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Diabetes Technol Ther. 2013 Aug;15(8):644-53. doi: 10.1089/dia.2012.0309.

Knowledge, attitude, and practices of individuals to prevent and manage metabolic syndrome in an Indian setting.

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Center for Global Health and Development, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA.



Patients' knowledge, attitudes, and behavior play a large role in preventing and managing the risk factors making up metabolic syndrome (MetS). MetS is associated with increased morbidity and mortality per the World Health Organization criteria. The objective of the study was to examine the current health literacy levels, risk perceptions about MetS, and associated management challenges in diverse Indian settings.


This cross-sectional study was performed during the period of April-May 2012 by enrolling 125 individuals at risk of MetS from urban, rural, and slum settings in India. A convenience sample was recruited from primary care clinics. In-depth interviews were conducted using ground theory and framework analysis. Individuals 30 years old and above with confirmed diagnosis of obesity, type 2 diabetes mellitus, hypertension, or hypercholesterolemia and willing to participate in the in-depth interviews were included in the study. Individuals involved in other research studies were excluded.


Difficulty in understanding healthcare information was commonly reported, especially in rural and slum settings. Only 10% of the individuals perceived lifestyle behaviors as a risk factor of acquiring MetS. Significant disparities were seen among urban, rural, and slum individuals about using diet and exercise as means to manage their MetS. Individuals in slum and rural settings were rarely advised about diet and exercise approaches to manage MetS. Access to appropriate information and direction from the healthcare professionals is lacking.


Different perceptions about MetS and its varied management approaches exist across the three settings. An urgent need exists to develop interactive health education programs that can enhance self-management approaches to meet the growing burden of MetS by providing access to right information applicable to individuals living in diverse Indian settings.

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