Assessment of Patients' Knowledge, Attitudes, and Practices Toward Diabetic Complications in Outpatient Clinics in Ibb City, Yemen

Assessment of Patients' Knowledge, Attitudes, and Practices Toward Diabetic Complications in Outpatient Clinics in Ibb City, Yemen | 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 Assessment of Patients' Knowledge, Attitudes, and Practices Toward Diabetic Complications in Outpatient Clinics in Ibb City, Yemen Basheer Abdu, AbdulraKeeb Shomais, Asma Salam, Alia Baalwi, Alyah Nahshal, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9060718/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background Diabetic mellitus is a common long-term disease worldwide, causing many serious microvascular and macrovascular complications. Knowing how patients understand, feel, and respond to these complications (KAP) is very important for early detection and prevention, especially in countries like Yemen. Objective This study aimed to assess the levels of Knowledge, Attitude, and Practice of diabetic patients regarding diabetic complications in outpatient clinics in Ibb City, Yemen. Method A descriptive cross-sectional study was conducted among 384 patients selected via convenience sampling. Data were collected through a structured questionnaire that underwent expert review and a pilot study. Data were analyzed using SPSS 27. Results More than half of the patients were female (56.5%) and married (83.6%). The largest age group was 40–59 years (49.5%). Most participants were illiterate (39.6%) and worked as housewives (44.5%). A majority (60.9%) lived in urban areas and had a low monthly income (52.6%). Most participants had a diabetes duration of 1 to 5 years (43.2%) and were unaware of their specific diabetes type (70.6%). The disease was most often diagnosed based on symptoms (51.6%). A slight majority (52.1%) had no family history of the disease. Regarding management, the most common plan was Diet and oral drugs (73.4%), with the majority of patients using pills (80.5%). Self-monitoring was the most frequent follow-up method (50.5%). Knowledge of Diabetes complications was moderate to high. (79.6%), with a mean score of 9.55 (SD = 2.15). Their Attitude was positive (87%), with a mean score of 26.20 (SD = 3.16). Their practice level was moderate (63.6%), with a mean score of 24.8 (SD = 5.7). Significant positive correlations between Knowledge, Attitude, and Practice (p < 0.001). Knowledge scores were significantly higher among participants with high income (p = 0.004), using insulin (p = 0.033), and performing self-monitoring (p = 0.021). For Attitude, significant differences were observed by gender (p < 0.001), marital Status (p = 0.042), education (p < 0.001), job (p < 0.001), discovery method (p = 0.012), and follow-up type (p = 0.007). Practice scores differed significantly by gender (p = 0.001), living area (p = 0.026), marital Status (p = 0.012), education (p < 0.001), discovery method (p = 0.004), management plan (p < 0.001), drug type (p = 0.009), and follow-up (p < 0.001 Higher medication burden (B=-0.475, p = 0.025) and inconsistent follow-up (B=-0.340, p = 0.026) significantly reduced knowledge scores, while income showed no effect. Male gender (B = -0.756, p = 0.029) and poor follow-up (B = -0.654, p = 0.009) negatively affected attitudes, whereas higher education improved them (B = 0.482, p = 0.001). Inconsistent follow-up was the strongest negative predictor (B = -2.351, p = 0.001), with additional negative effects from male gender, complex management, and polypharmacy. Urban residence uniquely improved practice scores (B = 1.225, p = 0.026), and education enhanced attitudes but not Knowledge or Practice. Conclusion Knowledge of the complications of Diabetes was moderate to high; Attitudes were positive, but practices were moderate. significant positive correlations between Knowledge, Attitude, and Practice, with Attitude having the strongest link to Practice. Inconsistent follow-up and male gender consistently impaired all KAP domains, with polypharmacy specifically harming Knowledge and Practice. At the same time, higher education and urban residence emerged as key, yet domain-specific, positive factors for Attitude and Practice, respectively. Enhance Structured Follow-up Programs, Develop Targeted Education Initiatives> Knowledge Attitudes Practice Diabetic Complications Associated factors Yemen Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction Diabetes mellitus (DM), a chronic metabolic disorder characterized by hyperglycemia resulting from insufficient insulin production or insulin resistance (Al-Sharif & Gunaid, 2014; Dika et al., 2023), poses a substantial global health burden, with type 2 diabetes mellitus (T2DM) being the more prevalent form (Dika et al., 2023). is a primary focus of the World Health Organization's prevention and control efforts (Skolnik, 2018). The global prevalence of DM is rapidly increasing (Cole & Florez, 2022), affecting an estimated 10.5% of adults worldwide (IDF, 2021) and projected to reach 783 million by 2045 (idf.org). The Middle East region, including Yemen, faces a significant challenge related to T2DM (Meo et al., 2019). While regional data suggests a lower prevalence of Diabetes among men in Yemen compared to some neighboring countries (Meo et al., 2019) ( While DM is a recognized health issue in Yemen, with a recent estimate of 9.8% prevalence among men in 2019 (Meo et al., 2019) and an older study reporting an overall prevalence of 4.6% (Abdul Razzak et al., 2017),(The chronic complications of Diabetes are broadly categorized into microvascular (neuropathy, nephropathy, retinopathy) and macrovascular (cardiovascular disease, stroke, peripheral artery disease), with microvascular complications exhibiting a higher prevalence (Deshpande et al., 2008). Diabetic foot syndrome, a serious complication involving foot ulcers, neuropathy, peripheral artery disease, and infection, is a major cause of lower limb amputation (Tuttolomondo et al., 2015). The effective management of DM and the prevention of its chronic complications, including microvascular (neuropathy, nephropathy, retinopathy) and macrovascular (cardiovascular disease, stroke, peripheral artery disease) conditions (Deshpande et al., 2008) Relies significantly on patients' Knowledge, attitudes, and practices (KAP) towards their condition. Studies across various regions have revealed varying levels of KAP, with some indicating suboptimal knowledge (Al Shafaee et al., 2008; Nyamagoud et al., 2023), less than optimal attitudes (Herath et al., 2017; Nyamagoud et al., 2023), and inadequate self-management practices (Das et al., 2023; Herath et al., 2017; Nyamagoud et al., 2023; Alhariri et al., 2017( Local studies indicate a high prevalence of associated metabolic risk factors such as overweight/obesity and hypertension among T2DM patients (Mareai & Gawli, 2023). Factors such as education level, gender, and socioeconomic Status have been shown to influence KAP (Al Shafaee et al., 2008; Obirikorang et al., 2016; Rahaman et al., 2017; Alhariri et al.,2017). While some local studies in Yemen have explored diabetes prevalence and risk factors (Mareai & Gawli, 2023; Alhariri et al., 2017), they have also been shown to influence KAP (Al Shafaee et al., 2008; Obirikorang et al., 2016; Rahaman et al., 2017; Alhariri et al., 2017). Despite prior local investigations into Diabetes and its risk factors across various regions in Yemen, a significant research gap persists concerning the specific assessment of diabetic patients' Knowledge, attitudes, and practices (KAP) regarding the complications of their condition, particularly within Ibb City. Therefore, this study aims to assess patients' Knowledge, attitudes, and practices regarding diabetes complications in outpatient clinics in Ibb City, Yemen. Methods Study Design and Setting The study was designed as a questionnaire-based, cross-sectional analysis from January 1 to July 1, 2025. It was conducted in outpatient clinics in the city of Ibb. Yemen. Study population and Selection criteria: The sample included patients with Diabetes ≥ 18 years attending for follow-up or seeking general treatment in medicine outpatient Clinics. Exclusion criteria included the presence of gestational diabetes mellitus and an age younger than 18 years. Those unable to answer the questionnaire due to dementia, psychosis, or profound deafness were excluded from the study. Sample size and sampling technique The sample size was estimated using a formula that considers p = 50%, a 95% degree of certainty, and a 5% margin of error. Accordingly, by employing convenient sampling, 384 patients with Diabetes were recruited from outpatient clinics in the city of Ibb. Tool of data collection 1. Tool Design The questionnaire was adapted from relevant literature (Rahaman et al., 2017). A pre-tested, structured, bilingual questionnaire was developed to investigate key research questions, comprising closed-ended questions. The questionnaire was divided into 5 main categories, including Sociodemographic information, Medical History and Knowledge, Attitude, and Practice-related information. Relevant questions were asked of the respondents, such as the emphasis placed on the knowledge module, to assess the level of Knowledge of respondents for complications of Diabetes. To assess Knowledge, Attitude, and practices, (12) Items (True/False), 10 Items (Positive Attitude, Moderate Attitude, Negative Attitude), and (13) Items (Low, Moderate, High) questions were asked, respectively. related questions regarding diabetes complications. The questionnaire was prepared in English by a language expert, translated into the local language (Arabic), and then back-translated into English by another language expert to ensure consistency and wording. (Supplementary) S1 2.Tools validity: The questionnaire's validity was verified by presenting the research instrument to a group of experts, and based on their feedback, the necessary adjustments were made. A pilot study was then conducted on 10% of the total sample (30 patients) to assess the validity and clarity of the study tool and to identify potential problems researchers might encounter that could affect the data collection process. Internal consistency validity was calculated using Spearman's correlation coefficient. significant at p<0.001, indicating the internal consistency of the instrument items and their components. 3.Tools reliability The questionnaire's reliability was assessed using Cronbach's alpha coefficient. It was 0.71 for the knowledge domain, 0.71 for the attitudes domain, and 0.71 for the practice domain. At the level of the overall study instrument, it was 0.79, indicating acceptable internal consistency and reliability. 4.Assessment of KAP(The KAP Score) To calculate the Knowledge, Attitude, and Practice (KAP) score, a scoring system was prepared. Knowledge score: Each correct answer was coded as 1, while each incorrect answer was coded as 0. The knowledge score was calculated by adding the scores for the correct answers. The total score of Knowledge ranged from (0_12). The mean knowledge score was divided by the highest score of 12, then multiplied by 100 to get the total knowledge percentage. To evaluate the level of Knowledge in general. To evaluate the level of Knowledge of Categories as follows: Low Knowledge: < 50%, Moderate Knowledge: (50% - 80%), High Knowledge (81 – 100 %) Attitudes score: Each item was scored (3) if the answer is (Positive Attitude), (2) if the answer is (Moderate Attitude), and (1) if the answer is (Negative Attitude). The total attitude score ranged from 10 to 30. The mean Attitudes score was divided by the highest score of 30, then multiplied by 100 to get the total knowledge percentage. To evaluate the level of Attitudes in general. Also, evaluate the level of Attitudes of Categories: Negative Attitude: Less than 50%, Moderate attitude (50% - Less than 80 %), Positive attitude (80% – 100 %) Practices Score: Each item was scored (3) if the answer is (high), scored (2) if the answer is (moderate), scored (1) if the answer is (low). The total Practices score ranged from 13 to 30. The mean Practices score was divided by the highest score of 39, then multiplied by 100 to get the total knowledge percentage. To evaluate the level of Practices in general. Also, evaluate the level of Practices of Categories: low Practices: Less than 50%, Moderate Practices: (50% - 80%), High Practices: (81% – 100 %) Data Analysis The collected data were entered into the Statistical Package for the Social Sciences (SPSS) version 27 for Windows. All continuous data were expressed as mean (SD), and categorical variables were expressed as numbers and percentages. Descriptive statistics and frequency distributions were used to describe participant characteristics. The Kolmogorov-Smirnov Test revealed a non-normal distribution. Use Spearman's correlation coefficient test to determine the relationship between Knowledge, attitudes, and Practice. Spearman's rank correlation coefficient was used to determine the relationship between the mean KAP score. For variables with two categories, the Mann-Whitney U Test was used, and for variables with more than two categories, the Kruskal-Wallis Test was used to compare means. "To overcome the normality assumption in linear regression, we used the Bootstrap resample technique to calculate corrected 95% confidence intervals, a method that does not require distributional assumptions and provides robust estimates." Variables with p-values less than 0.05 in previous tests were included in the multivariate model. The relationships between each factor and the mean scores for Knowledge, attitudes, and practices were represented by standardized coefficients (beta coefficients) and a 95% confidence interval. A p-value less than 0.05 was considered statistically significant.... Result A total of 384 patients with Diabetes were enrolled in the study. The gender distribution revealed that the majority of participants were female (N = 217, 56.5%), while males accounted for 43.5% (N = 167). The age group between 40 and 59 years was the largest among participants (N = 190, 49.5%), followed by those aged 60 years and older (N = 138, 35.9%). The youngest age group, 20 to 39 years, accounted for the smallest proportion (N = 56, 14.6%). The mean standard deviation (SD) of age of the study participants was 52.9 12.96. The vast majority of participants were married (N = 321, 83.6%). Single individuals accounted for 8.3% (N = 32) of the sample, and divorced or widowed participants accounted for 8.1% (N = 31). The participants' educational level indicated that the largest group was illiterate (N = 152, 39.6%). Participants who could read and write comprised 21.4% (N = 82). Smaller proportions had completed primary (N = 49, 12.8%) or secondary (N = 39, 10.2%) education. While 16.1% (N = 62) had attained university or higher education, the most common occupation reported was housewife (N = 171, 44.5%). Other significant categories included employees (N = 67, 17.4%), workers (N = 56, 14.6%), and retired individuals (N = 54, 14.1%). Students (N = 9, 2.3%) and those out of work (N = 27, 7.0%) constituted smaller segments of the study population. The distribution of living areas showed that the majority of participants resided in urban/civilized areas (N = 234, 60.9%), while 39.1% (N = 150) resided in rural areas. Finally, regarding monthly income, more than half of the participants reported low income (N = 202, 52.6%). Participants with moderate income accounted for 31.3% (N = 120), and only 16.1% (N = 62) reported a high income. The largest proportion of participants had been living with Diabetes for 1 to 5 years (N = 166, 43.2%). A significant number (N = 105, 27.3%) had a duration of 6 to 10 years. Longer durations, from 11 to 15 years, accounted for 12.0% (N = 46) of participants, while those with Table 1 Characteristics of the study participants (n = 384). Variable Category Frequency (%) Gender Male 167 43.5 Female 217 56.5 Age Mean(SD) 52.9(12.96) 20 to 39 Y 56 14.6 40 to 59 Y 190 49.5 ≥ 60 Y 138 35.9 Marital Status Married 321 83.6 Single 32 8.3 Divorced or a widow 31 8.1 Education Level Illiterate 152 39.6 Reads and Writes 82 21.4 Primary 49 12.8 Secondary 39 10.2 University or Higher 62 16.1 Job Student 9 2.3 Employee 67 17.4 Out of work 27 7.0 Worker 56 14.6 House wife 171 44.5 Retired 54 14.1 Living area Rural 150 39.1 Civilize 234 60.9 Income Low 202 52.6 Moderate 120 31.3 High 62 16.1 Duration From 1 to 5 Y 166 43.2 From 6 to 10 Y 105 27.3 From 11 to 15 Y 46 12.0 More than 15 Y 67 17.4 Type Type 1 16 4.2 Type 2 97 25.3 I do not know 271 70.6 Discovery Method Routine investigations 29 7.6 Coincidence 157 40.9 Symptoms 198 51.6 Family History Yes 184 47.9 No 200 52.1 Herbal Yes 77 20.1 No 307 79.9 Management Plan Diet and oral drugs 282 73.4 Diet and insulin 65 16.9 Non 37 9.6 Drugs Insulin 67 17.4 Pills 309 80.5 Insulin and pills 8 2.1 Follow Up Self-monitoring 194 50.5 Hospital 137 35.7 Non 53 13.8 Diabetes for more than 15 years represented 17.4% (N = 67) of the sample. A striking majority of participants (N = 271, 70.6%) reported not knowing their diabetes type. Among those who did know, Type 2 diabetes was far more prevalent (N = 97, 25.3%) than Type 1 diabetes (N = 16, 4.2%). The method of Diabetes discovery was predominantly through symptoms (N = 198, 51.6%), indicating that many patients sought medical attention due to the disease's manifestations. A substantial portion (N = 157, 40.9%) discovered their Diabetes by coincidence, while routine investigations accounted for a smaller percentage (N = 29, 7.6%) Participants were almost equally divided, with slightly more (N = 200, 52.1%) reporting no family history than those who did (N = 184, 47.9%). The use of herbal medication was reported by a minority of participants, with 20.1% (N = 77) indicating 'Yes' and the majority (79.9%, N = 307) reporting 'No'. Regarding the management plan, the most common approach was Diet and oral drugs (N = 282, 73.4%). A smaller proportion managed their condition with Diet and insulin (N = 65, 16.9%), while 9.6% (N = 37) reported no specific management plan. Concerning drug regimens, the majority of participants were using pills (N = 309, 80.5%). Insulin was used by 17.4% (N = 67) of patients, and a very small percentage (2.1%, N = 8) used both insulin and pills. Finally, for follow-up methods, self-monitoring was the most common approach (N = 194, 50.5%). Follow-up at a hospital was reported by 35.7% (N = 137) of participants, and 13.8% (N = 53) reported no regular follow-up. in Table 1 Knowledge of diabetic patients towards complications of Diabetes The maximum knowledge score was 12. The mean score was 9.55 (95% CI 9.3–9.8), and the standard deviation (SD) was ± 2.15, with a range of 2 to 12. Knowledge of the complications of Diabetes was moderate to high. (79.6%). The study indicated that more than 80% of participants had high Knowledge regarding diabetic complications (n = 224; 85.3%). Fewer than 60% % of participants possessed medium Knowledge (n = 141; 36.7%). Only 19 participants (4.9%) possessed low Knowledge, Fig. 1 . A notable majority of participants demonstrated high levels of Knowledge, with over 80% providing correct responses, concerning Coma, dizziness, and fainting (96.4% ) Retinopathy (95.1% correct) Hypoglycemia (94.0% ) Neuropathy (87.5% correct) Diabetic foot ulcers and wounds (82.8% ) Conversely, knowledge