Abstract 9839: Correlates of Exercise Self-Care Behavior in Type 2 Diabetes Adults with and without Comorbid Heart Failure at a Tertiary Healthcare Setting in Ethiopia

Abstract

Introduction: Exercise self-care behavior (ESCB) is recognized to improve glycemic control, cardiorespiratory fitness, and reduce cardiometabolic risk factors in persons with type 2 diabetes (T2D) and heart failure (HF). Aim: This study compared the demographic, clinical, and psychosocial correlates of ESCB in T2D adults with and without HF. Methods: This cross-sectional study recruited 210 T2D adults (105 with HF and 105 without HF) from Tikur Anbessa Specialized Referral Hospital in Ethiopia. The exercise subscale of the Summary of Diabetes Self-Care Activities (SDSCA) was used to measure ESCB. Correlational bivariate and stepwise logistic regression analyses were used to examine and compare correlates of ESCB. Variables included in the logistic regression model were: demographic (age, sex, marital status, occupation, living arrangement), clinical (body mass index [BMI], years since diagnosis of T2D, diabetes medication type, Ney York Heart Association [NYHA] classification, Charlson comorbidity index) and psychosocial (diabetes self-efficacy, depressive symptoms, and social support). Results: The participants mean age was 58.7±10.9 years while those with HF (61.6±10.5) were significantly older ( p < 0.001) than those without HF (55.7±10.6). The percentage who exercised 5 days per week was significantly lower ( p = 0.03) in comorbid HF participants (n = 41, 39.1%) compared to those without HF (n = 48, 45.7%). In T2D adults without HF, for each 1 kg/m 2 increase in BMI there was a 12% lower odds of ESCB ( p = 0.028). In T2D adults with HF, a 1-year increase in age ( p = 0.029) and a 1-unit increase in depressive symptom score ( p = 0.009) independently predicted a 5.5% and 12.4% lower odds of performing ESCB, respectively. A 1 unit increase in diabetes self-efficacy score predicted a 24% higher of odds of ESCB ( p = 0.01). Conclusions: Findings indicate that multimorbidity negatively influenced participation in ESCB in T2D. Studies that improve diabetes self-efficacy, address weight and depressive symptoms may be beneficial for enhancing ESCB in T2D patients with HF or other serious chronic conditions.