Abstract 13213: Correlates of Dietary Self-care Behaviors in Adults With Type 2 Diabetes and Comorbid Heart Failure

Abstract

Introduction: Multi-morbidity is increasingly recognized to negatively influence self-care behaviors such as dietary adherence in persons living with serious or life-threatening chronic conditions such as type 2 diabetes (T2D) and heart failure (HF). Aim: The aim of this study was to describe demographic, clinical, and psychosocialcorrelates of dietary self-care behaviors in adult patients with T2D and comorbid HF. Methods: The parent study for this secondary analysis was a randomized trial that tested a 6-month integrated self-care intervention for 180 participants with comorbid HF and T2D. Cross-sectional, baseline data was used for the predictive model which included demographic (age, sex, marital status, and education) psychosocial (depression [PhQ-9], self-efficacy [PDSMS], and diabetes knowledge [MDKT]); and clinical variables (years diagnosed with T2D and HF, New York Heart Association (NYHA) functional classification, Charlson comorbidity index (CCI), and implanted cardiac device). The general and specific diet components of the Summary of Diabetes Self-Care Activities (SDSCA) were used to measure dietary self-care behaviors. Correlational bivariate and stepwise linear regression analyses were performed to examine correlates of dietary self-care behaviors. Results: Participants mean age was 58 ±11 years and the majority were male (n = 118, 66%) and African American (n = 119, 66%). Charlson comorbidity >2 ( p <0.05) and implanted device ( p <0.05) predicted lower SDSCA general diet score. Diabetes self-efficacy ( p <0.01) predicted higher SDSCA specific diet score while implanted cardiac device ( p <0.05) predicted lower score, collectively explaining 18.2% of the variance in diabetes-specific dietary self-care behavior. Conclusion: Findings suggest that multimorbidity may increase risk for lower diabetes dietary self-care behaviors, particularly those with more advanced HF requiring an implanted device. Future research should focus on how to promote effective self-care behaviors in persons living with multimorbidity as a strategy to improve clinical outcomes and enhance quality of life.