levels were relatively lower, but still moderate (below 80% correct responses but generally above 60%), for the following complications: Teeth Decay (78.6%), Renal Complications (75.3%) Skin discoloration in diabetic foot (73.4%), High blood pressure (72.9% correct) Heart and Vascular Complications (70.3%), Stroke (68.8%). Pneumonia (60.2% ). Figure 2 Ll Attitude of diabetic patients towards complications of Diabetes Attitude Score: The maximum attitude score was 10. The mean score was 26.20 (95% CI for mean 25.9–26.5), and the standard deviation (SD) was ± 3.16 with a range of 14 to 30. Their Attitude was positive (87%). The study indicated that more than 50% of participants had high Knowledge regarding diabetic complications (n = 335; 87.3%). (n = 48; 12.4%) Of the participants had a moderate attitude regarding diabetic complications. About 0.3% (n = 1) of the participants had a negative attitude level. Figure 1 There was Attitude positive in "You believe that healthy food is important for preventing diabetes complications" (95.3%) "You believe that regular examinations are necessary for early detection of diabetes complications" (89.1%) "You believe that regular exercise helps control diabetes complications" (87.2%) "You believe that controlling blood sugar levels reduces complications" (86.7%)"You trust the information you receive from the doctor about diabetes complications" (85.7%), A considerable proportion of participants also "You believe that monitoring cholesterol level is important for diabetes patients" (75.3%) "You worry about diabetes complications" (68.8%) "You are willing to change your lifestyle to control diabetes complications" (57.8%) "You are interested in reading health information about diabetes and its complications" (51.6%) The percentage of Moderate Attitude responses for most items remained relatively low (typically below 15%), "You believe you can control diabetes" (34.6%), and "You are interested in reading health information about diabetes and its complications" (26.3%). Practice of diabetic patients towards complications of Diabetes The maximum practice score was 37. The mean score was 24.8 (95% CI for the mean 24.2 to 25.5), and the standard deviation (SD) was ± 5.7, with a range of 13 to 39. The study indicated that more than 50% of participants had moderate Practice regarding diabetic complications (n = 244; 36.5%). The finding was that 25% (n = 96) of participants scored low in Practice regarding diabetic complications. Almost (n = 44; 11.5%) of the participants possessed High Practice. Figure 1 The vast majority of participants reported taking their medications regularly (79.9%), indicating strong compliance with prescribed treatments. However, for most other crucial practices, adherence was notably lower: Regularly checking blood sugar levels was reported as high by fewer than half of the participants (43.8%), with 36.5% at a medium level, and 19.8% at a low level. While following a healthy diet was reported as high by 40.6% (N = 156), an equal proportion (40.6%) reported a medium level, suggesting inconsistent dietary adherence for many. Visiting the doctor regularly and checking blood pressure showed moderate to low adherence: only 29.9% and 30.2% reported high adherence, respectively, while a substantial proportion (33.1% and 34.6%) reported low adherence to these essential activities. Exercising regularly was also a challenge, with only 28.9% reporting high Practice, and 34.4% reporting low Practice. Reading about diabetes complications had the highest percentage of low Practice among specific items (43.5%). Furthermore, key preventive practices showed particularly low adherence: More than half of the participants reported low adherence for: Examining their feet daily (57.6% Low), Having regular eye examinations (63.5% Low), Checking their kidneys periodically (56.8% Low), Controlling their weight (52.9% Low), Checking cholesterol levels (55.2% Low) Correlation Between Knowledge, Attitude, and Practice Knowledge showed a significant positive correlation with Attitude (r = 0.237, p < 0.0001) and Practice (r = 0.268, p < 0.0001; Figs. 3 and 4 ). Attitude demonstrated a strong positive correlation with Practice (r = 0.482, p < 0.0001). Figure 5 Factors associated with mean KAP scores towards complications of Diabetes Factors associated with Knowledge about the complications of Diabetes: The study indicated that Income level, drugs , and Follow-up were associated with mean knowledge scores. Patients with higher income had better Knowledge (p = 0.004). Participants in the high-income group (mean rank = 229.10) had higher knowledge scores than those with moderate (mean rank = 195.59) or low (mean rank = 187.39) income. Additionally, the type of drugs used showed a significant association with Knowledge (p = 0.033), with patients using both insulin and pills having the Highest mean rank (238.69), followed by those on insulin (219.56), and then those on pills only (185.44). Follow-up methods were also significantly associated with Knowledge (p = 0.021); those relying on self-monitoring (mean rank = 207.80) had higher knowledge scores than those attending hospitals or having no follow-up. No significant associations were found between knowledge scores and Gender, Living area, Family History, Herbal Use, Age, Marital Status, Education, Job, Duration of Diabetes, Type of Diabetes, Discovery Method, or Management Plan (Table 2 ). Factors associated with Attitude towards complications of Diabetes : Gender was significantly associated with Attitude (p < 0.001), with males (mean rank = 220.37) demonstrating more positive attitudes than females (mean rank = 171.06). Marital Status was significantly associated with Attitude (p = 0.042). Married individuals (mean rank = 197.11) and single individuals (mean rank = 192.39) tended to have better attitudes than those who were divorced or widowed (mean rank = 144.87). Education level had a Dramatically association with Attitude (p < 0.001). Participants with higher education levels (Secondary school: mean rank = 253.18; University or higher: mean rank = 241.83) had more positive attitudes than those with lower educational backgrounds (Illiterate: mean rank = 164.16; Primary: mean rank = 166.29). Job status also showed a strong, significant association with Attitude (p < 0.001). Employees (mean rank = 237.88) and workers (mean rank = 231.90) showed better attitudes than other occupational groups, such as housewives (mean rank = 172.01) and the unemployed (mean rank = 152.76). The discovery method of Diabetes was significantly related to Attitude (p = 0.012). Participants whose Diabetes was discovered through routine investigations (mean rank = 222.72) tended to have more positive attitudes than those whose Diabetes was discovered by coincidence or symptoms. Follow-up methods also appear to be significantly associated with Attitude (p = 0.007), with individuals who are self-monitoring (mean rank = 205.06) demonstrating more positive attitudes than those who primarily rely on hospital visits or have no follow-up. No significant associations were reported between attitude scores and Living area, Family History, Herbal Use, Age, Income, Duration of Diabetes, Type of Diabetes, Management Plan, or Drugs. Table 2 Factors associated with Practice towards complications of Diabetes : Gender was significantly associated with Practice (p = 0.001), with males (mean rank = 214.37) reporting better practices than females (mean rank = 175.67). The living area showed a significant association (p = 0.026), with participants from civilized/urban areas (mean rank = 202.55) demonstrating better practices compared to those from rural areas (mean rank = 176.82). Marital Status was also significantly associated with Practice (p = 0.012). Single individuals (mean rank = 217.17) reported the highest practice scores, followed by married individuals (mean rank = 195.17), while divorced or widowed individuals had the lowest practice scores (mean rank = 139.44). Education level exhibited a strong, significant association with Practice (p < 0.001). Participants with higher education levels (Reads and Writes: mean rank = 214.40; Secondary school: mean rank = 227.08; University or higher: mean rank = 222.15) reported better practices compared to those who were illiterate (mean rank = 172.02) or had only primary education (mean rank = 154.33). The discovery method of Diabetes was significantly associated with Practice (p = 0.004). Patients whose Diabetes was discovered through routine investigations (mean rank = 234.55) reported better practices. The management plan was significantly associated with Practice (p < 0.001). Patients on a diet and insulin (mean rank = 220.39) reported the best practices, followed by those on Diet and oral drugs (mean rank = 194.10), while those with no stated management plan had the lowest practice scores (mean rank = 131.30). The type of drugs used was significantly associated with Practice (p = 0.009). Patients using insulin (mean rank = 228.87) or a combination of insulin and pills (mean rank = 215.13) reported better practices than those using only pills (mean rank = 184.03). Follow- Table 2 Factors associated with mean KAP scores towards complications of Diabetes (n = 384). Variable Mean score knowledge Attitude Practice Categories N Mean Rank . p Value Mean Rank . p Value Mean Rank . p Value Gender Male 167 203.33 0.089 220.37 0.001* 214.37 0.001* Female 217 184.16 171.06 175.67 Living area Rural 150 204.45 0.087 181.76 0.126 176.82 0.026* Civilize 234 202.55 199.38 202.55 Family History Yes 184 195.85 0.565 194.01 0.797 188.96 0.548 No 200 189.42 191.11 195.76 Herbal Use Yes 77 192.03 0.967 205.60 0.243 190.12 0.833 No 307 192.62 189.21 193.10 Age 20 to 39 Y 56 181.00 0.626 206.73 0.105 184.26 0.395 40 to 59 Y 190 196.85 199.66 200.28 ≥ 60 Y 138 191.18 176.86 185.13 Marital State Married 321 194.63 0.626 197.11 0.042* 195.17 0.012* Single 32 187.70 192.39 217.17 Divorced or a widow 31 175.44 144.87 139.44 Education Illiterate 152 190.47 0.118 164.16 0.001* 172.02 0.001* Reads and Writes 82 195.93 194.54 214.40 Primary 49 163.39 166.29 154.33 Secondary school 39 187.35 253.18 227.08 University or higher 62 219.18 241.83 222.15 Job Student 9 152.67 0.344 183.61 0.001* 178.83 0.102 Employee 67 212.03 237.88 225.29 Out of work 27 189.43 152.76 188.04 Worker 56 184.59 231.90 204.44 House wife 171 184.92 172.01 181.15 Retired 54 208.65 181.56 179.89 Income Low 202 193.37 0.004* 187.39 0.574 183.80 0.222 Moderate 120 172.13 195.59 198.48 High 62 229.10 203.16 209.26 Duration 1 to 5 Y 166 180.53 0.089 200.95 0.201 190.40 0.797 6 to 10 Y 105 195.74 189.11 186.97 11 to 15 Y 46 187.65 204.00 204.09 ¬ 15 Y 67 220.40 168.98 198.43 Type Type 1 16 194.91 0.316 215.41 0.585 225.97 0.430 Type 2 97 206.86 197.18 194.99 I do not know 271 187.22 189.47 189.63 Discover Routine investigations 29 160.86 0.270 222.72 0.012* 234.55 0.004* Coincidence 157 195.06 173.35 172.10 Symptoms 198 195.11 203.26 202.52 Management Diet and oral drugs 282 185.63 0.103 196.64 0.442 194.10 0.001* Diet and insulin 65 216.48 178.04 220.39 Non 37 202.73 186.38 131.30 Drugs Insulin 67 219.56 0.033* 185.73 0.811 228.87 0.009* Pills 309 185.44 193.60 184.03 Insulin and pills 8 238.69 206.81 215.13 Follow-up Self-monitoring 194 207.80 0.021* 205.06 0.007* 217.26 0.000* Hospital 137 175.68 190.74 193.01 Non 53 179.97 151.07 100.55 Up methods had a highly significant association with Practice (p < 0.001), with self- monitoring (mean rank = 217.26) associated with the highest practice scores, followed by hospital follow-up, and then no follow-up (mean rank = 100.55). No significant associations were found between practice scores and Family History, Herbal Use, Age, Job, Income, Duration of Diabetes, or Type of Diabetes. Table 2 Factors affecting KAP towards complications of Diabetes The bootstrapped regression model identified two statistically significant predictors of knowledge scores. Medication burden showed a significant negative association (B = -0.475, 95% Bootstrapped CI: -0.892 to -0.062, p = 0.025), indicating that patients prescribed more medications had lower knowledge scores. Follow-up status also demonstrated a significant negative relationship (B = -0.340, 95% CI: -0.625 to -0.054, p = 0.026), with inconsistent follow-up associated with diminished Knowledge. Monthly income did not reach statistical significance (B = 0.197, 95% CI: -0.121 to 0.480, p = 0.174). Table 3 Factors affecting the mean KAP score towards DM complications among DM patient s B Bias Std. Error P.value 95% Confidence Interval Lower Upper knowledge (Constant) 10.662 0.005 0.444 0.001 9.750 11.494 Income 0.197 -0.003 0.148 0.174 -0.121 0.480 Drugs -0.475 0.001 0.217 0.025 -0.892 -0.062 Follow Up -0.340 -0.003 0.148 0.026 -0.625 -0.054 Attitude (Constant) 26.670 0.000 1.184 0.001 24.381 29.129 Gander -0.756 -0.003 0.354 0.029 -1.460 -0.076 Marital State -0.267 0.012 0.261 0.291 -0.798 0.248 Education 0.482 0.001 0.140 0.001 0.208 0.759 Job 0.133 0.000 0.141 0.342 -0.138 0.410 Discover 0.155 0.000 0.225 0.484 -0.297 0.592 Follow Up -0.654 -0.011 0.242 0.009 -1.135 -0.205 Practice (Constant) 34.196 0.088 2.557 0.001 28.639 39.261 Gander -1.861 -0.014 0.647 0.006 -3.084 -0.522 Living area 1.225 -0.009 0.556 0.026 0.139 2.283 Marital State -0.435 0.013 0.387 0.258 -1.208 0.350 Education 0.075 0.005 0.231 0.745 -0.375 0.531 Discover 0.404 -0.016 0.439 0.363 -0.477 1.291 Management -1.257 -0.003 0.475 0.007 -2.216 -0.358 Drugs -1.914 -0.049 0.760 0.019 -3.436 -0.471 Follow Up -2.351 0.033 0.352 0.001 -2.997 -1.614 Attitude Score: Three significant predictors emerged. Male gender was negatively associated with positive attitudes (B = -0.756, 95% CI: -1.460 to -0.076, p = 0.029). Higher education level showed a strong positive association (B = 0.482, 95% CI: 0.208 to 0.759, p = 0.001). Inconsistent follow-up again demonstrated a significant negative relationship (B = -0.654, 95% CI: -1.135 to -0.205, p = 0.009). Marital Status, employment status, and method of disease discovery were not statistically significant predictors in this model Practice Score: The practice score model revealed the most robust findings. Follow-up inconsistency emerged as the strongest predictor (B = -2.351, 95% CI: -2.997 to -1.614, p = 0.001). Other significant negative predictors included male gender (B = -1.861, 95% CI: -3.084 to -0.522, p = 0.006), complex disease management (B = -1.257, 95% = CI: -2.216 to -0.358, p = 0.007), and higher medication burden (B = -1.914, 95% CI: -3.436 to -0.471, p = 0.019). Urban residence was the sole positive predictor (B = 1.225, 95% = CI: 0.139 to 2.283, p = 0.026). Educational attainment, marital Status, and discovery method showed no significant associations with practice scores. Table 3 Discussion This study aimed to determine the Knowledge, Attitudes, and Practices regarding diabetic complications among diabetic patients, and the demographic factors affecting patients' Knowledge, Attitudes, and Practices toward diabetic complications. Of 384 patients, the majority (56,5%) were female. In contrast (43,5%) were male, which is consistent with the gender distribution seen in the Mumbai study (Kazi et al., 2017). Furthermore, the study found a significant relationship between patients' gender and their Attitude and Practice. The mean age was 52.9; 190 patients (49.5%) were in the age group (40_59), which is consistent with Aldossari et al. (2015) (KAP) study in Saudi Arabia, 138 (35.9%) were 60 and older. The majority of the sample was illiterate (39.6%) and housewives (44.5%), which has an effect on Attitude and Practice. Most of the sample was living in urban areas (60.9%), which affects patients' practices regarding their disease. According to the income effect on Knowledge of Diabetes complications, low-income individuals were the dominant group (52.6%), which is comparable with the Ghana study by Obirikorang et al. (2016).In this research, knowledge level increased with the duration of the disease, despite the mean duration of the disease being 1_5 year (43.2%), which contradicts Sana'a's study by Al-omaisi et al. (2023), which showed that older patients had lower knowledge scores. Despite expectations that family history would improve patients' Knowledge, attitudes, and Practice, this study found no association, unlike the Dhaka study, which found an association between family history and patients' Practice (Rahman et al., 2017). Patients who discovered their disease through symptoms were almost half (51.6%), followed by those who discovered it by coincidence (40.9%). This affected patients' Attitude and Practice. Regarding the management of Diabetes mellitus, 282 of the sample size followed a diet and oral drugs; this improved their Practice toward the disease, whereas patients who took oral drugs with or without Diet had a better level of Knowledge and Practice. In the present study, it is observed that (50.5%) had a self-monitoring follow-up, then (35.7%) had a hospital follow-up, which strongly strengthens their results toward the Knowledge, Attitude, and Practice; however, patients who did not follow their blood sugar at all (13.8%) had weak results. Regarding Knowledge, the findings of the present study revealed that the majority of participants (58.3%) demonstrated a high level of Knowledge regarding diabetes complications. In comparison, 36.7% showed moderate Knowledge, and only 4.9% had low Knowledge, with a mean score of 9.55 (79.5). These results align with the study by Aldossari et al. (2015) in Saudi Arabia, which reported good awareness among diabetic patients, especially regarding common complications such as retinopathy, hypoglycemia, and diabetic foot. Supported by other studies, Nyamagoud et al. (2023) in India concluded that improved Knowledge positively impacts diabetes management. In our study, the maximal awareness was observed for complications such as coma/dizziness (96.4%), retinopathy (95.1%), and hypoglycemia (94.0%). In contrast, Knowledge was lower for pneumonia (60.2%) and stroke (68.8%). These results are consistent with Babelgaith et al. (2013) in Yemen, who highlighted poor awareness of less Obvious complications, such as pulmonary and neurological issues, despite adequate Comprehension of the Observation complication. Regarding factors influencing Knowledge, the duration of Diabetes showed a statistically significant positive correlation with Knowledge (p = 0.026), indicating that longer disease duration is associated with greater awareness. This is in line with Rahaman et al. (2017), who found that patients with a longer history of Diabetes had greater Knowledge of complications. Furthermore, follow-up methods were significantly associated with Knowledge (p = 0.010), with patients who practiced self-monitoring scoring higher than those who relied on hospital visits or had no follow-up. This finding is consistent in Wang et al. (2024) and Nyamagoud et al. (2023), who Certain the role of self-monitoring in Optimizing Knowledge and self-empowerment. Additionally, the type of medication used was significantly associated with Knowledge (p = 0.033). Patients using insulin or a combination of insulin and pills had higher knowledge levels than those using pills only, which is consistent with Bin Ahmed et al. (2019), who suggested that more intensive treatments encourage greater patient engagement and awareness. Interestingly, our study did not find statistically significant