Correlations between Diabetes Mellitus Self-Care Activities and Glycaemic Control in the Adult Population: A Cross-Sectional Study.

Simona Diana Stefan,Cosmin Mihai Vesa,Ali A Rizvi,Mihaela Simona Popoviciu,Emanuele Maria Merlo,Manfredi Rizzo,Roxana Adriana Stoica,Stefan Busnatu,Violeta Nicoleta Marin,Anca Pantea Stoian,Cristian Serafinceanu

doi:10.3390/healthcare10010174

Abstract

Although it is well known that lifestyle changes can affect plasma glucose levels, there is little formal evidence for the sustained effectiveness of exercise and diet in diabetes mellitus (DM) management. Self-care in DM refers to the real-life application of the knowledge that the patient gained during the education programmes. The goals are to bring about changes in the patient’s behaviour, thus improving glycaemic control. We evaluated the influence of DM self-care activities (SCA) on glycaemic control in a total of 159 patients with DM. Plasma glycated haemoglobin (HbA1c) levels were used to monitor glycaemic control, while SCA were assessed using the standardised Diabetes Self-Management Questionnaire (DSMQ). In our study, 53% of the patients had a HbA1c ≥ 7%. In univariate linear regression models, a statistically significant inverse association was observed between the HbA1c (the dependent variable) and both the DSMQ Dietary Control Score (R2 = 0.037, p = 0.0145) and the DSMQ Sum Score (R2 = 0.06, p = 0.0014). The mean absolute change in the HbA1c% associated with one standard deviation (SD) change in the DSMQ Sum Score, independent of the other significant variables retained in the compacted multivariate regression model, was −0.419% (confidence interval: 95%: from −0.18 to −0.65). Although the impact of the DSMQ Score was modest when compared to the other independent variables in the multivariate model, the findings emphasise the importance of maintaining optimal lifestyle changes to avoid hyperglycaemia and its complications. In conclusion, enhanced self-management of DM is associated with improved glucose control. In patients with chronic diseases such as DM, the role of streamlining SCA encompassing physical activity and proper dietary choices is imperative because of a significantly reduced access to healthcare globally as a result of the COVID-19 pandemic.

Highlights

Diabetes mellitus (DM) is an increasingly common metabolic disorder that is a major cause of morbidity and mortality across the globe [1]
In the univariate linear regression models (Table 2), a statistically significant inverse association was observed between the HbA1c and each Diabetes Self-Management Questionnaire (DSMQ) Dietary Control Score (p = 0.0145), DSMQ Physical Activity Score (p = 0.0468), and DSMQ Sum Score (p = 0.0014)
Since R2 could be interpreted as a measure of the proportion of the variance of the dependent variable explained by the model, the DSMQ Dietary Control, DSMQ Physical

Summary

Introduction

Diabetes mellitus (DM) is an increasingly common metabolic disorder that is a major cause of morbidity and mortality across the globe [1]. The concept of DM self-care has gained increased attention from clinicians and researchers in the past few decades. Given the fact that DM complications remain highly prevalent, increased importance has recently been given to enhancing DM education, especially through the implementation of structured education programmes. Since daily self-care activities (SCA) in DM are largely the responsibility of the patients and their families, it is expected that effective DM self-management education (DSME) will result in superior performance in the former [2]. Self-care in DM refers to the real-life application of the knowledge that the patient gained during the education programmes [3]. The goals are to bring about changes in the patient’s behaviour, improving glycaemic control [3]

Objectives

Methods

Results

Discussion

Conclusion