{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T11:27:23Z","timestamp":1768217243412,"version":"3.49.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Introduction<\/jats:title>\n Type 2 diabetes mellitus (T2DM) represents a major and rising clinical and economic challenge in Latin America. Strengthening patients\u2019 knowledge, attitudes, and practices (KAP) is essential to improve self-care behaviors and optimize primary care outcomes.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To assess self-care KAP among adults with T2DM in Cali, Colombia, and to examine their associations with sociodemographic and sociocultural factors.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A cross-sectional observational study was conducted among adults (\u226518\u202fyears) with confirmed T2DM enrolled in a public primary-care network in Cali (January 2020\u2013June 2024). Data were obtained through a 43-item structured questionnaire comprising the culturally adapted DKQ-24 (knowledge), Likert-type items (attitudes), and an adapted SDSCA incorporating traditional-medicine practices. KAP scores were categorized\n a priori<\/jats:italic>\n . Descriptive statistics were used to characterize the sample, and chi-square tests examined associations between sociodemographic\/sociocultural variables and KAP levels.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 336 participants, most were women (62.2%) and older adults (\u226560\u202fyears, 65.7%). High knowledge was observed in 81.8%, positive attitudes in 99.0%, and frequent practices in 88.1%. Gaps emerged in daily meal planning (26.5% correct) and understanding the value of blood-glucose self-monitoring (31.8% correct). Strong behaviors included medication adherence and foot care (both 76.0% frequent); risk behaviors were uncommon (recent smoking 4.0%; dessert\/sweet intake 19.0%). Knowledge was significantly associated with socioeconomic stratum (\n p<\/jats:italic>\n =\u202f0.003), with lower performance at extreme strata. Attitudes differed by marital status (\n p<\/jats:italic>\n =\u202f0.001), religion (\n p\u202f&lt;<\/jats:italic>\n 0.001), socioeconomic stratum (\n p\u202f&lt;<\/jats:italic>\n 0.001), and household size (\n p\u202f&lt;<\/jats:italic>\n 0.001), showing lower positivity among widowed individuals and households with more than five members.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Adults with T2DM in this urban primary-care setting demonstrate a favorable KAP profile, though persistent gaps remain in dietary planning and glycemic self-monitoring. Targeted, culturally sensitive educational strategies\u2014integrating family and faith-based networks\u2014should prioritize these areas while reinforcing adherence and foot care. Multivariable and longitudinal analyses are recommended to deepen understanding and evaluate tailored interventions.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1719863","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:17:50Z","timestamp":1768205870000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A cross-sectional primary care study of knowledge, attitudes, and practices of type 2 diabetes self-care and their association with sociodemographic and sociocultural factors in Cali, Colombia"],"prefix":"10.3389","volume":"13","author":[{"given":"Janeth C.","family":"Gil","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Felipe Ram\u00edrez","family":"Otero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria A.","family":"Tunubala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clemente","family":"Caicedo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jhan S.","family":"Saavedra T.","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. A.","family":"Nati-Castillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan S.","family":"Izquierdo-Condoy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"ref1","year":"2025"},{"key":"ref2","year":"2025"},{"key":"ref3","volume-title":"Federaci\u00f3n Internacional de Diabetes","year":"2024"},{"key":"ref4","volume-title":"Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants - PubMed","year":""},{"key":"ref5","year":"2025"},{"key":"ref6","volume-title":"Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021 - The Lancet","year":"2025"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"11","DOI":"10.19053\/uptc.01203053.v43.n78.2024.17963","article-title":"Economic growth in Colombia","volume":"43","author":"Vallejo Zamudio","year":"2024","journal-title":"Apunt Cenes"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"67","DOI":"10.5334\/aogh.4539","article-title":"Prevalence of type 2 diabetes, overweight, obesity, and metabolic syndrome in adults in Bogot\u00e1, Colombia, 2022-2023: a cross-sectional population survey","volume":"90","author":"Arteaga","year":"2024","journal-title":"Ann Glob Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"629","DOI":"10.2139\/ssrn.4687126","article-title":"Diabetes in urban Colombia: a cross-sectional study of its prevalence, lifestyle habits, and sources of health information","volume":"19","author":"Guti\u00e9rrez-Romero","year":"2025","journal-title":"Prim Care Diabetes"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1958","DOI":"10.3390\/biomedicines12091958","article-title":"Management of microcomplications of diabetes mellitus: challenges, current trends, and future perspectives in treatment","volume":"12","author":"Yapislar","year":"2024","journal-title":"Biomedicine"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2659","DOI":"10.1007\/s12325-025-03185-9","article-title":"Diabetes mellitus and associated vascular disease: pathogenesis, complications, and evolving treatments","volume":"42","author":"Islam","year":"2025","journal-title":"Adv Ther"},{"key":"ref12","first-page":"e56674","article-title":"Understanding the clinical relationship between diabetic retinopathy, nephropathy, and