associations between Knowledge and variables such as age, gender, educational level, occupation, income, living area, family history, method of diagnosis, or use of herbal medicine. This is unlike findings from Obirikorang et al. (2016) and Al Shafaee et al. (2008), which indicated that younger age, female gender, and higher education were associated with better Knowledge. Similarly, ALhariri et al. (2017) in Yemen found that urban residence and higher education were key predictors of awareness, a finding that was not confirmed in our study. This divergence may be explained by the lack of Organized diabetes education programs in Ibb city or differences in participants' backgrounds and access to information. It also suggests that Knowledge may be acquired more through personal experience and interaction with healthcare providers than solely through sociodemographic factors. Therefore, our findings emphasize the need to strengthen diabetes education programs—especially for newly diagnosed patients, those without regular follow-up, and those treated only with oral medications—to improve Knowledge and prevent long-term complications. With reference to Attitude, plurality of respondents had an attitude percentage (87.3%), which is considered a fair Attitude. (95.3%) Of participants agreed that "healthy food is important for preventing diabetes complications"; this is consistent with the Mumbai study by Kazi et al. (2017). "You believe that regular examinations are necessary for early detection of Diabetes complications "had a positive attitude with (89.1%) percentage, this is consistent with the assessment of the level of (KAP) about diabetes mellitus in the Saudi Arabia study with (79.7%) Aldossari et al. (2015). In this study "you believe that controlling blood sugar levels reduces complications "had an agreement by the participants by (86.7%) which disagreed with Sana'a study Al-Omaisi et al. (2023), also in "you believe that monitoring cholesterol level is important for diabetes patients "disagreed with Mumbai study Kazi et al. (2017) in (75.3%),(12.9%) respectively. (87.2%) of participants had a positive attitude regarding the effect of exercise in controlling diabetes complications, which is almost similar to the result in Adaossari et al (2017), Rahman et al. (2017) with (79.7%), (70%%) respectively. The current study identified several significant correlations between patients' attitudes towards diabetic complications and their demographic and clinical characteristics. Gender exhibited a significant correlation with attitude scores, with males attaining higher scores than females (p = 0.000). This indicates that men might possess greater awareness or concern regarding diabetic complications. Marital Status was significantly correlated with attitude scores (p = 0.042), suggesting that married individuals generally exhibit more favorable attitudes. A study conducted in Dhaka found that similarly identified significant sociodemographic predictors of patients' attitudes towards Diabetes complications. In the Bangladesh sample, age, female gender, and marital Status were significantly correlated with more positive attitudes: older patients and women exhibited higher attitude scores. At the same time, married individuals outperformed their unmarried counterparts (Rahaman et al.,2017). Moreover, educational attainment exhibited a significant correlation (p = 0.000), with individuals possessing university degrees indicating higher attitude scores. A KAP study conducted in Karachi, Pakistan, assessed attitudes about Diabetes and its complications. The Pakistani study found that higher education was the only demographic factor significantly associated with more positive attitudes (p < 0.001) (Waris et al., 2021). This is similar to what we found in this study, where educational level also had a strong association with attitude scores (p = 0.000). A significant correlation was identified (p = 0.004), indicating that individuals with elevated income levels exhibited more positive attitudes. The method of Diabetes discovery was also significant (p = 0.012), indicating that people who discovered they had Diabetes through symptoms had better attitudes. This could be because they were diagnosed earlier and got help sooner. Follow-up practices, especially self-monitoring, were strongly linked to attitude scores (p = 0.007). This suggests that consistent monitoring may cultivate a more responsible and informed approach to the management and prevention of complications. These findings underscore the necessity of directing educational and behavioral interventions towards less-educated, low-income, and non-compliant patient populations to enhance attitudes and ultimately mitigate diabetes-related complications. About the Practice, the findings of this study revealed that more than half of the participants (56.3%) exhibited low levels of Practice concerning diabetes complications. In comparison, 32.3% showed moderate Practice, and only 11.5% reported high Practice, with a mean practice score of 24.8 (± 5.7). This indicates suboptimal self-care behaviors among diabetic patients, despite their relatively high Knowledge and positive attitudes. This finding is consistent with previous studies conducted in Yemen and other regions. For example, Alhariri et al. (2017) reported poor adherence to Diet (21%) and exercise (15.2%) among T2DM patients in Hodeidah city, leading to poor glycemic control. Similarly, Das et al. (2023) and Herath et al. (2017) in Sri Lanka and India observed insufficient self-monitoring, irregular foot care, and low commitment to preventive practices. These results reinforce the global trend that Knowledge alone does not always translate into appropriate Practice. In our study, only 43.8% of participants reported regularly checking their blood sugar levels, 40.6% followed a healthy diet, and 28.9% exercised regularly. Meanwhile, practices such as daily foot examination, regular eye checks, kidney screening, weight control, and cholesterol monitoring were largely neglected by most participants. These gaps may reflect a lack of motivation, limited access to healthcare services, or poor reinforcement of health education. Statistical analysis showed that several sociodemographic and clinical variables significantly influenced practice levels. Gender was a strong predictor, with males exhibiting better practices than females (p = 0.001), a result in contrast to Rahaman et al. (2017), who found better practices among females. The living area also showed a significant effect (p = 0.026), with participants from urban areas demonstrating better practices, consistent with ALhariri et al. (2017), who found that urban residents were more adherent to dietary recommendations. Moreover, education level showed a significant positive correlation with Practice (p = 0.003), where participants with secondary or higher education achieved higher practice scores. This is in line with Obirikorang et al. (2016) and Al Shafaee et al. (2008), who confirmed education as a key determinant of Diabetes self-care behaviors. Similarly, marital Status (p = 0.012), type of drug used (p = 0.009), management plan (p < 0.001), and, especially, follow-up methods (p < 0.001) were significantly associated with Practice. Participants who practiced self-monitoring had the highest practice scores, supporting the findings of Wang et al. (2024) and Bin Ahmed et al. (2019), which emphasized the impact of active self-involvement in improving diabetes care. On the contrary, no significant relationship was found between practice and age, income, duration of Diabetes, family history, discovery method, or use of herbal medication. This inconsistency with previous research may stem from cultural, economic, or healthcare system differences in the Yemeni context. In conclusion, while diabetic patients in Ibb city possess acceptable levels of Knowledge and attitudes toward complications, their actual practices remain insufficient. This calls for targeted interventions focusing not only on education but also on behavior change strategies, practical skill training, and stronger follow-up systems to improve daily diabetes self-management. The discrepancy between Knowledge and Practice—wherein patients know about complications but fail to implement preventive behaviors—is a recurrent theme in Diabetes research, Heart et al. (2017); Das et al (2023). This gap may stem from socioeconomic constraints, lack of access to health services, or insufficient reinforcement of Knowledge through healthcare provider interactions. In terms of Attitude, most patients expressed a willingness to prevent complications by adopting healthy lifestyles and acknowledged the importance of medical advice, routine check-ups, and lifestyle changes. These findings align with those of Rahaman et al. (2017), who reported similar positive attitudes in a Bangladeshi cohort. Furthermore, the strong correlation between Attitude and Practice (r = 0.482, p < 0.001) underscores the potential of attitude-oriented interventions to improve patients' behaviors. Despite positive attitudes, poor practice scores were observed across essential preventive measures, including regular foot and eye examinations, weight control, and cholesterol monitoring. This supports the findings of ALhariri et al. (2017) in Yemen and Das et al. (2023) in India, both of which found that many diabetic patients lacked adherence to self-care routines. It emphasizes the need for more structured education and support systems to facilitate the translation of Knowledge into behavior. The correlation analysis revealed that educational level significantly influenced both Attitude and Practice, highlighting education as a key determinant in diabetic self-management, as also reported in previous studies (Obirikorang et al., 2016; Rahaman et al., 2017). In summary, although the study population had commendable knowledge and attitude levels, this was not reflected in Practice. The findings call for comprehensive interventions focused on behavioral change, particularly among females, less educated individuals, and those without structured follow-up care. Health education programs tailored to these subgroups, alongside improved access to diabetes care and follow-up services, are essential for reducing complications and improving patient outcomes. Conclusion Knowledge of the complications of Diabetes was moderate to high; attitudes were positive, but practices were moderate. significant positive correlations between Knowledge, Attitude, and Practice, with Attitude having the strongest link to Practice. Inconsistent follow-up and male gender consistently impaired all KAP domains, with polypharmacy specifically harming Knowledge and Practice. At the same time, higher education and urban residence emerged as key, yet domain-specific, positive factors for Attitude and Practice, respectively. Implement consistent, tailored follow-up systems, particularly for male patients and those with complex medication regimens, to address the strongest negative predictor across all KAP domains. Create gender-sensitive and literacy-appropriate educational interventions that focus on translating Knowledge and positive attitudes into practical self-management skills, especially for rural residents. When clinically feasible, streamline medication regimens and management plans to mitigate the negative effects of polypharmacy and complexity on patient knowledge and Practice. Abbreviations (KAP) Knowledge, Attitudes, Practice (DM) Diabetes mellitus (T2DM) Type 2 diabetes mellitus (SPSS) Statistical Package for the Social Sciences (SD) Standard deviation Declarations Ethics Approval and Consent to Participate The study protocol received approval from the Institutional Review Board of Ibb University (approval number: IU-RB-2024-092, dated December 11, 2024). Given the retrospective nature of the research involving anonymized data collected during routine clinical care, the requirement for informed consent was waived by the ethics committee. Patient confidentiality was safeguarded throughout by anonymizing all data during collection and analysis, with no personal identifiers included in the research database. The study was conducted in accordance with the principles of the Declaration of Helsinki and applicable local regulations governing observational research. Data Availability Statement The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request. Competing Interests All authors declare that they have no competing interests to disclose. Consent for publication Not applicable. Contributors BA: Investigation, Methodology, Project Administration, Writing – Review & Editing ASH, WA: Conceptualization, Data Curation, Formal Analysis, Writing – Original Draft AS, AB, AN, AD: Investigation, Methodology, Project Administration, Writing – Review & Editing AA, EL, GA, RS, RA: Conceptualization, Data Curation, Formal Analysis, Writing – Original Draft WA: Supervision, Validation, Visualization, Writing – Review & Editing WA: Writing – Review & Editing, Corresponding Author Corresponding author Correspondence to Wadee Abdullah Al-Shehari Data availability The datasets used and analyzed in the current analysis are available from the corresponding author upon reasonable request. 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Prevalence of Type 2 Diabetes Mellitus Among Men in the Middle East: A Retrospective Study. American Journal of Men's Health ,13 (3), Deshpande, A. D., Harris-Hayes, M., & Schootman, M. (2008). Epidemiology of diabetes and diabetes-related complications. Physical Therapy , 88(11), 1254-1264. Tuttolomondo, A., Maida, C., & Pinto, A. (2015). Diabetic foot syndrome as a possible cardiovascular marker in diabetic patients . Journal of Diabetes Research , 2015, 1-12. Herath, H. M. M., Weerasinghe, N. P., Dias, H., & Weerarathna, T. P. (2017). Knowledge, Attitude and Practice related to Diabetes mellitus among the general public in Galle district in Southern Sri Lanka: A pilot study. BMC Public Health , 17, Article 535. https://doi.org/10.1186/s12889-017-4459-5 Das, A. K., Kalra, S., Joshi, S., Mithal, A., Prasanna Kumar, K. M., Unnikrishnan, A. G., Thacker, H., Sethi, B., Chowdhury, S., Sugumaran, A., Satpathy, A., Gadekar, A., Menon, S. K., Neogi, R., Chodankar, D., Trivedi, C., Wangnoo, S. K., Zargar, A. H., Rais, N., … LANDMARC Study Group. (2023). The Longitudinal Nationwide Study on Management and Real-world Outcomes of Diabetes in India over 3 years (LANDMARC trial). Endocrinology, Diabetes & Metabolism , 6(5), e422. https://doi.org/10.1002/edm2.422 Alhariri, A., Daud, F., Almaiman, A., and Saghir S. A. (2017). Factors associated with adherence to Diet and exercise among type 2 diabetes Patients in Hodeida city, Yemen. Diabetes Manag , 7(3), 264–271 Mareai S.S., Gawli K. (2023). Type 2 diabetes with obesity and hypertension: prevalence and sociodemographic risk factors in Yemen. Diabetes mellitus , 26(2):124-130 Al Shafaee, M. A., Al-Shukaili, S., Syed Gauher, Rizvi, S. G., Al Farsi, Y., Mushtaq A Khan, M. A., Ganguly, S. S., Mustafa Afifi, M., & Al Adawi, S. (2008). Knowledge and perceptions of Diabetes in a semi-urban Omani population. BMC Public Health ,8,249. https://doi.org/10. Obirikorang, Y., Obirikorang, C., Ant, E.O., Acheampong, E., Batu, E.N., Stella, A.D., Constance, O., and Peter Kojo Brenya, P.K.(2016). Knowledge of complications of Diabetes Mellitus among patients visiting the Diabetes clinic in the Samoan Government Rahaman, K. S., Majdzadeh, R., Naieni, K. H., & Raza, O. (2017). Knowledge, Attitude, and Practices (KAP) Regarding Chronic Complications of Diabetes among Patients with Type 2 Diabetes in Dhaka. International Journal of Endocrinology and Metabolism .15(3). Pop-Busui, R., Boulton, A. J. M., Feldman, E. L., Bril, V., Freeman, R., Malik, R. A., Sosenko, J. M., & Ziegler, D. (2023). Diabetic neuropathy: A position statement by the American Diabetes Association. Diabetes Care , 46(Suppl. 1), S133–S147. https://diabetesjournals.org Tesfaye, S., & Selvarajah, D. (2017). Advances in the epidemiology, pathogenesis, and management of diabetic peripheral neuropathy. Nature Reviews Endocrinology , 13(2), 88–100. https://www.nature.com Bamahel, A. S., Bafakeer, S., Bajaber, E., Baangood, F., Alkhalaqi, J., Bashkiail, K., Alsowial, K., Alkhalaqi, M., Baabbad, M., Bindahman, N., Binsehielan, S., & Bagetyan, W. (2022). Prevalence of diabetic nephropathy among type 2 diabetes mellitus patients in Mukalla City, Yemen. Ekst , 2(2), 046. doi: 10.30880/ekst.2022.02.02.046 Fan, W. (2017). Diabetes mellitus and cardiovascular disease. Cardiovascular Endocrinology , 6, 8-16. Mosenzon, O., Cheng, A. Y. Y., Rabinstein, A. A., & Sacco, S. (2023). Diabetes and stroke: What are the connections? Journal of Stroke , 25(1), 26-38. Soyoye, D. O., Abiodun, O. O., Ikem, R. T., Kolawole, B. A., & Akintomide, A. O. (2021). Diabetes and peripheral artery disease. World Journal of Diabetes , 2021 June 15;12 (6):827-838. https://www.f6publishing.com. Armstrong, D. G., Boulton, A. J. M., & Bus, S. A. (2017). Diabetic foot ulcers and their recurrence. The New England Journal of Medicine , 376(24), 2367–2375. https://doi.org/10.1056/NEJMra1615439 Kazi, R. N., Bote, M. M., & Raikar, K. J. (2017). Knowledge, Attitude, and Practices regarding diabetes mellitus and its complications among T2DM patients attending the UHC in Mumbai. International Journal of Community Medicine and Public Health , 4(8), 2793–2797. https://doi.org/10.18203/2394-6040.ijcmph20173325 Aldossari, K., Abdelrazik, M., Kamal, S., Al-Zahrani, J., Al-Ghamdi, S. (2015).Assessment of Levels of Knowledge, Attitude, and Practice regarding diabetes mellitus (DM), its Complications, and self-management among diabetic patients in AlKharj city, Saudi Arabia. International Journal of Advanced Research . 3(5)23_32. Al-Omaisi, A., Masoud, A., Abdullah, A., Madar, D., Al-Surabi, G., Al-Wainany, N., Saeed, O., Al.qopaty, R., Alemad, S., Alshehab, S. et al (2023). "Knowledge, Attitude and Practice among Diabetic Patients regarding Diabetic Complications at Public Diabetic Centers in Sana'a" [ Unpublished research manuscript]. Supervised by Dr. Aisha Khaled Al-Daeri, Community Medicine Department. Babelgaith, S. D., Baidi, M., & Alfadly, S. (2013). Assessment of the Knowledge and Practice of health care professionals towards diabetes care in Mukalla, Yemen. International Journal of Pharmacy Teaching & Practices , 4(4), 826–831. Wang, D., Liu, Z., Liu, Y., Zhao, L., He, S., &Duan, B. (2024). Knowledge, attitudes, and Practice among patients with diabetes mellitus and hyperuricemia toward disease self-management. Frontiers in Public Health, 12, Article 1426259. https://doi.org/10. Bin Ahmed, I., Binnwejim, M. S., Alnahas, T. M., Raes, A. A. A., Basamad, M. A., Alqurashi, A. E., Alotaibi, L. T., Alqasem, R. M., Ghazwani, S. M., Almuyidi, S. M., Alshehri, W. A., Alfuhigi, Z. D., & Almeshref, M. N. H. (2019). Level of diabetic patients' Knowledge of Diabetes mellitus, its complications, and management. Archives of Pharmacy Practice , 10(4), 80-86. Waris, N., Butt, A., Askari, S., Fawwad, A., & Basit, A. (2021). Diabetes and its complications: Knowledge, Attitude, and Practices (KAP) and their determinants in Pakistani people with type 2 diabetes . Journal of Diabetology , 12(3), 293–298. Additional Declarations No competing interests reported. Supplementary Files SupplementaryS1.