Diabetes Self-care Behaviors Research Articles

The Effects of Diabetes Empowerment and Health Perception on Diabetes Self-Care Behavior in Community Diabetic Elderly

The Effects of Diabetes Empowerment and Health Perception on Diabetes Self-Care Behavior in Community Diabetic Elderly

The contribution of self esteem and self-care behaviors to the eating attitudes: A correlational study in type 2 diabetes patients

Context: Type 2 diabetes mellitus (T2DM) is a common metabolic disorder. Self-care plays a crucial role in the management of diabetes. Self esteem can affect diabetes management. Aim: This study was conducted to determine the contribution of self esteem and diabetes self-care behaviors to the eating attitudes of patients with T2DM. Setting and Design: This study was conducted in a University Hospital between November 2019 and March 2020. Materials and Methods: The sample of this cross-sectional and descriptive study was composed of 150 patients with T2DM. Descriptive Characteristics Form, Coopersmith self esteem Inventory, and Eating Attitude Test were used to collect data. Statistical Analysis: SPSS 25 software was used along with descriptive and inferential statistics in data analysis. Results: It was found that the self esteem mean score of the patients with T2DM was 63.60 (±15.92), 26% of them had an impaired eating attitude, and there was no statistically significant correlation between eating attitude and self esteem of patients with T2DM (P > 0.05). Conclusions: It was concluded that high self esteem, and self-esteem of patients with T2DM were not associated with eating attitude.

Self-Care Practices Among Of Diabetic Patients in a Rural Area of Karnataka

Introduction: Diabetes mellitus causing a significant public health problem by increasing its burden globally. It is also considered a disease of poor lifestyle. The risk of these complications can be minimized by maintaining a good glycaemic control. The patients with good diabetes self-care behaviours can attain an excellent glycaemic control and lowering the micro and macro vascular complications
 Methods: A community based cross-sectional study was conducted in a rural area of Bengaluru. Diabetic patients aged 20 years and above residing in the same area for more than 6 months were included. Multistage sampling technique used to select samples. The semi structured questionnaire from The Summary of Diabetes Self-care Activities (SDSCA) Measure was used.
 Results: A total of 169 diabetic patients were included in the study. Healthy diet was consumed by 71.6% and regular physical activities for at least 30 min a day was followed by 16.6%. Weight monitoring was done by 49.1% subjects. Regular foot examination by the doctor was observed among 42.6% and 46.7% were using covered shoes.
 Conclusion: Diabetic patient in rural Bangalore follow good self-care behavior regarding diet, foot care and eye examination but very poor in exercise and glycemic/ HbA1c monitoring.

The Role of Knowledge, Self-Efficacy, and Social Support in Self-Care Behaviors among Diabetic Patients: A Meta-Analysis

Background: Diabetes mellitus is recognized as one of the emerging public health problems globally, in which the number of cases and prevalence have been steadily increasing over the past few decades. To reduce the burden posed to health systems and afflicted individuals, patients need to adopt self-care practices. At the same time, some studies found knowledge, self-efficacy, and support were essential. Hence, this meta-analysis aimed to assess these predictors of self-care behaviors among diabetic patients. Subjects and Method: This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We conducted a systematic search in electronic databases for observational studies about knowledge, self-efficacy, and family or social support for diabetic self-care behaviors published between 2012 and 2022. The Joanna Briggs Institute’s Critical Appraisal tool was used. For statistical analysis such as I-squared and Begg and Egger’s tests, the Review Manager (RevMan) 5.3 software was employed. Tables and forest plots were presented with 95% confidence intervals (CI). Statistical significance was declared at a p-value < 0.05. Results: Twelve studies with 5,482 participants were included. Good self-care behaviors were significantly associated with adequate diabetic knowledge (AOR= 2.22; 95% CI= 1.24 to 3.98; p= 0.007) and having family or social support (AOR= 2.5; 95% CI= 1.98 to 3.16; p<0.001), whereas poor self-efficacy was a significant predictor of poor self-care behaviors (AOR= 2.46; 95% CI= 1.66 to 3.65; p<0.001). Conclusion: Diabetic knowledge, self-efficacy, and family or social support are essential correlates and predictors of self-care behaviors. Researchers, healthcare professionals, third-sector organizations, and policymakers can use these findings to re-evaluate. Keywords: diabetes, self-care behaviors, knowledge, self-efficacy, social support, meta-analysis Correspondence: Ayu Nanda Sari. Faculty of Medicine, Universitas Malikussaleh. Jl. H. Meunasah Uteunkot Cunda, Lhokseumawe 24351, Aceh, Indonesia. Email: ayunandasari@student.uns.ac.id. Mobile: +62852­10688872. Journal of Health Promotion and Behavior (2021), 06(03): 250-262 DOI: https://doi.org/10.26911/thejhpb.2021.06.03.08