neuropathy: a comprehensive review","volume":"16","author":"Kulkarni","year":"","journal-title":"Cureus"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"550","DOI":"10.5551\/jat.65551","article-title":"A comprehensive analysis of diabetic complications and advances in management strategies","volume":"32","author":"Iwasaki","year":"2025","journal-title":"J Atheroscler Thromb"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.3390\/ijms26031094","article-title":"Type 2 diabetes mellitus: new pathogenetic mechanisms, treatment and the most important complications","volume":"26","author":"M\u0142ynarska","year":"2025","journal-title":"Int J Mol Sci"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1038\/s41573-023-00670-0","article-title":"Overcoming barriers to patient adherence: the case for developing innovative drug delivery systems","volume":"22","author":"Baryakova","year":"2023","journal-title":"Nat Rev Drug Discov"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"697","DOI":"10.2147\/PPA.S319084","article-title":"Barriers and solutions to improve therapeutic adherence from the perspective of primary care and hospital-based physicians","volume":"16","author":"Carratal\u00e1-Munuera","year":"2022","journal-title":"Patient Prefer Adherence"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"100167","DOI":"10.1016\/j.focus.2023.100167","article-title":"Health promotion, health protection, and disease prevention: challenges and opportunities in a dynamic landscape","volume":"3","author":"Caron","year":"2023","journal-title":"AJPM Focus"},{"key":"ref18","volume-title":"Honduras: building a national road map for diabetes surveillance [Internet]. [citado 9 de junio de 2025]","year":"2025"},{"key":"ref19","volume-title":"Knowledge and attitude about diabetes self-care of older adults in primary health care - PubMed","year":"2025"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"260","DOI":"10.17533\/udea.iee.v32n2a09","article-title":"How people with diabetes evaluate participation of their family in their health care","volume":"32","author":"de Lima","year":"2014","journal-title":"Investig Educ En Enfermeria"},{"key":"ref21","volume-title":"A Review on Medicinal Exploration of Costus Igneus: the Insulin Plant","year":"2025"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"67","DOI":"10.4103\/0973-7847.125536","article-title":"A review on Insulin plant (Costus igneus Nak)","volume":"8","author":"Hegde","year":"2014","journal-title":"Pharmacogn Rev"},{"key":"ref23","volume-title":"Self-care and type 2 diabetes mellitus (T2DM): a literature review in sex-related differences \u2013 PubMed","year":"2025"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1186\/s40545-023-00631-3","article-title":"Development and validation of patient diabetes knowledge questionnaire (PDKQ)","volume":"16","author":"Lim","year":"2023","journal-title":"J Pharm Policy Pract"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"100346","DOI":"10.1016\/j.jcte.2024.100346","article-title":"Development and acceptability of a culturally competent skills and knowledge assessment tool for patients with diabetes mellitus","volume":"36","author":"Hakimian","year":"2024","journal-title":"J Clin Transl Endocrinol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"183","DOI":"10.12669\/pjms.311.6317","article-title":"An assessment of knowledge, attitude and practices (KAP) towards diabetes and diabetic retinopathy in a suburban town of Karachi","volume":"31","author":"Memon","year":"2015","journal-title":"Pak J Med Sci"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12930-014-0014-z","article-title":"A cross-sectional study of the differences in diabetes knowledge, attitudes, perceptions and self-care practices as related to assessment of chronic illness care among people with diabetes consulting in a family physician-led hospital-based first line health service and local government health unit-based health centers in the Philippines","volume":"13","author":"Ku","year":"2014","journal-title":"Asia Pac Fam Med"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/j.pcd.2018.04.004","article-title":"Summary of diabetes self-care activities: a confirmatory factor analytic approach","volume":"12","author":"Jannoo","year":"2018","journal-title":"Prim Care Diabetes"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"943","DOI":"10.2337\/diacare.23.7.943","article-title":"The summary of diabetes self-care activities measure: results from 7 studies and a revised scale","volume":"23","author":"Toobert","year":"2000","journal-title":"Diabetes Care"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"205","DOI":"10.2147\/DMSO.S290639","article-title":"Dietary knowledge, attitude and practice (KAP) among the family members of patients with type 2 diabetes mellitus (T2DM) and its influence on the KAP of T2DM patients","volume":"14","author":"Hu","year":"2021","journal-title":"Diabetes Metab Syndr Obes Targets Ther"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"e0001351","DOI":"10.1371\/journal.pgph.0001351","article-title":"Determinants of knowledge, attitude, and practice among patients with type 2 diabetes mellitus: a cross-sectional multicenter study in Tanzania","volume":"3","author":"Joho","year":"2023","journal-title":"PLOS Glob Public Health"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.4102\/hsag.v27i0.1921","article-title":"Type 2 diabetes mellitus patients\u2019 knowledge, attitude and practice of lifestyle modifications","volume":"27","author":"Peter","year":"2022","journal-title":"Health SA SA Gesondheid"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"258","DOI":"10.2337\/dci20-0053","article-title":"Social determinants of health and diabetes: a scientific review","volume":"44","author":"Hill-Briggs","year":"2021","journal-title":"Diabetes Care"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"e0270476","DOI":"10.1371\/journal.pone.0270476","article-title":"Lifestyle