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 22 Apr, 2026 Reviews received at journal 19 Apr, 2026 Reviewers agreed at journal 15 Apr, 2026 Reviewers agreed at journal 13 Apr, 2026 Reviewers invited by journal 08 Apr, 2026 Editor assigned by journal 06 Apr, 2026 Editor invited by journal 16 Mar, 2026 Submission checks completed at journal 13 Mar, 2026 First submitted to journal 12 Mar, 2026 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. 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20:38:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9060718/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9060718/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107245545,"identity":"8d857cff-d71d-4ee0-8c44-f7e1dd65f71b","added_by":"auto","created_at":"2026-04-19 08:05:55","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":92723,"visible":true,"origin":"","legend":"\u003cp\u003ePercentage Distribution Categories of KAP of patients towards Diabetic Complications\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9060718/v1/54402dbaf5b7a56fd9915234.png"},{"id":107245547,"identity":"be2c18ac-937f-4447-8f5e-05efda0c7d81","added_by":"auto","created_at":"2026-04-19 08:05:55","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":56446,"visible":true,"origin":"","legend":"\u003cp\u003eFrequency Distribution of Knowledge Regarding Diabetic Complication\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-9060718/v1/f3a1b6f8e6701c381079d164.png"},{"id":107483052,"identity":"8808f57b-0419-49cf-bc34-110eba5ad963","added_by":"auto","created_at":"2026-04-22 02:26:05","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":28710,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCorrelation between total Scores of Knowledge and attitude\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-9060718/v1/b7da9345e3cff8c59f9ce06c.png"},{"id":107245548,"identity":"19564143-8e49-431b-8294-3c3d5f7837e6","added_by":"auto","created_at":"2026-04-19 08:05:55","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":39756,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCorrelation between total Scores of Knowledge and Practice\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-9060718/v1/c62772cac895c5ad6cdf6e9a.png"},{"id":107482775,"identity":"7548eda5-dd2f-4031-9d2c-63e5c5bb6656","added_by":"auto","created_at":"2026-04-22 02:24:50","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":33857,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCorrelation between total Scores of Practice and Attitude\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-9060718/v1/ba4e7329f273dc8541e3f198.png"},{"id":107485845,"identity":"7ade25ea-6bb5-4db2-ad3e-e808430c4e0b","added_by":"auto","created_at":"2026-04-22 02:36:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1353981,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9060718/v1/e907f1be-17de-4bb0-b2d6-5bdf0b0293df.pdf"},{"id":107482148,"identity":"f39f9bb2-c272-432b-b455-1b5ec2ef2125","added_by":"auto","created_at":"2026-04-22 02:22:10","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":51253,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryS1.docx","url":"https://assets-eu.researchsquare.com/files/rs-9060718/v1/60965901cefb6a6f4e4e3b8c.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessment of Patients' Knowledge, Attitudes, and Practices Toward Diabetic Complications in Outpatient Clinics in Ibb City, Yemen","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDiabetes mellitus (DM), a chronic metabolic disorder characterized by hyperglycemia resulting from insufficient insulin production or insulin resistance (Al-Sharif \u0026amp; Gunaid, 2014; Dika et al., 2023), poses a substantial global health burden, with type 2 diabetes mellitus (T2DM) being the more prevalent form (Dika et al., 2023). is a primary focus of the World Health Organization's prevention and control efforts (Skolnik, 2018).\u003c/p\u003e\n\u003cp\u003eThe global prevalence of DM is rapidly increasing (Cole \u0026amp; Florez, 2022), affecting an estimated 10.5% of adults worldwide (IDF, 2021) and projected to reach 783 million by 2045 (idf.org). The Middle East region, including Yemen, faces a significant challenge related to T2DM (Meo et al., 2019). While regional data suggests a lower prevalence of Diabetes among men in Yemen compared to some neighboring countries (Meo et al., 2019) (\u003c/p\u003e\n\u003cp\u003eWhile DM is a recognized health issue in Yemen, with a recent estimate of 9.8% prevalence among men in 2019 (Meo et al., 2019) and an older study reporting an overall prevalence of 4.6% (Abdul Razzak et al., 2017),(The chronic complications of Diabetes are broadly categorized into microvascular (neuropathy, nephropathy, retinopathy) and macrovascular (cardiovascular disease, stroke, peripheral artery disease), with microvascular complications exhibiting a higher prevalence (Deshpande et al., 2008). Diabetic foot syndrome, a serious complication involving foot ulcers, neuropathy, peripheral artery disease, and infection, is a major cause of lower limb amputation (Tuttolomondo et al., 2015).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe effective management of DM and the prevention of its chronic complications, including microvascular (neuropathy, nephropathy, retinopathy) and macrovascular (cardiovascular disease, stroke, peripheral artery disease) conditions (Deshpande et al., 2008)\u003c/p\u003e\n\u003cp\u003eRelies significantly on patients' Knowledge, attitudes, and practices (KAP) towards their condition. Studies across various regions have revealed varying levels of KAP, with some indicating suboptimal knowledge (Al Shafaee et al., 2008; Nyamagoud et al., 2023), less than optimal attitudes (Herath et al., 2017; Nyamagoud et al., 2023), and inadequate self-management practices (Das et al., 2023; Herath et al., 2017; Nyamagoud et al., 2023; Alhariri et al., 2017(\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLocal studies indicate a high prevalence of associated metabolic risk factors such as overweight/obesity and hypertension among T2DM patients (Mareai \u0026amp; Gawli, 2023). Factors such as education level, gender, and socioeconomic Status have been shown to influence KAP (Al Shafaee et al., 2008; Obirikorang et al., 2016; Rahaman et al., 2017; Alhariri et al.,2017). While some local studies in Yemen have explored diabetes prevalence and risk factors (Mareai \u0026amp; Gawli, 2023; Alhariri et al., 2017), they have also been shown to influence KAP (Al Shafaee et al., 2008; Obirikorang et al., 2016; Rahaman et al., 2017; Alhariri et al., 2017).\u003c/p\u003e\n\u003cp\u003eDespite prior local investigations into Diabetes and its risk factors across various regions in Yemen, a significant research gap persists concerning the specific assessment of diabetic patients' Knowledge, attitudes, and practices (KAP) regarding the complications of their condition, particularly within Ibb City. Therefore, this study aims to assess patients' Knowledge, attitudes, and practices regarding diabetes complications in outpatient clinics in Ibb City, Yemen.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy Design and Setting\u003c/p\u003e\n\u003cp\u003eThe study was designed as a questionnaire-based, cross-sectional analysis from January 1 to July 1, 2025. It was conducted in outpatient clinics in the city of \u0026nbsp;Ibb. Yemen.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy population and Selection criteria:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe sample included patients with Diabetes \u0026ge; 18 years attending for follow-up or seeking general treatment in medicine outpatient Clinics. Exclusion criteria included the presence of gestational diabetes mellitus and an age younger than 18 years. Those unable to answer the questionnaire due to dementia, psychosis, or profound deafness were excluded from the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample size and sampling technique\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe sample size was estimated using a formula that considers p = 50%, a 95% degree of certainty, and a 5% margin of error. Accordingly, by employing convenient sampling, 384 patients with Diabetes were recruited from outpatient clinics in the city of Ibb.\u003c/p\u003e\n\u003cp\u003eTool of data collection\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1. Tool Design\u003c/p\u003e\n\u003cp\u003eThe questionnaire was adapted from relevant literature (Rahaman et al., 2017). A pre-tested, structured, bilingual questionnaire was developed to investigate key research questions, comprising closed-ended questions. The questionnaire was divided into 5 main categories, including Sociodemographic information, Medical History and Knowledge, Attitude, and Practice-related information. Relevant questions were asked of the respondents, such as the emphasis placed on the knowledge module, to assess the level of Knowledge of respondents\u003c/p\u003e\n\u003cp\u003efor complications of Diabetes. To assess Knowledge, Attitude, and practices, (12) Items (True/False), 10 Items (Positive Attitude, Moderate Attitude, Negative Attitude), and (13) Items (Low, Moderate, High) \u0026nbsp;questions were asked, respectively. related questions regarding diabetes complications. The questionnaire was prepared in English by a language expert, translated into the local language (Arabic), and then back-translated into English by another language expert to ensure consistency and wording. (Supplementary) S1\u003c/p\u003e\n\u003cp id=\"_Toc205063242\"\u003e2.Tools validity:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The questionnaire\u0026apos;s validity was verified by presenting the research instrument to a group of experts, and based on their feedback, the necessary adjustments were made. A pilot study was then conducted on 10% of the total sample (30 patients) to assess the validity and clarity of the study tool and to identify potential problems researchers might encounter that could affect the data collection process. Internal consistency validity was calculated using Spearman\u0026apos;s correlation coefficient. significant at p\u0026lt;0.001, indicating the internal consistency of the instrument items and their components.\u003c/p\u003e\n\u003cp id=\"_Toc205063246\"\u003e3.Tools reliability\u003c/p\u003e\n\u003cp\u003eThe questionnaire\u0026apos;s reliability was assessed using Cronbach\u0026apos;s alpha coefficient. It was 0.71 for the knowledge domain, 0.71 for the attitudes domain, and 0.71 for the practice domain. At the level of the overall study instrument, it was 0.79, indicating acceptable internal consistency and reliability.\u003c/p\u003e\n\u003cp\u003e4.Assessment of KAP(The KAP Score)\u003c/p\u003e\n\u003cp\u003eTo calculate the Knowledge, Attitude, and Practice (KAP) score, a scoring system was prepared.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eKnowledge score: Each correct answer was coded as 1, while each incorrect answer was coded as 0. The knowledge score was calculated by adding the scores for the correct answers. The total score of Knowledge ranged from (0_12). The mean knowledge score was divided by the highest score of 12, then multiplied by 100 to get the total knowledge percentage. To evaluate the level of Knowledge in general. To evaluate the level of Knowledge of \u0026nbsp;Categories \u0026nbsp;as follows: \u0026nbsp; \u0026nbsp;Low Knowledge: \u0026lt; 50%, Moderate Knowledge: (50% - 80%), High Knowledge (81 \u0026ndash; 100 %)\u003c/p\u003e\n\u003cp\u003eAttitudes score: Each item was scored (3) if the answer is (Positive Attitude), (2) if the answer is (Moderate Attitude), and (1) if the answer is (Negative Attitude). The total attitude score ranged from 10 to 30. The mean Attitudes score was divided by the highest score of 30, then multiplied by 100 to get the total knowledge percentage. To evaluate the level of Attitudes in general. Also, evaluate the level of Attitudes of Categories: Negative Attitude: Less than 50%, Moderate attitude (50% - Less than 80 %), Positive attitude (80% \u0026ndash; 100 %)\u003c/p\u003e\n\u003cp\u003ePractices Score: Each item was scored (3) if the answer is (high), scored (2) if the answer is (moderate), scored (1) if the answer is (low). The total Practices score ranged from 13 to 30. \u0026nbsp; The mean Practices score was divided by the highest score of 39, then multiplied by 100 to get the total knowledge percentage. To evaluate the level of Practices in general. Also, evaluate the level of Practices of Categories: low Practices: \u0026nbsp;Less than 50%, Moderate Practices: (50% - 80%), High Practices: (81% \u0026ndash; 100 %)\u003c/p\u003e\n\u003cp\u003eData Analysis\u003c/p\u003e\n\u003cp id=\"_Toc205063253\"\u003eThe collected data were entered into the Statistical Package for the Social Sciences (SPSS) version 27 for Windows. All continuous data were expressed as mean (SD), and categorical variables were expressed as numbers and percentages. Descriptive statistics and frequency distributions were used to describe participant characteristics. The Kolmogorov-Smirnov Test revealed a non-normal distribution. Use Spearman\u0026apos;s correlation coefficient test to determine the relationship between Knowledge, attitudes, and Practice. Spearman\u0026apos;s rank correlation coefficient was used to determine the relationship between the mean KAP score. For variables with two categories, the Mann-Whitney U Test was used, and for variables with more than two categories, the Kruskal-Wallis Test was used to compare means. \u0026quot;To overcome the normality assumption in linear regression, we used the Bootstrap resample technique to calculate corrected 95% confidence intervals, a method that does not require distributional assumptions and provides robust estimates.\u0026quot; Variables with p-values less than 0.05 in previous tests were included in the multivariate model. The relationships between each factor and the mean scores for Knowledge, attitudes, and practices were represented by standardized coefficients (beta coefficients) and a 95% confidence interval. A p-value less than 0.05 was considered statistically significant....\u003c/p\u003e"},{"header":"Result","content":"\u003cp\u003eA total of 384 patients with Diabetes were enrolled in the study. The gender distribution revealed that the majority of participants were female (N\u0026thinsp;=\u0026thinsp;217, 56.5%), while males accounted for 43.5% (N\u0026thinsp;=\u0026thinsp;167). The age group between 40 and 59 years was the largest among participants (N\u0026thinsp;=\u0026thinsp;190, 49.5%), followed by those aged 60 years and older (N\u0026thinsp;=\u0026thinsp;138, 35.9%).\u003c/p\u003e\n\u003cp\u003eThe youngest age group, 20 to 39 years, accounted for the smallest proportion (N\u0026thinsp;=\u0026thinsp;56, 14.6%). The mean standard deviation (SD) of age of the study participants was 52.9 12.96. The vast majority of participants were married (N\u0026thinsp;=\u0026thinsp;321, 83.6%). Single individuals accounted for 8.3% (N\u0026thinsp;=\u0026thinsp;32) of the sample, and divorced or widowed participants accounted for 8.1% (N\u0026thinsp;=\u0026thinsp;31). The participants\u0026apos; educational level indicated that the largest group was illiterate (N\u0026thinsp;=\u0026thinsp;152, 39.6%). Participants who could read and write comprised 21.4% (N\u0026thinsp;=\u0026thinsp;82). Smaller proportions had completed primary (N\u0026thinsp;=\u0026thinsp;49, 12.8%) or secondary (N\u0026thinsp;=\u0026thinsp;39, 10.2%) education.\u003c/p\u003e\n\u003cp\u003eWhile 16.1% (N\u0026thinsp;=\u0026thinsp;62) had attained university or higher education, the most common occupation reported was housewife (N\u0026thinsp;=\u0026thinsp;171, 44.5%). Other significant categories included employees (N\u0026thinsp;=\u0026thinsp;67, 17.4%), workers (N\u0026thinsp;=\u0026thinsp;56, 14.6%), and retired individuals (N\u0026thinsp;=\u0026thinsp;54, 14.1%). Students (N\u0026thinsp;=\u0026thinsp;9, 2.3%) and those out of work (N\u0026thinsp;=\u0026thinsp;27, 7.0%) constituted smaller segments of the study population. The distribution of living areas showed that the majority of participants resided in urban/civilized areas (N\u0026thinsp;=\u0026thinsp;234, 60.9%), while 39.1% (N\u0026thinsp;=\u0026thinsp;150) resided in rural areas. Finally, regarding monthly income, more than half of the participants reported low income (N\u0026thinsp;=\u0026thinsp;202, 52.6%). Participants with moderate income accounted for 31.3% (N\u0026thinsp;=\u0026thinsp;120), and only 16.1% (N\u0026thinsp;=\u0026thinsp;62) reported a high income.\u003c/p\u003e\n\u003cp\u003eThe largest proportion of participants had been living with Diabetes for 1 to 5 years (N\u0026thinsp;=\u0026thinsp;166, 43.2%). A significant number (N\u0026thinsp;=\u0026thinsp;105, 27.3%) had a duration of 6 to 10 years. Longer durations, from 11 to 15 years, accounted for 12.0% (N\u0026thinsp;=\u0026thinsp;46) of participants, while those with\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eCharacteristics of the study participants (n\u0026thinsp;=\u0026thinsp;384).\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e(%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e43.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e56.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMean(SD) 52.9(12.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20 to 39 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40 to 59 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e49.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ge;\u0026thinsp;60 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e35.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarital Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e321\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e83.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDivorced or a widow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEducation Level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e39.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eReads and Writes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e21.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e12.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUniversity or Higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e16.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eJob\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEmployee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e17.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOut of work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWorker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHouse wife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e44.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e14.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLiving area\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e39.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCivilize\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e234\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e60.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIncome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e52.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e31.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e16.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDuration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom 1 to 5 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e43.