Symptoms of depression and anxiety in adults with type 1 diabetes: Associations with self-care behaviour, glycaemia and incident complications over four years – Results from diabetes MILES–Australia

ObjectiveTo examine whether symptoms of depression or anxiety predict glycaemia and incident diabetes complications four years later, and whether diabetes self-care behaviours mediate these associations, in adults with type 1 diabetes (T1DM). MethodsData of 205 adults with T1DM from the 2011 and 2015 Diabetes MILES–Australia surveys were analysed. Variables of interest were: baseline depression and anxiety (PHQ-8 and GAD-7, respectively) symptoms; HbA1c and incident complications at four-year follow-up; and self-care behaviours at both time points. Longitudinal associations were analysed using structural equation modelling. ResultsForty-two participants (20.6%) reported incident complications. Baseline depressive symptoms predicted higher HbA1c at follow-up indirectly via less optimal self-care at follow-up (β = 0.19, P = 0.011). Baseline anxiety was not independently associated with HbA1c or self-care at follow-up (P ≥ 0.64). Neither depressive nor anxiety symptoms predicted incident complications, although depressive symptoms were associated with less optimal self-care at baseline (β = -0.67, P < 0.001), and this predicted microvascular complications (β = -0.38, P = 0.044); however, the indirect association via self-care was not significant (β = 0.25, P = 0.067). LimitationsParticipants were self-selected; all study variables were assessed using self-report measures; and adjusting for baseline HbA1c was not possible. ConclusionsDepressive symptoms predicted suboptimal self-care behaviour and glycaemic outcome four years later, while anxiety symptoms did not. The findings suggest that tailored diabetes care should take the potential impact of comorbid depression into consideration to help people improve their diabetes self-care and achieve best possible health outcomes.

Step Up: An Evaluation of Question-Behavior Effects in Diabetes Footcare in Middle-Aged and Older Adults

Type 2 diabetes mellitus (T2DM) is a major public health concern requiring engagement with specific self-care activities for improvement. Due to the increased risk for neuropathy, foot ulcers, and infections, engagement with certain footcare practices (e.g., inspecting feet and inside shoes, washing and drying between toes) is an important part of overall diabetes self-care. However, interventions targeting blood glucose monitoring, medication management, nutrition, and/or physical activity often precede footcare interventions. Question-Behavior Effects (QBEs), which describe the effects of behavior questioning on future engagement in that behavior, provide a unique framework for studying diabetes self-care. Although clinicians may not administer footcare interventions for people with T2DM, footcare behaviors are often still assessed (e.g., through questionnaires) in session and, consistent with QBEs, may improve through the repetition of questioning. The present study evaluated footcare QBEs (specifically, the number of days of foot inspection and cleaning in the past week) across 7 sessions of an at-home diabetes management program without intentional footcare intervention. Paired-samples t-tests (N = 78, ages 40-88 years) revealed significant improvements in the number of days of foot inspection and cleaning from intake to session 1 and intake to session 5. However, from intake to session 7, only significant improvements in foot inspection were detected. These findings reflect the potency of footcare QBEs in the absence of specific footcare interventions. They also reveal differential engagement in foot inspection and cleaning after an extended period of questioning, suggesting certain diabetes self-care behaviors may taper without the intentional introduction of intervention.