and socioeconomic determinants of diabetes: evidence from country-level data","volume":"17","author":"Richards","year":"2022","journal-title":"PLoS One"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"191","DOI":"10.2217\/dmt.11.5","article-title":"Health literacy in diabetes care: explanation, evidence and equipment","volume":"1","author":"Cavanaugh","year":"2011","journal-title":"Diabetes Manag Lond Engl"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"129","DOI":"10.2147\/PROM.S243678","article-title":"The relationship between health literacy level and self-care behaviors in patients with diabetes","volume":"11","author":"RobatSarpooshi","year":"2020","journal-title":"Patient Relat Outcome Meas"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.annepidem.2020.08.007","article-title":"Do health behaviors mediate associations between personality traits and diabetes incidence?","volume":"53","author":"Luo","year":"2021","journal-title":"Ann Epidemiol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1629825","DOI":"10.3389\/fpsyg.2025.1629825","article-title":"Associations among personality traits, emotional states, and self-management behaviors with quality of life in type 2 diabetes: a structural equation modeling approach examining emotional mediation","volume":"16","author":"Fu","year":"2025","journal-title":"Front Psychol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"44434","DOI":"10.18632\/oncotarget.17902","article-title":"Socioeconomic status is associated with global diabetes prevalence","volume":"8","author":"Xu","year":"2017","journal-title":"Oncotarget"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"8816","DOI":"10.12998\/wjcc.v10.i25.8816","article-title":"Potential influences of religiosity and religious coping strategies on people with diabetes","volume":"10","author":"Onyishi","year":"2022","journal-title":"World J Clin Cases"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"630","DOI":"10.4239\/wjd.v12.i5.630","article-title":"Impact of spiritual beliefs and faith-based interventions on diabetes management","volume":"12","author":"Onyishi","year":"2021","journal-title":"World J Diabetes"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1186\/s12916-024-03518-5","article-title":"Advances and counterpoints in type 2 diabetes. What is ready for translation into real-world practice, ahead of the guidelines","volume":"22","author":"Schwartz","year":"2024","journal-title":"BMC Med"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"68","DOI":"10.4103\/sjmms.sjmms_86_17","article-title":"Closing gaps in diabetes care: from evidence to practice","volume":"6","author":"Ba-Essa","year":"2018","journal-title":"Saudi J Med Med Sci"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"102267","DOI":"10.1016\/j.healthplace.2019.102267","article-title":"Facilitating barriers: contextual factors and self-management of type 2 diabetes in urban settings","volume":"61","author":"Banasiak","year":"2020","journal-title":"Health Place"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"e14070","DOI":"10.1111\/hex.14070","article-title":"Barriers and facilitators of self-management of diabetes amongst people experiencing socioeconomic deprivation: a systematic review and qualitative synthesis","volume":"27","author":"Woodward","year":"2024","journal-title":"Health Expect Int J Public Particip Health Care Health Policy"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1016\/j.bbadis.2017.01.007","article-title":"Methods needed to measure predictive accuracy: a study of diabetic patients","volume":"1863","author":"Khan","year":"2017","journal-title":"Biochim Biophys Acta Mol basis Dis"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"203","DOI":"10.7429\/pi.2019.723203","article-title":"Self-care in people with type 2 diabetes mellitus research protocol of a multicenter mixed methods study (SCUDO)","volume":"72","author":"Luciani","year":"2019","journal-title":"Prof Inferm"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"2728","DOI":"10.1111\/dom.14528","article-title":"Completion of annual diabetes care processes and mortality: a cohort study using the National Diabetes Audit for England and Wales","volume":"23","author":"Holman","year":"2021","journal-title":"Diabetes Obes Metab"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1016381","DOI":"10.3389\/fmed.2023.1016381","article-title":"Comparison of diagnostic accuracy for diabetes diagnosis: a systematic review and network meta-analysis","volume":"10","author":"Duong","year":"2023","journal-title":"Front Med"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"747","DOI":"10.3390\/healthcare13070747","article-title":"The promotion and development of community health for personal health: theories and applications","volume":"13","author":"Gao","year":"2025","journal-title":"Healthc Basel"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1186\/s12913-025-12316-5","article-title":"Strengthening community actions to improve diabetes mellitus care optimising public health facilitators","volume":"25","author":"Nxedlana","year":"2025","journal-title":"BMC Health Serv Res"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"908","DOI":"10.25122\/jml-2024-0290","article-title":"The impact of patient support and health education on diabetes management and glycemic control","volume":"17","author":"Alotaibi","year":"2024","journal-title":"J Med Life"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1719863\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:17:52Z","timestamp":1768205872000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1719863\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":52,"alternative-id":["10.3389\/fpubh.2025.1719863"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1719863","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]},"article-number":"1719863"}}