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom 6 to 10 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e27.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom 11 to 15 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e12.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMore than 15 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e17.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eType\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eType 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eType 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e25.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI do not know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e70.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiscovery Method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRoutine investigations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCoincidence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e40.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSymptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e51.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFamily History\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e47.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e52.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHerbal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e20.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e307\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e79.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eManagement Plan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiet and oral drugs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e282\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e73.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiet and insulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e16.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e9.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDrugs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e17.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e309\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e80.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsulin and pills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFollow Up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSelf-monitoring\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e194\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e50.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e35.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\"\u003e\n \u003cp\u003e13.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\"\u003eDiabetes for more than 15 years represented 17.4% (N\u0026thinsp;=\u0026thinsp;67) of the sample. A striking majority of participants (N\u0026thinsp;=\u0026thinsp;271, 70.6%) reported not knowing their diabetes type. Among those who did know, Type 2 diabetes was far more prevalent (N\u0026thinsp;=\u0026thinsp;97, 25.3%) than Type 1 diabetes (N\u0026thinsp;=\u0026thinsp;16, 4.2%). The method of Diabetes discovery was predominantly through symptoms (N\u0026thinsp;=\u0026thinsp;198, 51.6%), indicating that many patients sought medical attention due to the disease\u0026apos;s manifestations. A substantial portion (N\u0026thinsp;=\u0026thinsp;157, 40.9%) discovered their Diabetes by coincidence, while routine investigations accounted for a smaller percentage (N\u0026thinsp;=\u0026thinsp;29, 7.6%)\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eParticipants were almost equally divided, with slightly more (N\u0026thinsp;=\u0026thinsp;200, 52.1%) reporting no family history than those who did (N\u0026thinsp;=\u0026thinsp;184, 47.9%). The use of herbal medication was reported by a minority of participants, with 20.1% (N\u0026thinsp;=\u0026thinsp;77) indicating \u0026apos;Yes\u0026apos; and the majority (79.9%, N\u0026thinsp;=\u0026thinsp;307) reporting \u0026apos;No\u0026apos;.\u003c/p\u003e\n\u003cp\u003eRegarding the management plan, the most common approach was Diet and oral drugs (N\u0026thinsp;=\u0026thinsp;282, 73.4%). A smaller proportion managed their condition with Diet and insulin (N\u0026thinsp;=\u0026thinsp;65, 16.9%), while 9.6% (N\u0026thinsp;=\u0026thinsp;37) reported no specific management plan. Concerning drug regimens, the majority of participants were using pills (N\u0026thinsp;=\u0026thinsp;309, 80.5%). Insulin was used by 17.4% (N\u0026thinsp;=\u0026thinsp;67) of patients, and a very small percentage (2.1%, N\u0026thinsp;=\u0026thinsp;8) used both insulin and pills.\u003c/p\u003e\n\u003cp\u003eFinally, for follow-up methods, self-monitoring was the most common approach (N\u0026thinsp;=\u0026thinsp;194, 50.5%). Follow-up at a hospital was reported by 35.7% (N\u0026thinsp;=\u0026thinsp;137) of participants, and 13.8% (N\u0026thinsp;=\u0026thinsp;53) reported no regular follow-up. in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003ch3\u003eKnowledge of diabetic patients towards complications of Diabetes\u003c/h3\u003e\n\u003cp\u003eThe maximum knowledge score was 12. The mean score was 9.55 (95% CI 9.3\u0026ndash;9.8), and the standard deviation (SD) was \u0026plusmn;\u0026thinsp;2.15, with a range of 2 to 12. Knowledge of the complications of Diabetes was moderate to high. (79.6%). The study indicated that more than 80% of participants had high Knowledge regarding diabetic complications (n\u0026thinsp;=\u0026thinsp;224; 85.3%). Fewer than 60% % of participants possessed medium Knowledge (n\u0026thinsp;=\u0026thinsp;141; 36.7%). Only 19 participants (4.9%) possessed low Knowledge, Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n\u003cp\u003eA notable majority of participants demonstrated high levels of Knowledge, with over 80% providing correct responses, concerning Coma, dizziness, and fainting (96.4% ) Retinopathy (95.1% correct) Hypoglycemia (94.0% ) Neuropathy (87.5% correct) Diabetic foot ulcers and wounds (82.8% ) Conversely, knowledge levels were relatively lower, but still moderate (below 80% correct responses but generally above 60%), for the following complications: Teeth Decay (78.6%), Renal Complications (75.3%) Skin discoloration in diabetic foot (73.4%), High blood pressure (72.9% correct) Heart and Vascular Complications (70.3%), Stroke (68.8%). Pneumonia (60.2% ). Figure \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003ch3\u003eLl\u003c/h3\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003eAttitude of diabetic patients towards complications of Diabetes\u003c/h2\u003e\n \u003cp\u003eAttitude Score: The maximum attitude score was 10. The mean score was 26.20 (95% CI for\u003c/p\u003e\n \u003cp\u003emean 25.9\u0026ndash;26.5), and the standard deviation (SD) was \u0026plusmn;\u0026thinsp;3.16 with a range of 14 to 30. Their Attitude was positive (87%). The study indicated that more than 50% of participants had high Knowledge regarding diabetic complications (n\u0026thinsp;=\u0026thinsp;335; 87.3%). (n\u0026thinsp;=\u0026thinsp;48; 12.4%) Of the participants had a moderate attitude regarding diabetic complications. About 0.3% (n\u0026thinsp;=\u0026thinsp;1) of the participants had a negative attitude level. Figure \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003eThere was Attitude positive in \u0026quot;You believe that healthy food is important for preventing diabetes complications\u0026quot; (95.3%) \u0026quot;You believe that regular examinations are necessary for early detection of diabetes complications\u0026quot; (89.1%) \u0026quot;You believe that regular exercise helps control diabetes complications\u0026quot; (87.2%) \u0026quot;You believe that controlling blood sugar levels reduces complications\u0026quot; (86.7%)\u0026quot;You trust the information you receive from the doctor about diabetes complications\u0026quot; (85.7%), A considerable proportion of participants also \u0026quot;You believe that monitoring cholesterol level is important for diabetes patients\u0026quot; (75.3%) \u0026quot;You worry about diabetes complications\u0026quot; (68.8%) \u0026quot;You are willing to change your lifestyle to control diabetes complications\u0026quot; (57.8%) \u0026quot;You are interested in reading health information about diabetes and its complications\u0026quot; (51.6%) The percentage of Moderate Attitude responses for most items remained relatively low (typically below 15%), \u0026quot;You believe you can control diabetes\u0026quot; (34.6%), and \u0026quot;You are interested in reading health information about diabetes and its complications\u0026quot; (26.3%).\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003ePractice of diabetic patients towards complications of Diabetes\u003c/h3\u003e\n\u003cp\u003eThe maximum practice score was 37. The mean score was 24.8 (95% CI for the mean 24.2 to 25.5), and the standard deviation (SD) was \u0026plusmn;\u0026thinsp;5.7, with a range of 13 to 39. The study indicated that more than 50% of participants had moderate Practice regarding diabetic complications (n\u0026thinsp;=\u0026thinsp;244; 36.5%). The finding was that 25% (n\u0026thinsp;=\u0026thinsp;96) of participants scored low in Practice regarding diabetic complications. Almost (n\u0026thinsp;=\u0026thinsp;44; 11.5%) of the participants possessed High Practice. Figure \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eThe vast majority of participants reported taking their medications regularly (79.9%), indicating strong compliance with prescribed treatments. However, for most other crucial practices, adherence was notably lower: Regularly checking blood sugar levels was reported as high by fewer than half of the participants (43.8%), with 36.5% at a medium level, and 19.8% at a low level. While following a healthy diet was reported as high by 40.6% (N\u0026thinsp;=\u0026thinsp;156), an equal proportion (40.6%) reported a medium level, suggesting inconsistent dietary adherence for many. Visiting the doctor regularly and checking blood pressure showed moderate to low adherence: only 29.9% and 30.2% reported high adherence, respectively, while a substantial proportion (33.1% and 34.6%) reported low adherence to these essential activities. Exercising regularly was also a challenge, with only 28.9% reporting high Practice, and 34.4% reporting low Practice. Reading about diabetes complications had the highest percentage of low Practice among specific items (43.5%).\u003c/p\u003e\n\u003cp\u003eFurthermore, key preventive practices showed particularly low adherence: More than half of the participants reported low adherence for: Examining their feet daily (57.6% Low), Having regular eye examinations (63.5% Low), Checking their kidneys periodically (56.8% Low), Controlling their weight (52.9% Low), Checking cholesterol levels (55.2% Low)\u003c/p\u003e\n\u003ch3\u003eCorrelation Between Knowledge, Attitude, and Practice\u003c/h3\u003e\n\u003cp\u003eKnowledge showed a significant positive correlation with Attitude (r\u0026thinsp;=\u0026thinsp;0.237, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) and Practice (r\u0026thinsp;=\u0026thinsp;0.268, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001; Figs. \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e and \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). Attitude demonstrated a strong positive correlation with Practice (r\u0026thinsp;=\u0026thinsp;0.482, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). Figure \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003ch2\u003eFactors associated with mean KAP scores towards complications of Diabetes\u003c/h2\u003e\n \u003cp\u003e\u003cstrong\u003eFactors associated with Knowledge about the complications of Diabetes: The study indicated that Income level, drugs\u003c/strong\u003e, and Follow-up were associated with mean knowledge scores. Patients with higher income had better Knowledge (p\u0026thinsp;=\u0026thinsp;0.004). Participants in the high-income group (mean rank\u0026thinsp;=\u0026thinsp;229.10) had higher knowledge scores than those with moderate (mean rank\u0026thinsp;=\u0026thinsp;195.59) or low (mean rank\u0026thinsp;=\u0026thinsp;187.39) income. Additionally, the type of drugs used showed a significant association with Knowledge (p\u0026thinsp;=\u0026thinsp;0.033), with patients using both insulin and pills having the Highest mean rank (238.69), followed by those on insulin (219.56), and then those on pills only (185.44). Follow-up methods were also significantly associated with Knowledge (p\u0026thinsp;=\u0026thinsp;0.021); those relying on self-monitoring (mean rank\u0026thinsp;=\u0026thinsp;207.80) had higher knowledge scores than those attending hospitals or having no follow-up. No significant associations were found between knowledge scores and Gender, Living area, Family History, Herbal Use, Age, Marital Status, Education, Job, Duration of Diabetes, Type of Diabetes, Discovery Method, or Management Plan (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFactors associated with Attitude towards complications of Diabetes\u003c/strong\u003e: Gender was significantly associated with Attitude (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with males (mean rank\u0026thinsp;=\u0026thinsp;220.37) demonstrating more positive attitudes than females (mean rank\u0026thinsp;=\u0026thinsp;171.06). Marital Status was significantly associated with Attitude (p\u0026thinsp;=\u0026thinsp;0.042). Married individuals (mean rank\u0026thinsp;=\u0026thinsp;197.11) and single individuals (mean rank\u0026thinsp;=\u0026thinsp;192.39) tended to have better attitudes than those who were divorced or widowed (mean rank\u0026thinsp;=\u0026thinsp;144.87). Education level had a Dramatically association with Attitude (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Participants with higher education levels (Secondary school: mean rank\u0026thinsp;=\u0026thinsp;253.18; University or higher: mean rank\u0026thinsp;=\u0026thinsp;241.83) had more positive attitudes than those with lower educational backgrounds (Illiterate: mean rank\u0026thinsp;=\u0026thinsp;164.16; Primary: mean rank\u0026thinsp;=\u0026thinsp;166.29). Job status also showed a strong, significant association with Attitude (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Employees (mean rank\u0026thinsp;=\u0026thinsp;237.88) and workers (mean rank\u0026thinsp;=\u0026thinsp;231.90) showed better attitudes than other occupational groups, such as housewives (mean rank\u0026thinsp;=\u0026thinsp;172.01) and the unemployed (mean rank\u0026thinsp;=\u0026thinsp;152.76). The discovery method of Diabetes was significantly related to Attitude (p\u0026thinsp;=\u0026thinsp;0.012). Participants whose Diabetes was discovered through routine investigations (mean rank\u0026thinsp;=\u0026thinsp;222.72) tended to have more positive attitudes than those whose Diabetes was discovered by coincidence or symptoms. Follow-up methods also appear to be significantly associated with Attitude (p\u0026thinsp;=\u0026thinsp;0.007), with individuals who are self-monitoring (mean rank\u0026thinsp;=\u0026thinsp;205.06) demonstrating more positive attitudes than those who primarily rely on hospital visits or have no follow-up. No significant associations were reported between attitude scores and Living area, Family History, Herbal Use, Age, Income, Duration of Diabetes, Type of Diabetes, Management Plan, or Drugs. Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFactors associated with Practice towards complications of Diabetes\u003c/strong\u003e: Gender was significantly associated with Practice (p\u0026thinsp;=\u0026thinsp;0.001), with males (mean rank\u0026thinsp;=\u0026thinsp;214.37) reporting better practices than females (mean rank\u0026thinsp;=\u0026thinsp;175.67). The living area showed a significant association (p\u0026thinsp;=\u0026thinsp;0.026), with participants from civilized/urban areas (mean rank\u0026thinsp;=\u0026thinsp;202.55) demonstrating better practices compared to those from rural areas (mean rank\u0026thinsp;=\u0026thinsp;176.82). Marital Status was also significantly associated with Practice (p\u0026thinsp;=\u0026thinsp;0.012). Single individuals (mean rank\u0026thinsp;=\u0026thinsp;217.17) reported the highest practice scores, followed by married individuals (mean rank\u0026thinsp;=\u0026thinsp;195.17), while divorced or widowed individuals had the lowest practice scores (mean rank\u0026thinsp;=\u0026thinsp;139.44). Education level exhibited a strong, significant association with Practice (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Participants with higher education levels (Reads and Writes: mean rank\u0026thinsp;=\u0026thinsp;214.40; Secondary school: mean rank\u0026thinsp;=\u0026thinsp;227.08; University or higher: mean rank\u0026thinsp;=\u0026thinsp;222.15) reported better practices compared to those who were illiterate (mean rank\u0026thinsp;=\u0026thinsp;172.02) or had only primary education (mean rank\u0026thinsp;=\u0026thinsp;154.33). The discovery method of Diabetes was significantly associated with Practice (p\u0026thinsp;=\u0026thinsp;0.004). Patients whose Diabetes was discovered through routine investigations (mean rank\u0026thinsp;=\u0026thinsp;234.55) reported better practices. The management plan was significantly associated with Practice (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Patients on a diet and insulin (mean rank\u0026thinsp;=\u0026thinsp;220.39) reported the best practices, followed by those on Diet and oral drugs (mean rank\u0026thinsp;=\u0026thinsp;194.10), while those with no stated management plan had the lowest practice scores (mean rank\u0026thinsp;=\u0026thinsp;131.30). The type of drugs used was significantly associated with Practice (p\u0026thinsp;=\u0026thinsp;0.009). Patients using insulin (mean rank\u0026thinsp;=\u0026thinsp;228.87) or a combination of insulin and pills (mean rank\u0026thinsp;=\u0026thinsp;215.13) reported better practices than those using only pills (mean rank\u0026thinsp;=\u0026thinsp;184.03). Follow-\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eFactors associated with mean KAP scores towards complications of Diabetes (n\u0026thinsp;=\u0026thinsp;384).\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eVariable\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eMean score\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eknowledge\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eAttitude\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ePractice\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eCategories\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMean Rank\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e. \u003cem\u003ep Value\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMean Rank\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e. \u003cem\u003ep Value\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMean Rank\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e. \u003cem\u003ep Value\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eGender\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e203.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.089\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e220.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e214.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e184.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e171.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e175.