Self-care, A1C and stigmatization as predictors of a negative perception of insulin among adults with type 2 diabetes: a hospital-based study in Turkey

PurposeThe purpose of this study was to investigate diabetes self-care behaviors, stigmatization and A1C as predictors of a negative perception of insulin treatment in insulin-treated type 2 diabetic patients.Design/methodology/approachA descriptive cross-sectional and relational design was used. The study was carried out in the Diabetes Training Centre and Endocrine and Metabolism Clinic of a university hospital in the southeast of Turkey between May and October 2017. The research sample consisted of 100 type 2 diabetic patients determined by using a convenience sampling method. An introductory information form for type 2 diabetic patients, the Insulin Treatment Appraisal Scale (ITAS), Diabetes Self-Care Activities Survey (DSCAS) and Barriers to Insulin Treatment Scale (BIT) were used to collect the research data. The data were analyzed using descriptive statistics, correlations and step wise multi-linear regression.FindingsThe number of daily insulin injections, training received about insulin and stigmatization was significant predictors of a negative perception of insulin treatment.Originality/valueStrategies to decrease diabetic individuals' fear of stigmatization should be utilized to minimize their negative insulin treatment perception (giving diabetic individuals training about diabetes, planning public training to inform society and using mass media tools). Diabetes educators should know that diabetic individuals' perception of the severity of the illness could influence the daily number of injections applied and decrease the negative perception regarding insulin.

Associations of Personality, Distress, Social Support With Self-Care Behaviors in Patients With Type 2 Diabetes

The findings of recent studies indicate that self-care behaviors are significantly associated with diabetes-related distress and social support in patients with type 2 diabetes. Moreover, Big-Five personality traits are also considered to be associated with self-care behaviors and should be considered. This study was designed to investigate the associations between Big-Five personality traits, diabetes-related distress, and social support and diabetes self-care behaviors in patients with type 2 diabetes. A cross-sectional study design was conducted with 200 participants recruited by convenience sampling. A self-reported questionnaire was used to collect data on demographic and disease characteristics, Big Five personality indicators, diabetes-related distress, social support, and self-care behavior. Data were analyzed using percentage, mean and standard deviation, independent t-test, one-way ANOVA, Pearson's correlation test, and enter method multiple regression analysis. Social support was found to relate positively and significantly with self-care behavior, while no significant relationship was found between diabetes-related distress and self-care behaviors. Participants with high scores for extroversion, agreeableness, and conscientiousness tended to have better self-care behavior, while those with a high score for neuroticism tended to have poor self-care behaviors. The results of the enter method multiple regression analysis showed age and social support to be significant factors associated with self-care behaviors, explaining 19.5% of the variance. Priority concern should be given to patient age and social support status when working to improve the self-care behaviors of patients with type 2 diabetes. As personality traits were found to be significantly associated with self-care behaviors, these should be included in the individual health education program.

Impact of health literacy and self-care behaviors on health-related quality of life in Iranians with type 2 diabetes: a cross-sectional study

BackgroundRegarding the importance of health literacy as a key factor in self-care, appropriate understanding of health information by patients with type 2 diabetes mellitus (T2DM) is fundamental for better management of risk factors, which can also benefit their quality of life. This study aimed to describe the relationship between health literacy (HL), and self-care behaviors with health-related quality of life (HRQL) in patients with T2DM.MethodsA cross-sectional survey was done in Iran in 2019. Patients were recruited randomly from health centers by medical records (n = 192, 55.2% male, mean age 58.12 years). The data collection included demographic form, health literacy questionnaire, diabetes self-care behavior questionnaire, and world health organization’s Quality of Life-BREF (WHOQOL-BREF). Analyses were adjusted for confounders using hierarchical regression analysis.ResultsHL as predictor variables explained 47.5% of variance in overall HRQL (p value < 0.001), reading health information was the strongest HL dimension (β = 0.478). Self-care behaviors explained an additional 13.6% of the HRQL variance. In total, 65.5% of the variation in the HRQL is explained by the HL, self-care behavior, and the demographic variables.ConclusionWe found that more almost two-third of the HRQL explained by the HL and self-care behaviors. Given the importance of health literacy and self-care behaviors in the quality of life in patients with T2DM, adoption of health-promoting behaviors and increasing health literacy can be beneficial for promoting quality of life among these patients.

