Knowledge, Practices, and Barriers to Diabetes Self-Management Among Patients with Type 2 Diabetes in a Rwandan Referral Hospital

Background: Effective self-management is essential for controlling type 2 diabetes mellitus (T2DM) and preventing complications. However, patients often encounter barriers that compromise adherence to recommended care practices. This study aimed to assess the level of knowledge, self-care practices, and barriers to diabetes self-management among patients attending a Rwandan referral hospital. Methods: This quantitative study was conducted at University Teaching Hospital of Kigali (CHUK) using a cross-sectional design. Data were collected from 140 patients with type 2 diabetes mellitus (T2DM) through a self-administered structured questionnaire. Participants were recruited using a systematic sampling technique. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 20, employing both descriptive statistics and logistic regression to identify factors associated with barriers to diabetes self-management. Results: The majority of participants (73.6%) reported regularly engaging in diabetes self-care practices, with 74.3% demonstrating an adequate understanding of the condition. Despite positive self-care behaviors, 60.7% of participants reported facing significant barriers, primarily related to financial constraints and lack of adequate information from healthcare providers. Multivariate analysis revealed that certain sociodemographic factors were significantly associated with the presence of self-management barriers. Patients aged 50-59 years (Adjusted Odds Ratio (AOR) = 1.235, p = 0.025), married patients (AOR = 1.32, p = 0.019), and those in Ubudehe Category 1 (AOR = 1.934, p = 0.032) were more likely to report barriers. In contrast, having university-level education (AOR = 0.527, p = 0.023) and residing in urban areas (AOR = 0.304, p = 0.041) were protective factors. Conclusion: While many patients demonstrated regular self-care and fair knowledge of T2DM, a significant number still face barriers, especially those related to financial hardship and limited health education. Tailored interventions that improve diabetes literacy and reduce socioeconomic inequalities are essential to enhance effective self-management and long-term outcomes for patients living with diabetes in Rwanda.