Low levels of self-care advice by healthcare providers in Kerala, India


Shalini Garg, V Raman Kutty


Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India



India has the second largest number of individuals with Type 2 Diabetes Mellitus (T2DM) in the world, and this is expected to exceed 100 million by 20451. Healthcare professionals can play an integral role in reducing the burden of disease by promoting self-care through health-enhancing behaviours, such as physical activity.


This study determines the proportion of adults in Kerala who are advised to start or increase their PA levels by a health care professional, with specific attention to people living with diabetes.

research and design methods

Prevention and control of non-communicable diseases in Kerala India is a project which collected data from over 12000 households covering all districts of Kerala. Around 12503 adults were asked about receiving advice from a health worker or doctor on starting or increasing physical activity during the past 12 months. Information on socio-demographic characteristics and health conditions were self-reported. Type 2 diabetes was tested for by measuring fasting blood sugar using a glucometer.


A total of 30% of adults with diabetes received advice from a health professional on starting or increasing physical activity (compared to 14% of adults without diabetes.) Among respondents with diabetes, the probability of receiving advice for physical activity as self-care varied by age, marital status, and education.


Few patients were advised to exercise, suggesting missed opportunities for disease prevention and a significant gap in service delivery of preventive care. These results underline the need for interventions to enhance counselling for patients with diabetes.

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