Self-Care Behavior in Diabetes Mellitus Patients Using Herbals as a Complement to Treatment

Diabetes mellitus (DM) is a chronic disease that requires treatment or management in the long term. DM patients have a tendency to seek other treatment besides medical treatment. The use of herbs is one of the choices for DM patients in complementing self-care, especially in the treatment component. This study aims to explore in depth about self-care behavior in DM patients who use herbs as a complement to medical treatment. This study used a qualitative design with a phenomenological method approach. Participants were determined by purposive sampling technique as many as 9 participants. Data collection was carried out in August and October 2015 with in-depth interview techniques. Data analysis using Interpretative Phenomenological Analysis. The data validation was done by using triangulation technique. There are three themes generated in this study, namely: 1) reasons for going to health services, 2) patient expectations after being diagnosed with diabetes, and 3) diabetes self-care. DM patients who have a tendency to use herbs as a complement to medical treatment must continue to carry out self-care regularly so that their blood sugar levels are controlled. The pattern of diabetes self-care behavior needs the attention of health workers, so that DM patients continue to carry out self-care regularly when using herbs as a companion to medical treatment.&#x0D; &#x0D; Keywords: diabetes mellitus; herbs; self-care

Building a Healthy Temple diabetes self-management education support program in Hispanic faith community settings: A cluster randomized controlled trial

Diabetes self-management is key to preventing diabetes complications disproportionately affecting Hispanics. Church appears a promising setting for delivering a diabetes self-management education support (DSMES) program. “Faith-placed” (FP) programing refers to health interventions implemented in the church setting; while “faith-based” (FB) signifies integrating spirituality with health interventions. The Building a Health Temple (BHT) DSMES program integrates spirituality with DSMES to improve diabetic outcomes.This cluster-randomized trial tests the effectiveness of BHT DSMES by adapting an existing DSMES program into faith-based context. A total of 360 participants will be recruited from 18 churches (~20 participants/church). Churches will be randomly assigned to either the FB or FP intervention arm. Intervention activities will be implemented over 14 consecutive weeks. Participants in the FB arm will participate in BHT DSMES including a Health Sermon, the Self-Management Resource Center (SMRC) Diabetes Self-Management Program (DSMP), and a 7-session Healthy Bible Study, delivered by two trained church lay health leaders. Participants in the FP arm will attend the same SMRC DSMP facilitated by outside health professional, followed by a 7-session community health and safety curriculum as a partial attention control intervention. The primary outcome will be a change in Hemoglobin A1c (HbA1c) level. Secondary outcomes include: changes in body mass index, waist circumference, diabetes distress score, diabetes self-care behaviors, eating behavior, and physical activity level. Data will be collected at baseline, 6, 9, and 12 months during the study period.The proposed study will lead to innovative DSMES program delivery through faith settings for Hispanic persons with diabetes.

Organizing framework to investigate associations between diabetes knowledge, health literacy, and self-care behaviors in patients with type 2 diabetes based on the extended parallel process model

The mechanisms underlying the relations between diabetes self-care behaviors, cognition, and social factors are still equivocal, and it is unclear how diabetes knowledge and health literacy is associated with self-care behaviors. Here, we tested a hypothetical path model linking diabetes self-care behaviors to knowledge, health literacy, and constructs of the extended parallel process model (EPPM) to understand potential predictors that may influence patients' self-care behavior with type 2 diabetes. A cross-sectional study was conducted, and 404 patients with type 2 diabetes were recruited from healthcare centers in Khaf, Iran. Diabetes self-care behaviors were indicated by, glucose self-control, foot care, physical activity, medications, smoking, and a healthy diet. The main data collection instruments in this study were the Health Literacy for Iranian Adults questionnaire (HELIA), diabetes knowledge, and self-care behavior based on the EPPM questionnaires. The results from path modeling indicated that perceived susceptibility, efficacy, self-efficacy, knowledge, and health literacy were significant (p< 0.05) predictors for diabetes self-care behaviors and path model accounted for 32% of the total variance. Based on the results, key constructs of EPPM, diabetes knowledge, and health-related literacy are empirically supported diabetes self-care behaviors. These factors could apply to health professionals for developing educational intervention programs to facilitate a physically active lifestyle.