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eLiving area\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e204.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.087\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e181.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e176.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.026*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCivilize\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e234\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e202.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e199.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e202.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eFamily History\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e195.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.565\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e194.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.797\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e188.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.548\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e189.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e191.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e195.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eHerbal Use\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e192.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.967\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e205.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e190.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.833\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e307\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e192.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e189.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e193.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20 to 39 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e181.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.626\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e206.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e184.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.395\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40 to 59 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e196.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e199.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e200.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ge;\u0026thinsp;60 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e191.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e176.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e185.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarital State\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e321\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e194.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.626\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e197.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.042*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e195.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.012*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e187.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e192.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e217.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDivorced or a widow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e175.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e144.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e139.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEducation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e190.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e164.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e172.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eReads and Writes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e195.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e194.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e214.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e163.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e166.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e154.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e187.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e253.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e227.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUniversity or higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e219.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e241.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e222.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eJob\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e152.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.344\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e183.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e178.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.102\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEmployee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e212.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e237.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e225.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOut of work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e189.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e152.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e188.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWorker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e184.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e231.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e204.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHouse wife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e184.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e172.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e181.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e208.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e181.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e179.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIncome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e193.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.004*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e187.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.574\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e183.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.222\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e172.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e195.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e198.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e229.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e203.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e209.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDuration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 to 5 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e180.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.089\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e200.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e190.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.797\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 to 10 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e195.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e189.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e186.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11 to 15 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e187.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e204.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e204.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026not; 15 Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e220.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e168.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e198.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eType\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eType 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e194.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.316\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e215.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.585\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e225.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.430\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eType 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e206.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e197.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e194.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI do not know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e187.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e189.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e189.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiscover\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRoutine investigations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e160.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.270\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e222.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.012*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e234.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.004*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCoincidence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e195.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e173.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e172.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSymptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e195.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e203.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e202.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eManagement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiet and oral drugs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e282\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e185.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e196.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.442\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e194.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiet and insulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e216.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e178.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e220.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e202.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e186.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e131.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDrugs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e219.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.033*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e185.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.811\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e228.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.009*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e309\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e185.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e193.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e184.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsulin and pills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e238.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e206.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e215.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFollow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSelf-monitoring\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e194\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e207.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.021*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e205.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.007*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e217.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e175.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e190.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e193.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e179.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e151.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e100.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003eUp methods had a highly significant association with Practice (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with self-\u003c/p\u003e\n \u003cp\u003emonitoring (mean rank\u0026thinsp;=\u0026thinsp;217.26) associated with the highest practice scores, followed by hospital follow-up, and then no follow-up (mean rank\u0026thinsp;=\u0026thinsp;100.55). No significant associations were found between practice scores and Family History, Herbal Use, Age, Job, Income, Duration of Diabetes, or Type of Diabetes. Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n \u003ch2\u003eFactors affecting KAP towards complications of Diabetes\u003c/h2\u003e\n \u003cp\u003eThe bootstrapped regression model identified two statistically significant predictors of \u003cstrong\u003eknowledge scores.\u003c/strong\u003e Medication burden showed a significant negative association (B = -0.475, 95% Bootstrapped CI: -0.892 to -0.062, p\u0026thinsp;=\u0026thinsp;0.025), indicating that patients prescribed more medications had lower knowledge scores. Follow-up status also demonstrated a significant negative relationship (B = -0.340, 95% CI: -0.625 to -0.054, p\u0026thinsp;=\u0026thinsp;0.026), with inconsistent follow-up associated with diminished Knowledge. Monthly income did not reach statistical significance (B\u0026thinsp;=\u0026thinsp;0.197, 95% CI: -0.121 to 0.480, p\u0026thinsp;=\u0026thinsp;0.174).\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cstrong\u003eFactors affecting the mean KAP score towards DM complications among DM patient\u003c/strong\u003es\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth rowspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/th\u003e\n \u003cth rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eBias\u003c/p\u003e\n \u003c/th\u003e\n \u003cth rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eStd. Error\u003c/p\u003e\n \u003c/th\u003e\n \u003cth rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eP.value\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e95% Confidence Interval\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eLower\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eUpper\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eknowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(Constant)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.662\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.444\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.750\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.494\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIncome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.197\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.480\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDrugs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.475\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.892\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.062\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFollow Up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.340\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.026\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.625\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAttitude\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(Constant)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.670\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24.381\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29.129\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGander\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.756\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.354\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.460\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.076\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarital State\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.261\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.291\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.798\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.248\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEducation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.482\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.140\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.208\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.759\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eJob\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.342\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.410\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiscover\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.484\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.297\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.592\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFollow Up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.654\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.205\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePractice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(Constant)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.196\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.557\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28.639\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.261\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGander\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.861\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.647\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.084\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.522\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLiving area\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.556\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.026\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.283\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarital State\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.435\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.387\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.258\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.208\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.350\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEducation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.075\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.745\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.375\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.531\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiscover\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.404\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.439\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.363\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.477\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.291\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eManagement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.475\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.358\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDrugs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.914\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.760\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.436\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.471\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFollow Up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.033\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.997\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.614\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp\u003e\u003cstrong\u003eAttitude Score:\u003c/strong\u003e Three significant predictors emerged. Male gender was negatively associated with positive attitudes (B = -0.756, 95% CI: -1.460 to -0.076, p = 0.029). Higher education level showed a strong positive association (B = 0.482, 95% CI: 0.208 to 0.759, p = 0.001). Inconsistent follow-up again demonstrated a significant negative relationship (B = -0.654, 95% CI: -1.135 to -0.205, p = 0.009). Marital Status, employment status, and method of disease discovery were not statistically significant predictors in this model\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePractice Score:\u0026nbsp;\u003c/strong\u003eThe practice score model revealed the most robust findings. Follow-up inconsistency emerged as the strongest predictor (B = -2.351, 95% CI: -2.997 to -1.614, p = 0.001). Other significant negative predictors included male gender (B = -1.861, 95% CI: -3.084 to -0.522, p = 0.006), complex disease management (B = -1.257, 95% = CI: -2.216 to -0.358, p = 0.007), and higher medication burden (B = -1.914, 95% CI: -3.436 to -0.471, p = 0.019). Urban residence was the sole positive predictor (B = 1.225, 95% = CI: 0.139 to 2.283, p = 0.026). Educational attainment, marital Status, and discovery method showed no significant associations with practice scores. \u003cstrong\u003eTable 3\u003c/strong\u003e\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to determine the Knowledge, Attitudes, and Practices regarding diabetic complications among diabetic patients, and the demographic factors affecting patients' Knowledge, Attitudes, and Practices toward diabetic complications. Of 384 patients, the majority (56,5%) were female. In contrast (43,5%) were male, which is consistent with the gender distribution seen in the Mumbai study (Kazi et al., 2017). Furthermore, the study found a significant relationship between patients' gender and their Attitude and Practice.