical illness, family history of diabetes mellitus, habits, attended any training program and income of type 2 diabetes mellitus were found non- significant at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 and they were homogenous and comparable.\u003c/p\u003e \u003cp\u003eThe results demonstrate a statistically significant improvement in knowledge scores following the nurse-directed interventions. The mean pre-test knowledge score was 7.97\u0026thinsp;\u0026plusmn;\u0026thinsp;4.219, while the mean post-test knowledge score significantly increased to 19.75\u0026thinsp;\u0026plusmn;\u0026thinsp;2.534. The mean difference in knowledge scores was 11.78.\u003c/p\u003e \u003cp\u003eThe obtained t-value of 32.75, with a degree of freedom (df) of 147, resulted in a p-value of 0.001. This indicates that the improvement in knowledge scores due to the nurse-directed interventions was highly significant at a p-value of less than 0.05.\u003c/p\u003e \u003cp\u003eThe results demonstrate a significant improvement in health promotion behavior scores following the nurse-directed interventions. The mean pre-test health promotion behavior score was 14.26\u0026thinsp;\u0026plusmn;\u0026thinsp;5.824, while the mean post-test health promotion behavior score significantly increased to 38.55\u0026thinsp;\u0026plusmn;\u0026thinsp;4.908. The mean difference in health promotion behavior scores was 24.29.\u003c/p\u003e \u003cp\u003eThe obtained t-value of 38.04, with a degree of freedom (df) of 147, resulted in a p-value of 0.001. This indicates that the improvement in health promotion behavior due to the nurse-directed interventions was highly significant at a p- value of less than 0.05.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of post-test level of knowledge and health promotion behavior of patients with type 2 diabetes mellitus in experimental group and control group. n\u0026thinsp;=\u0026thinsp;296\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePost-test\u003c/p\u003e \u003cp\u003eComparison\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExperimental\u003c/p\u003e \u003cp\u003egroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003cp\u003eD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003et value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003edf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eKnowledge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e19.75\u0026thinsp;\u0026plusmn;\u0026thinsp;2.534\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e9.07\u0026thinsp;\u0026plusmn;\u0026thinsp;3.452\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e294\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHealth promotion\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ebehavior\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e38.55\u0026thinsp;\u0026plusmn;\u0026thinsp;4.908\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e10.51\u0026thinsp;\u0026plusmn;\u0026thinsp;5.162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e47.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e294\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e*P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 level of significance NS-Non significance\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Illustrate that comparison of post-test level of knowledge and health promotion-behavior of patient\u0026rsquo;s with \u0026lsquo;Type-2 Diabetes Mellitus\u0026rsquo; in \u0026lsquo;experimental group\u0026rsquo; and control groups which was tested by using unpaired t-test. Regarding post-test knowledge score an experimental group mean-knowledge score was 19.75\u0026thinsp;\u0026plusmn;\u0026thinsp;2.534 and in control set was 9.07\u0026thinsp;\u0026plusmn;\u0026thinsp;3.452 with mean-difference of 10.68 with obtained t value (t\u0026thinsp;=\u0026thinsp;30.35, df\u0026thinsp;=\u0026thinsp;294, p\u0026thinsp;=\u0026thinsp;0.001) was statistically highly-significant at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 level of significance.\u003c/p\u003e \u003cp\u003eRegarding health-promotion-behavior mean post-test knowledge score in experimental group was 38.55\u0026thinsp;\u0026plusmn;\u0026thinsp;4.908 and in control group was 10.51\u0026thinsp;\u0026plusmn;\u0026thinsp;5.162 with mean difference of 28.04 with obtained \u0026lsquo;t\u0026rsquo; value (t\u0026thinsp;=\u0026thinsp;47.90, df\u0026thinsp;=\u0026thinsp;294, p\u0026thinsp;=\u0026thinsp;0.001) was statistically highly significant at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 level of significance.\u003c/p\u003e \u003cp\u003eFindings revealed that nurse-directed-interventions was effective in improving the knowledge and health promotion behavior of patients with \u0026lsquo;Type-2 Diabetes Mellitus\u0026rsquo; among elderly in \u0026lsquo;experimental group as compared to control group\u0026rsquo;.