The effects of cognitive behavioral therapy for insomnia in people with type 2 diabetes mellitus, pilot RCT part II: diabetes health outcomes

BackgroundPrevious studies have shown the negative impact of sleep disturbances, specifically insomnia symptoms, on glucose metabolism for people with type 2 diabetes (T2D). People with insomnia symptoms are at risk of poor glycemic control and suboptimal diabetes self-care behavior (DSCB). Investigating the impact of a safe and effective intervention for individuals with T2D and insomnia symptoms on diabetes’ health outcomes is needed. Therefore, the aim of this exploratory study is to examine the effects of Cognitive Behavioral Therapy for Insomnia (CBT-I) on glycemic control, DSCB, and fatigue.MethodsTwenty-eight participants with T2D and insomnia symptoms, after passing an eligibility criteria at a medical research center, were randomly assigned to CBT-I (n = 14) or Health Education (HE; n = 14). The CBT-I and HE groups received 6 weekly one-hour sessions. This Randomized Controlled Trial (RCT) used a non-inferiority framework to test the effectiveness of CBT-I. Validated assessments were administered at baseline and post-intervention to assess glycemic control, DSCB, and fatigue. A Wilcoxon signed-rank test was utilized to compare within-group changes from baseline to post-intervention. A Mann-Whitney test was utilized to measure the between-group differences. Linear regression was used to assess the association between the blood glucose level and the number of days in the CBT-I group.ResultsThe recruitment duration was from October 2018 to May 2019. A total of 13 participants completed the interventions in each group and are included in the final analysis. No adverse events, because of being a part of this RCT, were reported. CBT-I participants showed significantly greater improvement in glycemic control, DSCB, and fatigue. There was a significant association between the number of days in the CBT-I intervention with the blood glucose level before bedtime (B = -0.56, p = .009) and after awakening in the morning (B = -0.57, p = .007).ConclusionsThis study demonstrated a clinically meaningful effect of CBT-I on glycemic control in people with T2D and insomnia symptoms. Also, CBT-I positively impacted daytime functioning, including DSCB and fatigue. Future research is needed to investigate the long-term effects of CBT-I on laboratory tests of glycemic control and to understand the underlying mechanisms of any improvements.Trial registrationClinical Trials Registry (NCT03713996). Retrospectively registered on 22 October 2018,

Weight stigma and diabetes stigma in U.S. adults with type 2 diabetes: Associations with diabetes self-care behaviors and perceptions of health care

AimsDiabetes stigma and weight stigma have been identified as important but neglected issues that warrant attention among people with type 2 diabetes. This study assessed associations of diabetes stigma and weight stigma with diabetes self-care behaviors and health care in adults with type 2 diabetes. MethodsU.S. adults with type 2 diabetes (N = 1,227) completed self-report questionnaires to assess their experiences of weight stigma, diabetes stigma, diabetes self-management, diabetes-specific distress, healthcare utilization, perceptions of diabetes-specific health care. They also provided sociodemographic information. Linear regressions examined relationships among stigma and diabetes self-care and related health care, controlling for participants’ age, education, income, gender, race/ethnicity, and body mass index. ResultsInternalized weight stigma and diabetes self-stigma were both significantly associated with higher diabetes-specific distress. Adults who expressed self-stigma for their diabetes reported less diabetes self-management and lower self-efficacy, and those who reported being judged about their weight by a doctor exhibited greater diabetes-specific distress. While a history of experienced weight stigma (in general) did not reduce frequency of seeking health care, lower quality interactions with health care professionals were reported by adults who expressed diabetes self-stigma and those who experienced weight stigma from a doctor. ConclusionsSelf-stigma for diabetes and body weight, as well as experiencing judgment about weight from doctors, may have negative implications for diabetes-specific self-care behaviors and perceived quality of health care. Efforts to promote wellbeing in individuals with type 2 diabetes need to consider reducing both diabetes and weight stigma and their potentially harmful consequences.

