Abstract
AimTo appraise the Diabetes Self-Management Questionnaire (DSMQ)’s measurement of diabetes self-management as a statistical predictor of glycaemic control relative to the widely used SDSCA.Methods248 patients with type 1 diabetes and 182 patients with type 2 diabetes were cross-sectionally assessed using the two self-report measures of diabetes self-management DSMQ and SDSCA; the scales were used as competing predictors of HbA1c. We developed a structural equation model of self-management as measured by the DSMQ and analysed the amount of variation explained in HbA1c; an analogue model was developed for the SDSCA.ResultsThe structural equation models of self-management and glycaemic control showed very good fit to the data. The DSMQ’s measurement of self-management showed associations with HbA1c of –0.53 for type 1 and –0.46 for type 2 diabetes (both P < 0.001), explaining 21% and 28% of variation in glycaemic control, respectively. The SDSCA’s measurement showed associations with HbA1c of –0.14 (P = 0.030) for type 1 and –0.31 (P = 0.003) for type 2 diabetes, explaining 2% and 10% of glycaemic variation. Predictive power for glycaemic control was significantly higher for the DSMQ (P < 0.001).ConclusionsThis study supports the DSMQ as the preferred tool when analysing self-reported behavioural problems related to reduced glycaemic control. The scale may be useful for clinical assessments of patients with suboptimal diabetes outcomes or research on factors affecting associations between self-management behaviours and glycaemic control.
Highlights
When it comes to controlling blood glucose levels and establishing euglycaemia in diabetes, the probably most important factor is patients’ self-management of the condition [1,2,3]
We developed a structural equation model of self-management as measured by the Diabetes Self-Management Questionnaire (DSMQ) and analysed the amount of variation explained in HbA1c; an analogue model was developed for the Summary of Diabetes Self-Care Activities Measure (SDSCA)
Predictive power for glycaemic control was significantly higher for the DSMQ (P < 0.001)
Summary
When it comes to controlling blood glucose levels and establishing euglycaemia in diabetes, the probably most important factor is patients’ self-management of the condition [1,2,3]. A recent systematic review identified a total of 21 multidimensional scales of overall diabetes self-management plus some additional ones focussing on single self-management domains, originating from various countries [8]. Despite this seeming abundance of measurement options, the number of useful and psychometrically satisfactory instruments is limited. Out of the 21 scales, only ten were available in English language, and out of those, only five were rated sufficiently validated by the reviewing authors [8] This result clearly corresponds to two earlier reviews on the topic which collected a total of five [9] and seven [10] self-management scales, respectively
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