Do Perceptions of Empowerment Affect Glycemic Control and Self-Care Among Adults with Type 2 Diabetes?

Abstract

Background:The Arab adult with T2DM is understudied with less known facts about the perception of empowerment and its relationship with self-care and glycemic control.Purpose:The purpose of this study was to determine the extent to which perception of empowerment by Arab adults living with Type 2 Diabetes Mellitus (T2DM) was associated with better glycemic control and self-care management.Methods:A cross-sectional descriptive study was led among 300 Arab adults living in Oman with T2DM in an outpatient diabetes clinic. The Diabetes Empowerment Scale (DES), glycosylated haemaglobin (HbA1c) and Body mass index was assessed. The DES was found to be valid and reliable for the population. ANOVA, Regression analysis, and Structural equation modeling was used for analysis.Results:The composite score and three subscales of DES were a significant and strong predictor of good glycemic control among Omani adults with T2DM (p<0.001). Age, education, duration of DM, prior DM education program and medications were significantly associated with DES.Conclusion:Diabetes nurse educators engaged in the care of adults with T2DM should assess self-empowerment and tailor interventions to increase empowerment for better glycemic control. Patient empowerment plays an essential role in maintaining self-care behaviours and HbA1c.

Foot care behaviors among adults with type 2 diabetes

“…In addition, prevention of activities of daily living, diabetes patient education and attitude toward DM was associated with foot wear. Adults who had positively fit foot care in their daily life [31,32] and those who had good knowledge had lower HbA1c level [23]. Normal body mass index (<18.5 kg/m 2 ) and prevention of activities of daily living was associated with foot safety and prevention among adults with T2DM.…”

“…Aging led to changes in the vascular, neurological, and musculoskeletal systems causing high risk of peripheral vascular disease and neuropathy. Younger age, females, higher education, shorter duration of diabetes, and positive attitude to diabetes was significantly associated with foot care [34] and foot care and controlled HbA1c accounted for 78%, and 51% variances respectively [31,32]. Men have been found to be at a higher risk for foot ulcers than women [35].…”

“…history/current foot problems, heating pad, smoking, legs crossed, bare feet, shoes without socks, no exercise) were scored '0' and positive statements were given scored '1'. The total DFQ scores were summed and classified into poor (<15) and good (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) foot care behaviors (FCB). A higher score indicate higher foot care behaviors among adults with T2DM.…”

Empowerment in the Treatment of Diabetes and Obesity

“…The results of the DES correlate with age, level of education, disease duration, educational program of diabetes applied, and metabolic control [10, 11]. In a study conducted in a population of Chinese patients with type 2 diabetes, the results of the DES-SF helped predict patients' self-control (assessed according to the Diabetes Self-Care Activities Scale), including diet, physical activity, blood glucose monitoring, medication, taking care of the feet, and metabolic control [12].…”

How do multi-modality strategies affect outcomes in T2D using a randomized control trial?

“…Healthy BMI showed a controlled HbA1c with diabetes education among adults with T2D. 21 Omani adults have embraced the concept of self-efficacy and adapted to the experiences living with diabetes which makes them better able to understand the self-management. They would have received more self-care management compared with those with shorter duration of diabetes, increasing their self-efficacy to understand self-management.…”