Influence of social determinants, diabetes knowledge, health behaviors, and glycemic control in type 2 diabetes: an analysis from real-world evidence

BackgroundAlthough important achievements have been done in type 2 diabetes mellitus (T2D) treatment and glycemic control, new strategies may take advantage of non-pharmacological approaches and of other potential determinants of health (e.g., socioeconomic status, education, diabetes knowledge, physical activity, and self-care behavior). However, the relationships between these factors are not totally clear and have not been studied in the context of large urban settings. This study aimed to explore the relationship between these determinants of glycemic control (GC) in a low-income urban population from Mexico City, focused in exploring potential the mediation of self-care behaviors in the association between diabetes knowledge and GC.MethodsA multicenter cross-sectional study was conducted in patients with type 2 diabetes (T2D) from 28 primary care outpatient centers located in Mexico City. Using multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and GC. The mediation analyses to determine the pathways on glycemic control were done using linear regression models, where the significance of indirect effects was calculated with bootstrapping.ResultsThe population (N = 513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Both socioeconomic status and level of education were directly associated with diabetes knowledge. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with GC (β: -0.102, 95% Confidence Interval [95% CI] -0.189, − 0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with GC (for physical activity: β: -0.112, 95% CI -0.194, − 0.029). The association between diabetes knowledge and GC was not observed after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p-value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on GC was 17% independently mediated by physical activity (p-value: 0.049).ConclusionsSocioeconomic and educational gradients influence diabetes knowledge among primary care patients with type 2 diabetes. Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on GC. Our results indicate that diabetes knowledge should be reinforced in low-income T2D patients, with an emphasis on the benefits physical activity has on improving GC.

Association Between Dissatisfaction With Care and Diabetes Self-Care Behaviors, Glycemic Management, and Quality of Life of Adults With Type 2 Diabetes Mellitus.

The purpose of the study was to examine the associations between patient dissatisfaction and diabetes outcomes among patients with type 2 diabetes. Primary data from 615 adults with type 2 diabetes from 2 adult primary care clinics completed validated questionnaires. Patient dissatisfaction was measured by asking participants to what degree over the past 12 months were they very dissatisfied with the care they received from their primary care provider. Diabetes outcomes included self-care behaviors, quality of life, and A1C. A1C was abstracted from the medical record. Multiple linear regression models were used to assess associations between patient dissatisfaction, self-care, blood glucose, and quality of life. After adjusting for covariates, this study demonstrated that higher patient dissatisfaction was significantly associated with poor general diet, worse blood glucose levels, and lower mental component score for quality of life. In patients with type 2 diabetes, patient dissatisfaction had a significant association with higher blood glucose levels, poor general diet, and low quality of life. Demographic factors driving patient dissatisfaction included young age, low income, and low health literacy. Future studies should investigate how to address patient satisfaction in an effort to improve health outcomes.

The Relationship between HbA1c Control and Diabetes Self-care Knowledge, Competence, Behavior and Quality of Life on Diabetes elderly

The Relationship between HbA1c Control and Diabetes Self-care Knowledge, Competence, Behavior and Quality of Life on Diabetes elderly

The Effect of Peer Education on Self-Care Behaviors and the Mean of Glycosylated Hemoglobin in Adolescents with Type 1 Diabetes: A Randomized Controlled Clinical Trial.

