Knowledge and practice of nutritionists in management of type 2 diabetes mellitus using honey: A case study of selected hospitals in Nairobi county
Diabetes mellitus (DM) is a metabolic disorder that is characterized by chronic hyperglycemia, due to defects in insulin secretion and/or action activity. The prevalence of DM in Kenya is at 3.3% and is reported to be rising. The disease is managed through administration of drugs, healthy eating and exercises. There have been indications that combining anti-diabetic drugs with honey in diabetes mellitus management is more effective than use of drugs alone. However, this has not been authenticated and therefore most Kenyans with type 2 DM cannot benefit because honey is not widely accepted as a prescription item in management of diabetes. This study therefore was designed to assess the knowledge and practice of the use of honey in diabetic management by the nutritionists. The study was cross-sectional, involving practicing nutritionists in five selected large hospitals within Nairobi County and the heads of the nutrition from the hospitals departments as key informants. Altogether, 57 nutritionists were interviewed from various departments of the hospitals including clinical medical, paediatrics, surgical wards, reproductive health, maternal/family planning clinic and the diabetic clinic. Data was collected from the two groups using a structured questionnaire with section for each group. The study was approved by Kenyatta National Hospital (KNH)/ University of Nairobi (UoN) Ethics and Research Committee. Results showed that up to 50.9% of the respondents do not have knowledge on the use of honey in the management of type 2 diabetes mellitus (DM), while 42.1% indicated benefits in the use of honey to treat type 2 DM. The gains included lowering glycaemic index (7%), control of blood glucose (19.3%), medicinal value (7%), provision of energy (3.5%), food sweetener (1.8%) and antioxidant (1.8%). However, only 19.3% of the respondents were aware of studies done on the use of honey in type 2 DM management. Majority (80.7%) of the nutritionists were not aware of any studies on the benefits of honey in management of type 2 DM patients. Nutritionists prescribing honey to type 2 DM patients recommend unprocessed honey (94.1%) compared to the processed honey (5.9%). The common forms of usage of prescribed honey was indicated as spreads (41.2%), sweetener of foods such as tea and porridge (17.6%) as solution in hot water (11.8%) and direct eating (5.9%). The quantity of honey prescribed by nutritionists was found to be a teaspoonful (41.2%), two teaspoonfuls (29.4%), three teaspoonfuls (23.5%) and four teaspoonfuls (5.9%). Nutritionists found not in favour of the use of honey based their arguments on opinions which included honey raising blood glucose (60%), do not know the efficacy (20%), ignorance (17.5%) and patient’s aversion (2.5%). The study concludes that there is limited knowledge among nutritionists on the use of honey in controlling type 2 DM and that there is no guideline nor policy in the country for use of honey in the management of type 2 DM. Prescription of honey for management of Diabetes type 2 is therefore very low.