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe findings from this study demonstrate that nurse-directed interventions have a significant positive impact on the knowledge of patients with type 2 diabetes mellitus. The interventions resulted in a substantial improvement in knowledge levels, with the majority of participants attaining a good level of knowledge. These findings emphasize the importance of healthcare professionals in providing education and support to patients with type 2 diabetes mellitus to enhance their understanding of the condition and empower them to make informed decisions regarding their health.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eADA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAmerican Diabetes Association\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDiabetes Mellitus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNCDs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNon-Communicable Diseases\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLMICs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLow-and Middle-Income Countries\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eT1DM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eType 1 Diabetes Mellitus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eT2DM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eType 2 Diabetes Mellitus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNIDDM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNon-Insulin-Dependent Diabetes Mellitus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGDM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGestational Diabetes Mellitus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInsulin Resistance\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eICMR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIndian Council of Medical Research\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNWS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNew World Syndrome\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDGCI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDrugs Controller General of India\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePU\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIECHR-Parul University-Institutional Ethics Committee on Human Research\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eConflict of Interest\u003c/h2\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003ch2\u003e Ethical approval and consent to participant\u003c/h2\u003e\n\u003cp\u003eEthical approval for the study was obtained from the Parul University\u0026ndash;Institutional Ethics Committee on Human Research (PU-IECHR), which is registered with the Drugs Controller General of India (DGCI), Government of India (Registration No. ECR/102/Inst/GI/2025/RR-18) (Approval No. PU-IECHR/PIMSR/00/081734/3807). The committee reviewed, discussed, and approved the research proposal titled \u0026ldquo;Effectiveness of Nurse Directed Interventions on Knowledge and Health Promotion Behaviour of Patients with Type 2 Diabetes Mellitus in Selected Rural Community Areas of Vadodara \u0026ndash; A Community-Based Study\u0026rdquo; during its 38th meeting held on 30 July 2021.\u003c/p\u003e\n\u003ch2\u003eConsent for publication\u003c/h2\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003ch2\u003eCompeting Interest\u003c/h2\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThere is no any funding for the Study Design, Collection \u0026amp; analysis of data and drafting of the manuscript, this was the role of authors. The writing of this manuscript has not been funded.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eThe study protocol is written by AP. Data collection was performed by the MC and PB. JP Prepared the manuscript. AP, MC, JP and PB provided the comments.\u003c/p\u003e\n\u003ch2\u003eAcknowledgement\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eWe would like to express our gratitude to the Chief District Health officer, Zilla Parishad, Vadodara, Gujrat, India for letting us conduct the study in rural areas. We would really appreciate participant for the cooperation without them, the study would be impossible conduct.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are not publicly available due to ethical restrictions and to protect the confidentiality and privacy of the study participants. However, the data may be made available from the corresponding author upon reasonable request, subject to approval from the Parul University\u0026ndash;Institutional Ethics Committee on Human Research (PU-IECHR). The research tool (structured questionnaire) used for data collection is available as a supplementary file with this manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBhattamisra SK, Siang TC, Rong CY, Annan NC, Sean E, Xi LW. Type-3c Diabetes Mellitus, Diabetes of Exocrine Pancreas - An Update. Curr Diabetes Rev. 2019;15(5):382\u0026ndash;94.