\u003c/p\u003e \u003cp\u003eThe mean age was 52.9; 190 patients (49.5%) were in the age group (40_59), which is consistent with Aldossari et al. (2015) (KAP) study in Saudi Arabia, 138 (35.9%) were 60 and older. The majority of the sample was illiterate (39.6%) and housewives (44.5%), which has an effect on Attitude and Practice. Most of the sample was living in urban areas (60.9%), which affects patients' practices regarding their disease.\u003c/p\u003e \u003cp\u003eAccording to the income effect on Knowledge of Diabetes complications, low-income individuals were the dominant group (52.6%), which is comparable with the Ghana study by Obirikorang et al. (2016).In this research, knowledge level increased with the duration of the disease, despite the mean duration of the disease being 1_5\u0026nbsp;year (43.2%), which contradicts Sana'a's study by Al-omaisi et al. (2023), which showed that older patients had lower knowledge scores. Despite expectations that family history would improve patients' Knowledge, attitudes, and Practice, this study found no association, unlike the Dhaka study, which found an association between family history and patients' Practice (Rahman et al., 2017).\u003c/p\u003e \u003cp\u003ePatients who discovered their disease through symptoms were almost half (51.6%), followed by those who discovered it by coincidence (40.9%). This affected patients' Attitude and Practice. Regarding the management of Diabetes mellitus, 282 of the sample size followed a diet and oral drugs; this improved their Practice toward the disease, whereas patients who took oral drugs with or without Diet had a better level of Knowledge and Practice. In the present study, it is observed that (50.5%) had a self-monitoring follow-up, then (35.7%) had a hospital follow-up, which strongly strengthens their results toward the Knowledge, Attitude, and Practice; however, patients who did not follow their blood sugar at all (13.8%) had weak results.\u003c/p\u003e \u003cp\u003eRegarding Knowledge, the findings of the present study revealed that the majority of participants (58.3%) demonstrated a high level of Knowledge regarding diabetes complications. In comparison, 36.7% showed moderate Knowledge, and only 4.9% had low Knowledge, with a mean score of 9.55 (79.5). These results align with the study by Aldossari et al. (2015) in Saudi Arabia, which reported good awareness among diabetic patients, especially regarding common complications such as retinopathy, hypoglycemia, and diabetic foot. Supported by other studies, Nyamagoud et al. (2023) in India concluded that improved Knowledge positively impacts diabetes management.\u003c/p\u003e \u003cp\u003eIn our study, the maximal awareness was observed for complications such as coma/dizziness (96.4%), retinopathy (95.1%), and hypoglycemia (94.0%). In contrast, Knowledge was lower for pneumonia (60.2%) and stroke (68.8%). These results are consistent with Babelgaith et al. (2013) in Yemen, who highlighted poor awareness of less Obvious complications, such as pulmonary and neurological issues, despite adequate Comprehension of the Observation complication.\u003c/p\u003e \u003cp\u003eRegarding factors influencing Knowledge, the duration of Diabetes showed a statistically significant positive correlation with Knowledge (p\u0026thinsp;=\u0026thinsp;0.026), indicating that longer disease duration is associated with greater awareness. This is in line with Rahaman et al. (2017), who found that patients with a longer history of Diabetes had greater Knowledge of complications. Furthermore, follow-up methods were significantly associated with Knowledge (p\u0026thinsp;=\u0026thinsp;0.010), with patients who practiced self-monitoring scoring higher than those who relied on hospital visits or had no follow-up. This finding is consistent in Wang et al. (2024) and Nyamagoud et al. (2023), who Certain the role of self-monitoring in Optimizing Knowledge and self-empowerment.\u003c/p\u003e \u003cp\u003eAdditionally, the type of medication used was significantly associated with Knowledge (p\u0026thinsp;=\u0026thinsp;0.033). Patients using insulin or a combination of insulin and pills had higher knowledge levels than those using pills only, which is consistent with Bin Ahmed et al. (2019), who suggested that more intensive treatments encourage greater patient engagement and awareness.\u003c/p\u003e \u003cp\u003eInterestingly, our study did not find statistically significant associations between Knowledge and variables such as age, gender, educational level, occupation, income, living area, family history, method of diagnosis, or use of herbal medicine. This is unlike findings from Obirikorang et al. (2016) and Al Shafaee et al. (2008), which indicated that younger age, female gender, and higher education were associated with better Knowledge. Similarly, ALhariri et al. (2017) in Yemen found that urban residence and higher education were key predictors of awareness, a finding that was not confirmed in our study.\u003c/p\u003e \u003cp\u003eThis divergence may be explained by the lack of Organized diabetes education programs in Ibb city or differences in participants' backgrounds and access to information. It also suggests that Knowledge may be acquired more through personal experience and interaction with healthcare providers than solely through sociodemographic factors.\u003c/p\u003e \u003cp\u003eTherefore, our findings emphasize the need to strengthen diabetes education programs\u0026mdash;especially for newly diagnosed patients, those without regular follow-up, and those treated only with oral medications\u0026mdash;to improve Knowledge and prevent long-term complications.\u003c/p\u003e \u003cp\u003eWith reference to Attitude, plurality of respondents had an attitude percentage (87.3%), which is considered a fair Attitude. (95.3%) Of participants agreed that \"healthy food is important for preventing diabetes complications\"; this is consistent with the Mumbai study by Kazi et al. (2017). \"You believe that regular examinations are necessary for early detection of Diabetes complications \"had a positive attitude with (89.1%) percentage, this is consistent with the assessment of the level of (KAP) about diabetes mellitus in the Saudi Arabia study with (79.7%) Aldossari et al. (2015). In this study \"you believe that controlling blood sugar levels reduces complications \"had an agreement by the participants by (86.7%) which disagreed with Sana'a study Al-Omaisi et al. (2023), also in \"you believe that monitoring cholesterol level is important for diabetes patients \"disagreed with Mumbai study Kazi et al. (2017) in (75.3%),(12.9%) respectively. (87.2%) of participants had a positive attitude regarding the effect of exercise in controlling diabetes complications, which is almost similar to the result in Adaossari et al (2017), Rahman et al. (2017) with (79.7%), (70%%) respectively.\u003c/p\u003e \u003cp\u003eThe current study identified several significant correlations between patients' attitudes towards diabetic complications and their demographic and clinical characteristics. Gender exhibited a significant correlation with attitude scores, with males attaining higher scores than females (p\u0026thinsp;=\u0026thinsp;0.000). This indicates that men might possess greater awareness or concern regarding diabetic complications. Marital Status was significantly correlated with attitude scores (p\u0026thinsp;=\u0026thinsp;0.042), suggesting that married individuals generally exhibit more favorable attitudes. A study conducted in Dhaka found that similarly identified significant sociodemographic predictors of patients' attitudes towards Diabetes complications. In the Bangladesh sample, age, female gender, and marital Status were significantly correlated with more positive attitudes: older patients and women exhibited higher attitude scores. At the same time, married individuals outperformed their unmarried counterparts (Rahaman et al.,2017).\u003c/p\u003e \u003cp\u003eMoreover, educational attainment exhibited a significant correlation (p\u0026thinsp;=\u0026thinsp;0.000), with individuals possessing university degrees indicating higher attitude scores. A KAP study conducted in Karachi, Pakistan, assessed attitudes about Diabetes and its complications. The Pakistani study found that higher education was the only demographic factor significantly associated with more positive attitudes (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Waris et al., 2021). This is similar to what we found in this study, where educational level also had a strong association with attitude scores (p\u0026thinsp;=\u0026thinsp;0.000).\u003c/p\u003e \u003cp\u003eA significant correlation was identified (p\u0026thinsp;=\u0026thinsp;0.004), indicating that individuals with elevated income levels exhibited more positive attitudes. The method of Diabetes discovery was also significant (p\u0026thinsp;=\u0026thinsp;0.012), indicating that people who discovered they had Diabetes through symptoms had better attitudes. This could be because they were diagnosed earlier and got help sooner. Follow-up practices, especially self-monitoring, were strongly linked to attitude scores (p\u0026thinsp;=\u0026thinsp;0.007). This suggests that consistent monitoring may cultivate a more responsible and informed approach to the management and prevention of complications.\u003c/p\u003e \u003cp\u003eThese findings underscore the necessity of directing educational and behavioral interventions towards less-educated, low-income, and non-compliant patient populations to enhance attitudes and ultimately mitigate diabetes-related complications.\u003c/p\u003e \u003cp\u003eAbout the Practice, the findings of this study revealed that more than half of the participants (56.3%) exhibited low levels of Practice concerning diabetes complications. In comparison, 32.3% showed moderate Practice, and only 11.5% reported high Practice, with a mean practice score of 24.8 (\u0026plusmn;\u0026thinsp;5.7). This indicates suboptimal self-care behaviors among diabetic patients, despite their relatively high Knowledge and positive attitudes.\u003c/p\u003e \u003cp\u003eThis finding is consistent with previous studies conducted in Yemen and other regions. For example, Alhariri et al. (2017) reported poor adherence to Diet (21%) and exercise (15.2%) among T2DM patients in Hodeidah city, leading to poor glycemic control. Similarly, Das et al. (2023) and Herath et al. (2017) in Sri Lanka and India observed insufficient self-monitoring, irregular foot care, and low commitment to preventive practices. These results reinforce the global trend that Knowledge alone does not always translate into appropriate Practice.\u003c/p\u003e \u003cp\u003eIn our study, only 43.8% of participants reported regularly checking their blood sugar levels, 40.6% followed a healthy diet, and 28.9% exercised regularly. Meanwhile, practices such as daily foot examination, regular eye checks, kidney screening, weight control, and cholesterol monitoring were largely neglected by most participants. These gaps may reflect a lack of motivation, limited access to healthcare services, or poor reinforcement of health education.\u003c/p\u003e \u003cp\u003eStatistical analysis showed that several sociodemographic and clinical variables significantly influenced practice levels. Gender was a strong predictor, with males exhibiting better practices than females (p\u0026thinsp;=\u0026thinsp;0.001), a result in contrast to Rahaman et al. (2017), who found better practices among females. The living area also showed a significant effect (p\u0026thinsp;=\u0026thinsp;0.026), with participants from urban areas demonstrating better practices, consistent with ALhariri et al. (2017), who found that urban residents were more adherent to dietary recommendations.\u003c/p\u003e \u003cp\u003eMoreover, education level showed a significant positive correlation with Practice (p\u0026thinsp;=\u0026thinsp;0.003), where participants with secondary or higher education achieved higher practice scores. This is in line with Obirikorang et al. (2016) and Al Shafaee et al. (2008), who confirmed education as a key determinant of Diabetes self-care behaviors. Similarly, marital Status (p\u0026thinsp;=\u0026thinsp;0.012), type of drug used (p\u0026thinsp;=\u0026thinsp;0.009), management plan (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and, especially, follow-up methods (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were significantly associated with Practice. Participants who practiced self-monitoring had the highest practice scores, supporting the findings of Wang et al. (2024) and Bin Ahmed et al. (2019), which emphasized the impact of active self-involvement in improving diabetes care.\u003c/p\u003e \u003cp\u003eOn the contrary, no significant relationship was found between practice and age, income, duration of Diabetes, family history, discovery method, or use of herbal medication. This inconsistency with previous research may stem from cultural, economic, or healthcare system differences in the Yemeni context.\u003c/p\u003e \u003cp\u003eIn conclusion, while diabetic patients in Ibb city possess acceptable levels of Knowledge and attitudes toward complications, their actual practices remain insufficient. This calls for targeted interventions focusing not only on education but also on behavior change strategies, practical skill training, and stronger follow-up systems to improve daily diabetes self-management.\u003c/p\u003e \u003cp\u003eThe discrepancy between Knowledge and Practice\u0026mdash;wherein patients know about complications but fail to implement preventive behaviors\u0026mdash;is a recurrent theme in Diabetes research, Heart et al. (2017); Das et al (2023). This gap may stem from socioeconomic constraints, lack of access to health services, or insufficient reinforcement of Knowledge through healthcare provider interactions.\u003c/p\u003e \u003cp\u003eIn terms of Attitude, most patients expressed a willingness to prevent complications by adopting healthy lifestyles and acknowledged the importance of medical advice, routine check-ups, and lifestyle changes. These findings align with those of Rahaman et al. (2017), who reported similar positive attitudes in a Bangladeshi cohort. Furthermore, the strong correlation between Attitude and Practice (r\u0026thinsp;=\u0026thinsp;0.482, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) underscores the potential of attitude-oriented interventions to improve patients' behaviors.\u003c/p\u003e \u003cp\u003eDespite positive attitudes, poor practice scores were observed across essential preventive measures, including regular foot and eye examinations, weight control, and cholesterol monitoring. This supports the findings of ALhariri et al. (2017) in Yemen and Das et al. (2023) in India, both of which found that many diabetic patients lacked adherence to self-care routines. It emphasizes the need for more structured education and support systems to facilitate the translation of Knowledge into behavior. The correlation analysis revealed that educational level significantly influenced both Attitude and Practice, highlighting education as a key determinant in diabetic self-management, as also reported in previous studies (Obirikorang et al., 2016; Rahaman et al., 2017).\u003c/p\u003e \u003cp\u003eIn summary, although the study population had commendable knowledge and attitude levels, this was not reflected in Practice. The findings call for comprehensive interventions focused on behavioral change, particularly among females, less educated individuals, and those without structured follow-up care. Health education programs tailored to these subgroups, alongside improved access to diabetes care and follow-up services, are essential for reducing complications and improving patient outcomes.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eKnowledge of the complications of Diabetes was moderate to high; attitudes were positive, but practices were moderate. significant positive correlations between Knowledge, Attitude, and Practice, with Attitude having the strongest link to Practice. Inconsistent follow-up and male gender consistently impaired all KAP domains, with polypharmacy specifically harming Knowledge and Practice. At the same time, higher education and urban residence emerged as key, yet domain-specific, positive factors for Attitude and Practice, respectively. Implement consistent, tailored follow-up systems, particularly for male patients and those with complex medication regimens, to address the strongest negative predictor across all KAP domains. Create gender-sensitive and literacy-appropriate educational interventions that focus on translating Knowledge and positive attitudes into practical self-management skills, especially for rural residents. When clinically feasible, streamline medication regimens and management plans to mitigate the negative effects of polypharmacy and complexity on patient knowledge and Practice.