Impact of Diabetes-related Self-management on Glycemic Control in Type II Diabetes Mellitus

Abstract

Introduction: Self-care activities are behaviors adopted in order to enhance one's health. Selfcare behaviors and activities are studied in their role to enhance glycemic control, reduce diabetes-related complications, and contribute to enhancing overall quality of life in people with diabetes. The aim of this observational study was to evaluate the impact of diabetes selfcare activities and behaviors on glycemic control in people with diabetes.Methods: This observational, cross-sectional study was conducted at the outpatient department of a secondary care hospital in Karachi, Pakistan from 1st September 2019 till 30th November 2019. Patients with known type II diabetes of age ≥45 years visiting the hospital for routine follow-up visit were included. Diabetes Self-Management Questionnaire (DSMQ) in Urdu version was used to assess their status of self-management. For data entry and statistical analysis SPSS for Windows version 21.0 was used.Results: There were 174 (54.9%) males and 152 (47.9%) were of age 45-60 years. Glycemic control was good (HbA1c <7%) in 125 (39.4%) and poor (HbA1c ≥7%) in 192 (60.6%) patients. Patients with good glycemic control scored significantly better on DSMQ overall (5.53 ± 0.35 vs. 4.32 ± 0.61; p<0.0001), and on three sub-scales -dietary control (4.24 ± 1.04 vs. 3.63 ± 0.98; p<0.0001), physical activity (4.16 ± 0.56 vs. 3.47 ± 1.17; p<0.0001), and healthcare use (4.22 ± 0.78 vs. 3.98 ± 0.65; p=0.003). Conclusions:The self-care activities that impact glycemic control in patients with diabetes include dietary control, physical activity, and healthcare use.

The effect of the COVID-19 pandemic on self-management in patients with type 2 diabetics

“…Only 9-15% of individuals with type 2 diabetes achieved optimal glycemic control [15], and poor glycemic control in diabetic individuals can lead to greater sensitivity to the effects of COVID-19. A viral infection in diabetic individuals can make treatment more difficult because of sudden fluctuations in blood sugar levels and the presence of diabetes complications [5].…”

“…This form was prepared by the researchers in accordance with the literature [2,13,14,16], and consisted of questions on information concerning sociodemographic characteristics and characteristics relating to illness and COVID-19.…”

“…Item 16 is not included in any subscales. The scale includes four subscales: glucose management (1,4,6,10,12), diet control (2,5,9,13), physical activity (8,11,15), and use of health services (3,7,14).…”

“…Thus, it is a significant health problem which constitutes a heavy burden on society [11][12][13]. The worry of diabetic individuals about going to a hospital during the pandemic makes it more difficult for health professionals to monitor them and to support their self-confidence [3,14]. Holistic self-management in diabetes includes regular glucose monitoring, medical nutrition treatment, adherence to regular drug use, and self-care behaviors ensuring adherence to physical activity [11,13].…”

The association between diabetes numeracy and diabetes self-management among Saudi adults with insulin-treated diabetes

“…In our patient population, the mean total DSMQ score was 6.4, which is higher compared to the mean scores of other studied population. [38][39][40] Of note, it has been demonstrated that the association between diabetes numeracy and diabetes self-management was more pronounced among patients who used insulin. 13 Furthermore, a study showed that patients with type I diabetes were found to express higher confidence in their diabetes self-management.…”