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChu CK, Mazo AE, Sarmiento JM, Staley CA, Adsay NV, Umpierrez GE. Impact of Diabetes Mellitus on Perioperative Outcomes after Resection for Pancreatic Adenocarcinoma. J Am Coll Surg. 2010;210(4):463\u0026ndash;73.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFrench K, Donihi E, Korytkowski AC. Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic Syndrome: Review of Acute Decompensated Diabetes in Adult Patients. \u003cem\u003eBMJ\u003c/em\u003e 2019, \u003cem\u003e365\u003c/em\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHan HS, Kang G, Kim JS, Choi BH, Koo SH. Regulation of Glucose Metabolism from a Liver-Centric Perspective. Exp Mol Med 2016, \u003cem\u003e48\u003c/em\u003e (3).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInaishi J, Saisho Y. Beta-Cell Mass in Obesity and Type 2 Diabetes, and Its Relation to Pancreas Fat: A Mini-Review. Nutrients 2020, \u003cem\u003e12\u003c/em\u003e (12).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi W, Huang E, Gao S. Type 1 Diabetes Mellitus and Cognitive Impairments: A Systematic Review. J Alzheimers Dis. 2017;57(1):29\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRahman MS, Hossain KS, Das S, Kundu S, Adegoke EO, Rahman MA. Role of Insulin in Health and Disease: An Update. Int J Mol Sci 2021, \u003cem\u003e22\u003c/em\u003e (12).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUnnikrishnan AG, Kalra S, Purandare V, Vasnawala H. Genital Infections with Sodium Glucose Cotransporter-2 Inhibitors: Occurrence and Management in Patients with Type 2 Diabetes Mellitus. Indian J Endocrinol Metab. 2018;22(6):837\u0026ndash;42. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.4103/ijem.IJEM_159_17\u003c/span\u003e\u003cspan address=\"10.4103/ijem.IJEM_159_17\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Nurse-Directed-Intervention, Knowledge, Health-promotion-behaviour model, Type-2-diabetes- mellitus","lastPublishedDoi":"10.21203/rs.3.rs-8665478/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8665478/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eHistorically, national health policies have primarily focused on communicable diseases and malnutrition. While these issues remain relevant in many low- and middle-income countries, recent changes in lifestyle patterns have contributed to a rising prevalence of non-communicable diseases (NCDs). These include diabetes, cardiovascular disorders, obesity, and joint diseases. Developing nations are experiencing an epidemiological transition, driven by sedentary behavior, unhealthy dietary habits, and increased substance use. As a result, they are increasingly vulnerable to NCD epidemics in the coming years.\u003c/p\u003e \u003cp\u003e \u003cb\u003eMethods\u003c/b\u003e: A quasi-experimental study was conducted in selected rural communities of Vadodara. The study was based on Nola Pender\u0026rsquo;s Health Promotion Model and focused on individual characteristics, behavior-specific cognitions, and behavioral outcomes. Nurse-directed interventions were implemented to improve knowledge and health-promotion behaviors among patients with Type 2 Diabetes Mellitus (T2DM).\u003c/p\u003e \u003cp\u003e \u003cb\u003eResults\u003c/b\u003e:The mean pre-test health-promotion behavior score was 14.26\u0026thinsp;\u0026plusmn;\u0026thinsp;5.824. This significantly increased to 38.55\u0026thinsp;\u0026plusmn;\u0026thinsp;4.908 in the post-test. The mean difference was 24.29, with a t-value of 38.04 (df\u0026thinsp;=\u0026thinsp;147) and a highly significant p-value of 0.001 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). These results indicated that nurse-directed interventions were highly effective in improving health- promotion behaviors among T2DM patients.\u003c/p\u003e \u003cp\u003e \u003cb\u003eConclusion\u003c/b\u003e: Nurse-directed interventions played a vital role in enhancing knowledge and promoting positive health behaviors in patients with T2DM. Incorporating such interventions into community healthcare programs may improve diabetes management and help reduce the long-term burden of NCDs in developing nations.\u003c/p\u003e","manuscriptTitle":"A Community Based Study-Effectiveness of nurse directed interventions on knowledge and health-promotion behavior of patients with Type-2 Diabetes Mellitus","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-13 12:45:34","doi":"10.21203/rs.3.rs-8665478/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6a6daa24-030a-445a-813f-334ef0c59e7d","owner":[],"postedDate":"February 13th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-24T09:41:54+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-13 12:45:34","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8665478","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8665478","identity":"rs-8665478","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}