The association between diabetes self-management and microvascular complications in patients with type 2 diabetes

Abstract

OBJECTIVES:Diabetes is a major public health problem that is approaching epidemic proportions globally. Diabetes self-management can reduce complications and mortality in type 2 diabetic patients. The purpose of this study was to examine associations between diabetes self-management and microvascular complications in patients with type 2 diabetes. METHODS:In this cross-sectional study, 562 Iranian patients older than 30 years of age with type 2 diabetes who received treatment at the Diabetes Research Center of the Endocrinology and Metabolism Research Institute of the Tehran University of Medical Sciences were identified. The participants were enrolled and completed questionnaires between January and April 2014. Patients' diabetes self-management was assessed as an independent variable by using the Diabetes Self-Management Questionnaire translated into Persian. The outcomes were the microvascular complications of diabetes (retinopathy, nephropathy, and neuropathy), identified from the clinical records of each patient. A multiple logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between diabetes self-management and the microvascular complications of type 2 diabetes, adjusting for potential confounders. RESULTS:After adjusting for potential confounders, a significant association was found between the diabetes self-management sum scale and neuropathy (adjusted OR, 0.64; 95% CI, 0.45 to 0.92, p= 0.01). Additionally, weak evidence was found of an association between the sum scale score of diabetes self-management and nephropathy (adjusted OR, 0.71; 95% CI, 0.47 to 1.05, p= 0.09). CONCLUSIONS:Among patients with type 2 diabetes, a lower diabetes self-management score was associated with higher rates of nephropathy and neuropathy.

Psychometric properties of the Diabetes Self-Management Questionnaire (DSMQ) in Urdu

“…In the original DSMQ study [ 23 ], patients with good glycaemic control (HbA1c ≤ 7.5%), reported higher score for Physical Activity and Glucose Management, which could be due to cultural and health care facilities difference among the countries. More or less a similar finding was observed in a recent study conducted in Iran [ 35 ], where higher scores on Glucose Management and Dietary Control subscales were reported as compared to rest of the sub-scales of the DSMQ.…”

“…This finding supports the fact that those patients who practice good self-care management and are more concerned about their disease have good glycaemic control and experience lesser chances of diabetes associated late complications [ 7 – 9 ]. A low prevalence of diabetes associated neuropathy and nephropathy has been reported in T2DM patients in Iran, who scored higher on Glucose Management scale of DSMQ [ 35 ].…”

Incidence and risk factors of vascular complications in people with impaired fasting glucose: a national cohort study in Korea

“…Large and small vessel diseases are major complications of diabetes. Diabetic patients are prone to coronary heart disease, stroke, ischemic heart disease, cerebrovascular disease, peripheral vascular disease, retinopathy, and chronic kidney disease [11][12][13][14] . In a variety of ways, these conditions can be attributed to prolonged hyperglycemia.…”

Self-management in patients with diabetes mellitus

“…Dalšími faktory jsou pak správné pochopení edukace a schopnost zvládat praktiky self-managementu (2). Některé studie prokázaly, že dlouhodobý laxní přístup pacientů s diabetem k self-managementu vede ke vzniku diabetických komplikací, nefropatii a neuropatii (16). Umožnit lidem sebe sama dobře řídit (uplatňovat self-management) vyžaduje vhodnou podporu od zdravotníků, především všeobecných sester (17).…”

“…Význam self-managementu u pacientů s diabetem mellitem je prokazatelný především v oblasti prevence vzniku diabetických komplikací, jak dokazují výsledky studie realizované v Íránu. U pacientů s výrazně nízkým skóre self managementu byl prokázán výrazně větší výskyt cévních komplikací (16).…”