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e(KAP) \u0026nbsp;Knowledge, Attitudes, Practice\u003c/p\u003e\n\u003cp\u003e(DM) \u0026nbsp;Diabetes mellitus\u003c/p\u003e\n\u003cp\u003e(T2DM) \u0026nbsp;Type 2 diabetes mellitus\u003c/p\u003e\n\u003cp\u003e(SPSS) \u0026nbsp;Statistical Package for the Social Sciences\u003c/p\u003e\n\u003cp\u003e(SD) \u0026nbsp;Standard deviation\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study protocol received approval from the Institutional Review Board of Ibb University (approval number: IU-RB-2024-092, dated December 11, 2024). Given the retrospective nature of the research involving anonymized data collected during routine clinical care, the requirement for informed consent was waived by the ethics committee. Patient confidentiality was safeguarded throughout by anonymizing all data during collection and analysis, with no personal identifiers included in the research database. The study was conducted in accordance with the principles of the Declaration of Helsinki and applicable local regulations governing observational research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;All authors declare that they have no competing interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContributors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBA: Investigation, Methodology, Project Administration, Writing – Review \u0026amp; Editing\u003c/p\u003e\n\u003cp\u003eASH, WA: Conceptualization, Data Curation, Formal Analysis, Writing – Original Draft\u003c/p\u003e\n\u003cp\u003eAS, AB, AN, AD: Investigation, Methodology, Project Administration, Writing – Review \u0026amp; Editing\u003c/p\u003e\n\u003cp\u003eAA, EL, GA, RS, RA: Conceptualization, Data Curation, Formal Analysis, Writing – Original Draft\u003c/p\u003e\n\u003cp\u003eWA: Supervision, Validation, Visualization, Writing – Review \u0026amp; Editing\u003c/p\u003e\n\u003cp\u003eWA: Writing – Review \u0026amp; Editing, Corresponding Author\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding author\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCorrespondence to\u0026nbsp;Wadee Abdullah Al-Shehari\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe datasets used and analyzed in the current analysis are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAl-Sharif, B. 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Assessment of the Knowledge and Practice of health care professionals towards diabetes care in Mukalla, Yemen. \u003cem\u003eInternational Journal of Pharmacy Teaching \u0026amp; Practices\u003c/em\u003e, 4(4), 826\u0026ndash;831.\u003c/li\u003e\n \u003cli\u003eWang, D., Liu, Z., Liu, Y., Zhao, L., He, S., \u0026amp;Duan, B. (2024). Knowledge, attitudes, and Practice among patients with diabetes mellitus and hyperuricemia toward disease self-management. \u003cem\u003eFrontiers in Public Health,\u0026nbsp;\u003c/em\u003e12, Article 1426259. https://doi.org/10. \u0026nbsp;\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBin Ahmed, I., Binnwejim, M. S., Alnahas, T. M., Raes, A. A. A., Basamad, M. A., Alqurashi, A. E., Alotaibi, L. T., Alqasem, R. M., Ghazwani, S. M., Almuyidi, S. M., Alshehri, W. A., Alfuhigi, Z. D., \u0026amp; Almeshref, M. N. H. (2019). Level of diabetic patients\u0026apos; Knowledge of Diabetes mellitus, its complications, and management. \u003cem\u003eArchives of Pharmacy Practice\u003c/em\u003e, 10(4), 80-86.\u003c/li\u003e\n \u003cli\u003eWaris, N., Butt, A., Askari, S., Fawwad, A., \u0026amp; Basit, A. (2021). Diabetes and its complications: Knowledge, Attitude, and Practices (KAP) and their determinants in Pakistani people with type 2 diabetes\u003cem\u003e. Journal of Diabetology\u003c/em\u003e, 12(3), 293\u0026ndash;298.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAl-Sharif, B. Gunaid, A. (2014). Prevalence of obesity in patients with type 2 Diabetes Mellitus in Yemen. \u003cem\u003eInternational Journal of Endocrinology and Metabolism.\u003c/em\u003e12(2).1-5.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eDika, H., Deogratias, M., Byamungu, D., Marwa, K., Kapesa, A., \u0026amp; Mwita, S. (2023) Practice and Knowledge of Type 2 Diabetes Mellitus Risk Factors Among Office Workers in Mwanza City, Tanzania, East African Health Research Journal, 7(1), 81. Htts://pmc.ncbi.nlm.nih.gov/articles\u003c/li\u003e\n \u003cli\u003eCole, J. B., \u0026amp; Florez, J. C. (2022). Genetics of diabetes and diabetes complications. Broad Institute of Harvard and MIT, Massachusetts General Hospital, Boston Children\u0026apos;s Hospital, and Harvard Medical School.\u003c/li\u003e\n \u003cli\u003eMeo, S. A., Sheikh, S. A., Sattar, K., Akram, A., Hassan, A., Meo, A. S., Usmani, A. M., Qalbani, E., \u0026amp; Ullah, A. (2019). Prevalence of Type 2 Diabetes Mellitus Among Men in the Middle East: A Retrospective Study. \u003cem\u003eAmerican Journal of Men\u0026apos;s Health\u003c/em\u003e,13 (3),\u003c/li\u003e\n \u003cli\u003eDeshpande, A. D., Harris-Hayes, M., \u0026amp; Schootman, M. (2008). Epidemiology of diabetes and diabetes-related complications. \u003cem\u003ePhysical Therapy\u003c/em\u003e, 88(11), 1254-1264.\u003c/li\u003e\n \u003cli\u003eTuttolomondo, A., Maida, C., \u0026amp; Pinto, A. (2015). Diabetic foot syndrome as a possible cardiovascular marker in diabetic patients\u003cem\u003e. Journal of Diabetes Research\u003c/em\u003e, 2015, 1-12.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eHerath, H. M. M., Weerasinghe, N. P., Dias, H., \u0026amp; Weerarathna, T. P. (2017). Knowledge, Attitude and Practice related to Diabetes mellitus among the general public in Galle district in Southern Sri Lanka: A pilot study. \u003cem\u003eBMC Public Health\u003c/em\u003e, 17, Article 535. https://doi.org/10.1186/s12889-017-4459-5\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eDas, A. K., Kalra, S., Joshi, S., Mithal, A., Prasanna Kumar, K. M., Unnikrishnan, A. G., Thacker, H., Sethi, B., Chowdhury, S., Sugumaran, A., Satpathy, A., Gadekar, A., Menon, S. K., Neogi, R., Chodankar, D., Trivedi, C., Wangnoo, S. K., Zargar, A. H., Rais, N., \u0026hellip; LANDMARC Study Group. (2023). The Longitudinal Nationwide Study on Management and Real-world Outcomes of Diabetes in India over 3 years (LANDMARC trial). \u003cem\u003eEndocrinology, Diabetes \u0026amp; Metabolism\u003c/em\u003e, 6(5), e422. https://doi.org/10.1002/edm2.422\u003c/li\u003e\n \u003cli\u003eAlhariri, A., Daud, F., Almaiman, A., and Saghir S. A. (2017). Factors associated with adherence to Diet and exercise among type 2 diabetes Patients in Hodeida city, Yemen. \u003cem\u003eDiabetes Manag\u003c/em\u003e, 7(3), 264\u0026ndash;271\u003c/li\u003e\n \u003cli\u003eMareai S.S., Gawli K. (2023). Type 2 diabetes with obesity and hypertension: prevalence and sociodemographic risk factors in Yemen. \u003cem\u003eDiabetes mellitus\u003c/em\u003e, 26(2):124-130\u003c/li\u003e\n \u003cli\u003eAl Shafaee, M. A., Al-Shukaili, S., Syed Gauher, Rizvi, S. G., Al Farsi, Y., Mushtaq A Khan, M. A., Ganguly, S. S., Mustafa Afifi, M., \u0026amp; Al Adawi, S. (2008). Knowledge and perceptions of Diabetes in a semi-urban Omani population. \u003cem\u003eBMC Public Health\u003c/em\u003e,8,249. https://doi.org/10.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eObirikorang, Y., Obirikorang, C., Ant, E.O., Acheampong, E., Batu, E.N., Stella, A.D., \u0026nbsp;Constance, O., and Peter Kojo Brenya, P.K.(2016). Knowledge of complications of Diabetes Mellitus among patients visiting the Diabetes clinic in the Samoan Government\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eRahaman, K. S., Majdzadeh, R., Naieni, K. H., \u0026amp; Raza, O. (2017). Knowledge, Attitude, and Practices (KAP) Regarding Chronic Complications of Diabetes among Patients with Type 2 Diabetes in Dhaka. \u003cem\u003eInternational Journal of Endocrinology and Metabolism\u003c/em\u003e.15(3).\u003c/li\u003e\n \u003cli\u003ePop-Busui, R., Boulton, A. J. M., Feldman, E. L., Bril, V., Freeman, R., Malik, R. A., Sosenko, J. M., \u0026amp; Ziegler, D. (2023). Diabetic neuropathy: A position statement by the American Diabetes Association. \u003cem\u003eDiabetes Care\u003c/em\u003e, 46(Suppl. 1), S133\u0026ndash;S147. https://diabetesjournals.org\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eTesfaye, S., \u0026amp; Selvarajah, D. (2017). Advances in the epidemiology, pathogenesis, and management of diabetic peripheral neuropathy. \u003cem\u003eNature Reviews Endocrinology\u003c/em\u003e, 13(2), 88\u0026ndash;100. https://www.nature.com\u003c/li\u003e\n \u003cli\u003eBamahel, A. S., Bafakeer, S., Bajaber, E., Baangood, F., Alkhalaqi, J., Bashkiail, K., Alsowial, K., Alkhalaqi, M., Baabbad, M., Bindahman, N., Binsehielan, S., \u0026amp; Bagetyan, W. (2022). Prevalence of diabetic nephropathy among type 2 diabetes mellitus patients in Mukalla City, Yemen. \u003cem\u003eEkst\u003c/em\u003e, 2(2), 046. doi: 10.30880/ekst.2022.02.02.046\u003c/li\u003e\n \u003cli\u003eFan, W. (2017). Diabetes mellitus and cardiovascular disease. \u003cem\u003eCardiovascular Endocrinology\u003c/em\u003e, 6, 8-16.\u003c/li\u003e\n \u003cli\u003eMosenzon, O., Cheng, A. Y. Y., Rabinstein, A. A., \u0026amp; Sacco, S. (2023). Diabetes and stroke: What are the connections? \u003cem\u003eJournal of Stroke\u003c/em\u003e, 25(1), 26-38.\u003c/li\u003e\n \u003cli\u003eSoyoye, D. O., Abiodun, O. O., Ikem, R. T., Kolawole, B. A., \u0026amp; Akintomide, A. O. (2021). Diabetes and peripheral artery disease.\u003cem\u003e\u0026nbsp;World Journal of Diabetes\u003c/em\u003e, 2021 June 15;12 (6):827-838. https://www.f6publishing.com.\u003c/li\u003e\n \u003cli\u003eArmstrong, D. G., Boulton, A. J. M., \u0026amp; Bus, S. A. (2017). Diabetic foot ulcers and their recurrence. \u003cem\u003eThe New England Journal of Medicine\u003c/em\u003e, 376(24), 2367\u0026ndash;2375. https://doi.org/10.1056/NEJMra1615439\u003c/li\u003e\n \u003cli\u003eKazi, R. N., Bote, M. M., \u0026amp; Raikar, K. J. (2017). Knowledge, Attitude, and Practices regarding diabetes mellitus and its complications among T2DM patients attending the UHC in Mumbai. \u003cem\u003eInternational Journal of Community Medicine and Public Health\u003c/em\u003e, 4(8), 2793\u0026ndash;2797. https://doi.org/10.18203/2394-6040.ijcmph20173325\u003c/li\u003e\n \u003cli\u003eAldossari, K., Abdelrazik, M., Kamal, S., Al-Zahrani, J., Al-Ghamdi, S. (2015).Assessment of Levels of Knowledge, Attitude, and Practice regarding diabetes mellitus (DM), its Complications, and self-management among diabetic patients in AlKharj city, Saudi Arabia. \u003cem\u003eInternational Journal of Advanced Research\u003c/em\u003e. 3(5)23_32.\u003c/li\u003e\n \u003cli\u003eAl-Omaisi, A., Masoud, A., Abdullah, A., Madar, D., Al-Surabi, G., Al-Wainany, N., \u0026nbsp;Saeed, O., Al.qopaty, R., Alemad, S., Alshehab, S. et al (2023). \u0026quot;Knowledge, Attitude and Practice among Diabetic Patients regarding Diabetic Complications at Public Diabetic Centers in Sana\u0026apos;a\u0026quot; [ Unpublished research manuscript]. Supervised by Dr. Aisha Khaled Al-Daeri, Community Medicine Department.\u003c/li\u003e\n \u003cli\u003eBabelgaith, S. D., Baidi, M., \u0026amp; Alfadly, S. (2013). Assessment of the Knowledge and Practice of health care professionals towards diabetes care in Mukalla, Yemen. \u003cem\u003eInternational Journal of Pharmacy Teaching \u0026amp; Practices\u003c/em\u003e, 4(4), 826\u0026ndash;831.\u003c/li\u003e\n \u003cli\u003eWang, D., Liu, Z., Liu, Y., Zhao, L., He, S., \u0026amp;Duan, B. (2024). Knowledge, attitudes, and Practice among patients with diabetes mellitus and hyperuricemia toward disease self-management. \u003cem\u003eFrontiers in Public Health,\u0026nbsp;\u003c/em\u003e12, Article 1426259. https://doi.org/10. \u0026nbsp;\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBin Ahmed, I., Binnwejim, M. S., Alnahas, T. M., Raes, A. A. A., Basamad, M. A., Alqurashi, A. E., Alotaibi, L. T., Alqasem, R. M., Ghazwani, S. M., Almuyidi, S. M., Alshehri, W. A., Alfuhigi, Z. D., \u0026amp; Almeshref, M. N. H. (2019). Level of diabetic patients\u0026apos; Knowledge of Diabetes mellitus, its complications, and management. \u003cem\u003eArchives of Pharmacy Practice\u003c/em\u003e, 10(4), 80-86.\u003c/li\u003e\n \u003cli\u003eWaris, N., Butt, A., Askari, S., Fawwad, A., \u0026amp; Basit, A. (2021). Diabetes and its complications: Knowledge, Attitude, and Practices (KAP) and their determinants in Pakistani people with type 2 diabetes\u003cem\u003e. Journal of Diabetology\u003c/em\u003e, 12(3), 293\u0026ndash;298.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"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":"bmc-primary-care","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"famp","sideBox":"Learn more about [BMC Primary Care](https://bmcprimcare.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12875","title":"BMC Primary Care","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Knowledge, Attitudes, Practice, Diabetic Complications, Associated factors, Yemen","lastPublishedDoi":"10.21203/rs.3.rs-9060718/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9060718/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDiabetic mellitus is a common long-term disease worldwide, causing many serious microvascular and macrovascular complications. Knowing how patients understand, feel, and respond to these complications (KAP) is very important for early detection and prevention, especially in countries like Yemen.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eThis study aimed to assess the levels of Knowledge, Attitude, and Practice of diabetic patients regarding diabetic complications in outpatient clinics in Ibb City, Yemen.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e \u003cp\u003eA descriptive cross-sectional study was conducted among 384 patients selected via convenience sampling. Data were collected through a structured questionnaire that underwent expert review and a pilot study. Data were analyzed using SPSS 27.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eMore than half of the patients were female (56.5%) and married (83.6%). The largest age group was 40\u0026ndash;59 years (49.5%). Most participants were illiterate (39.6%) and worked as housewives (44.5%). A majority (60.9%) lived in urban areas and had a low monthly income (52.6%). Most participants had a diabetes duration of 1 to 5 years (43.2%) and were unaware of their specific diabetes type (70.6%). The disease was most often diagnosed based on symptoms (51.6%). A slight majority (52.1%) had no family history of the disease. Regarding management, the most common plan was Diet and oral drugs (73.4%), with the majority of patients using pills (80.5%). Self-monitoring was the most frequent follow-up method (50.5%). Knowledge of Diabetes complications was moderate to high. (79.6%), with a mean score of 9.55 (SD\u0026thinsp;=\u0026thinsp;2.15). Their Attitude was positive (87%), with a mean score of 26.20 (SD\u0026thinsp;=\u0026thinsp;3.16). Their practice level was moderate (63.6%), with a mean score of 24.8 (SD\u0026thinsp;=\u0026thinsp;5.7). Significant positive correlations between Knowledge, Attitude, and Practice (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Knowledge scores were significantly higher among participants with high income (p\u0026thinsp;=\u0026thinsp;0.004), using insulin (p\u0026thinsp;=\u0026thinsp;0.033), and performing self-monitoring (p\u0026thinsp;=\u0026thinsp;0.021). For Attitude, significant differences were observed by gender (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), marital Status (p\u0026thinsp;=\u0026thinsp;0.042), education (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), job (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), discovery method (p\u0026thinsp;=\u0026thinsp;0.012), and follow-up type (p\u0026thinsp;=\u0026thinsp;0.007). Practice scores differed significantly by gender (p\u0026thinsp;=\u0026thinsp;0.001), living area (p\u0026thinsp;=\u0026thinsp;0.026), marital Status (p\u0026thinsp;=\u0026thinsp;0.012), education (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), discovery method (p\u0026thinsp;=\u0026thinsp;0.004), management plan (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), drug type (p\u0026thinsp;=\u0026thinsp;0.009), and follow-up (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001 Higher medication burden (B=-0.475, p\u0026thinsp;=\u0026thinsp;0.025) and inconsistent follow-up (B=-0.340, p\u0026thinsp;=\u0026thinsp;0.026) significantly reduced knowledge scores, while income showed no effect. Male gender (B = -0.756, p\u0026thinsp;=\u0026thinsp;0.029) and poor follow-up (B = -0.654, p\u0026thinsp;=\u0026thinsp;0.009) negatively affected attitudes, whereas higher education improved them (B\u0026thinsp;=\u0026thinsp;0.482, p\u0026thinsp;=\u0026thinsp;0.001). Inconsistent follow-up was the strongest negative predictor (B = -2.351, p\u0026thinsp;=\u0026thinsp;0.001), with additional negative effects from male gender, complex management, and polypharmacy. Urban residence uniquely improved practice scores (B\u0026thinsp;=\u0026thinsp;1.225, p\u0026thinsp;=\u0026thinsp;0.026), and education enhanced attitudes but not Knowledge or Practice.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eKnowledge of the complications of Diabetes was moderate to high; Attitudes were positive, but practices were moderate. significant positive correlations between Knowledge, Attitude, and Practice, with Attitude having the strongest link to Practice. Inconsistent follow-up and male gender consistently impaired all KAP domains, with polypharmacy specifically harming Knowledge and Practice. At the same time, higher education and urban residence emerged as key, yet domain-specific, positive factors for Attitude and Practice, respectively. Enhance Structured Follow-up Programs, Develop Targeted Education Initiatives\u0026gt;\u003c/p\u003e","manuscriptTitle":"Assessment of Patients' Knowledge, Attitudes, and Practices Toward Diabetic Complications in Outpatient Clinics in Ibb City, Yemen","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-19 08:05:51","doi":"10.21203/rs.3.rs-9060718/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-22T23:44:11+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-19T12:02:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"200208979086869261112549356175918794436","date":"2026-04-15T10:01:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"285937355960443839111661250125970091376","date":"2026-04-13T18:45:07+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-08T17:40:27+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-06T11:57:02+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-16T15:09:17+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-13T14:18:35+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Primary Care","date":"2026-03-12T20:49:06+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-primary-care","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"famp","sideBox":"Learn more about [BMC Primary Care](https://bmcprimcare.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12875","title":"BMC Primary Care","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fb41032e-1ab3-4417-9ab2-744f72fd5efd","owner":[],"postedDate":"April 19th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-19T08:05:51+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-19 08:05:51","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9060718","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9060718","identity":"rs-9060718","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}