Knowledge, Attitudes, and Practices of Indian Cross-specialty Healthcare Professionals Managing Diabetes on Nondiarrheal Dehydration and Its Management in Persons with Diabetes

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BACKGROUND: Hydration plays a vital role in metabolic health, particularly in diabetes, where factors such as osmotic diuresis, polypharmacy, and comorbidities heighten the risk of dehydration. Effective management of fluid, electrolyte, and energy (FEE) deficits is crucial, yet gaps persist in current practices. This is the first study to assess the knowledge, attitude, and practices of cross-specialty healthcare professionals (HCPs) managing diabetes on such a unique issue in persons with diabetes. OBJECTIVES: This study assessed the knowledge, attitudes, and practices (KAP) of 525 cross-specialty HCPs managing diabetes in India regarding FEE management in diabetic patients with acute nondiarrheal illnesses to identify gaps and inform interventions. MATERIALS AND METHODS: An online cross-sectional survey evaluated physician perspectives on dehydration in diabetes using a 30-item questionnaire covering knowledge of dehydration in diabetes, attitudes toward the oral FEE formulations, and current practice. RESULTS: Most respondents (90%) identified osmotic diuresis as a key driver of dehydration in diabetes, with 75% highlighting Sodium-glucose cotransporter 2 (SGLT-2) inhibitors as a risk factor. Despite widespread recognition of the adverse effects of dehydration and energy deficits (86%), only 46.5% routinely assessed hydration status during acute illnesses in persons with diabetes. Slow-release carbohydrates, such as isomaltulose, D-tagatose, and trehalose, were favored by 68.9% of respondents for their metabolic benefits to address energy deficits. 84.2% of HCPs perceived ready-to-drink (RTD) FEE formulations supporting rehydration and enhanced recovery, with an average impact on recovery time of 4.1 days. CONCLUSION: This study highlights the gaps in understanding the role of hydration in persons with diabetes. It also underscores the need for standardized oral FEE management guidelines and innovative solutions, such as RTD FEE drinks, to improve outcomes in diabetic care.

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