Abstract
Background: Diabetes is a global public health problem. Optimal diabetes self-management is associated with decreased diabetes-related complications and improved glycemic control. Objective: To identify the factors associated with diabetes self-management among adults with type 2 diabetes. Methods: A hospital-based cross-sectional study was conducted among 384 adults with type 2 diabetes attending their routine outpatient appointment at Tribhuvan University Teaching Hospital in Nepal. Data was collected via face-face interviews and a medical record review. Self-management was measured using the Summary of Diabetes Self-Care Activities (SDSCA). A series of structured questionnaires were used to measure sociodemographic, clinical factors, social support, self-efficacy and depression. Multiple linear regression analysis with backward elimination method was used to assess factors associated with self-management. Results: The participants’ mean score for diabetes self-management was 3.3 ± 1.3 on a mean range of 0 to 7. Multiple linear regression analysis showed that low (β= -0.984, 95% CI: -1.313, -0.656) and moderate perceived social support (β = -0.702, 95% CI: -0.991, -0.412), low or moderate self-efficacy (β = -0.515, 95% CI: -0.912, -0.118), rural residence (β = -0.484, 95% CI: -0.791, -0.177), poor glycemic control (β = -0.265, 95% CI: -0.504, -0.027) and presence of any diabetes complication (β = -0.248, 95% CI: -0.490, -0.006) significantly lowered the level of self-management, after adjusting for age, educational status, marital status, comorbidity, family history of diabetes, BMI, diabetes knowledge, alcohol consumption and depression. Conclusion: The diabetes education programs should use strategies that enhance self-efficacy of people with diabetes. People with type 2 diabetes from rural areas, with diabetes complications, impaired glucose control and poor social support may need special attention from health professionals to improve their self-management. Disclosure M. Shrestha: None. A. Ng: Consultant; Self; Roche Diabetes Care, Ypsomed AG. R.J. Gray: None.
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