ABSTRACTBackground: Diabetes control in adolescents is a difficult and tedious process. Diabetic teens need training to control it and prevent its complications. This study aimed to investigate the effect of peer education on self-care behaviors and glycosylated hemoglobin among adolescents with type 1 diabetesMethods: This controlled clinical trial was conducted in Iran from July 2018 to June 2019. 84 teenagers with type 1 diabetes were selected using a simple random sampling and randomly divided into control and intervention groups using block randomization. The intervention group received 4 sessions of training by peers on self care behaviors in diabetes. The control group received the routine training. The self-care questionnaire was filled out, and glycosylated hemoglobin was measured before and three months after the intervention. Data were analyzed using SPSS version 23.0. The significance level was set at P<0.0Results: Three months after the intervention, the intervention group reported significantly higher levels of score of self-care behaviors (P<0.001) and lower levels of mean glycosylated hemoglobin (P<0.001), as compared with the control. Also, the mean self-care score was not significantly different in the control group before and three months after the intervention (P>0.05). Besides, the mean glycosylated hemoglobin significantly increased three months after the intervention in the controls (P<0.001)Conclusion: The implementation of peer education can improve the self-care behaviors and glycosylated hemoglobin in adolescents. Hence, regarding its low cost and high safety, it is suggested that this approach should be established in the control of other chronic diseases in order to strengthen the self-care behaviors in adolescents.Trial Registration Number: IRCT20180904040944N1.

Relationships of diabetes self-care behaviours to glycaemic control in adults with type 2 diabetes and comorbid heart failure.

AimTo describe the relationship between diabetes self‐care behaviours and glycaemic control in patients with type 2 diabetes and comorbid heart failure.DesignA cross‐sectional, correlational study.MethodA secondary analysis of 180 participants’ baseline data from a clinical trial that tested a 6‐month integrated self‐care intervention was performed. Correlational and hierarchical linear regression analysis was used to assess the relationships between diabetes self‐care behaviours and glycaemic control.ResultThe Summary of Diabetes Self‐Care Activities general diet and Summary of Diabetes Self‐Care Activities exercise were negatively associated with glycated haemoglobin (HbA1c), while Summary of Diabetes Self‐Care Activities specific diet was positively associated. Diabetic end‐organ failure, taking insulin only and taking both oral antiglycaemic and insulin, predicted higher HbA1c and fasting blood glucose. African American race and dyslipidaemia predicted higher HbA1c while taking higher total daily medication predicted higher fasting blood glucose. Longer years lived with heart failure, lower ventricular ejection fraction and exposure to chemotherapy predicted lower fasting blood glucose.

789-P: Self-Care for Blood Glucose Monitoring (BGM) in Teens with Type 1 Diabetes (T1D): Impact of Real-Time Positive and Negative Affect

Aim: Teens with T1D often report negative emotions related to diabetes self-care. Affect tends to vary throughout the day and may provide an explanatory pathway to poor diabetes self-care and suboptimal glycemic control in teens. We used momentary sampling to examine associations between affect and BGM adherence in teens with T1D. Methods: Over 2 weeks, 32 teens (ages 14-18 years) used handheld computers to self-report positive (POS) and negative (NEG) affect (Positive and Negative Affect Schedule) and BGM adherence 4 times daily. Teens selected the times to receive the messages based on their usual BGM times. There were 225 paired affect and BG adherence reports. Z-scores were calculated for the NEG and POS subscales to reflect deviations from each teen’s overall affect. Separate logistic generalized estimating equations, adjusted for age, sex, T1D duration, and pump therapy assessed associations between POS and NEG affect and BGM adherence. Results: Teens (56% female) were (M±SD) 16.6±1.4 years old with T1D duration of 8.8±4.2 years; 63% were pump treated and A1c was 8.8±1.4%. Teens reported checking BG 59% of the time. In adjusted models, greater NEG affect was associated with lower odds of BGM (OR=0.5, 95% CI: 0.4-0.8, p=.001). POS affect was not significantly associated with BGM. Age, sex, T1D duration, and pump therapy were not significantly associated with BGM. Conclusions: In a sample of teens with T1D receiving multiple daily prompts to check BG, positive affect did not relate to BGM frequency; however, negative affect was associated with being half as likely to check BG. These findings suggest a need to provide teens with strategies for maintaining diabetes self-care behaviors when they are experiencing negative emotions. Disclosure A. Shapira: None. L.K. Volkening: None. J. Borus: None. L.M. Laffel: Advisory Panel; Self; Roche Diabetes Care. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., ConvaTec Inc., Dexcom, Inc., Insulet Corporation, Insulogic LLC, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk Inc., Sanofi US. Funding JDRF International; National Institutes of Health (P30DK036836, K12DK094721)