Diabetes Self-care Research Articles

The Michigan Men's Diabetes Project Randomized Clinical Control Trial: A Pilot/Feasibility Study of a Peer-Led Diabetes Self-Management and Support Intervention for Black Men With Type 2 Diabetes.

Black men are disproportionately affected by type 2 diabetes (T2D) and experience higher diabetes-related complications than non-Hispanic White men. To address the complex barriers in diabetes self-management for Black men, we implemented a 3-month peer-led and empowerment-based Diabetes Self-Management Education (DSME) and Support (DSMS) intervention in Metro Detroit. Twenty-five Black men ≥55 years of age with self-reported T2D were randomized to the intervention group (n=12)-10 hr of DSME and 9 hr of DSMS-or enhanced usual care (EUC) group (n=13)-10 hr of DSME. Peer leaders (n = 3) were trained by certified diabetes care and education specialists (CDCESs) to cofacilitate the support sessions. Outcomes (hemoglobin A1c [HbA1c], diabetes self-care activities, and diabetes distress) were assessed preintervention and postintervention. In the intervention and EUC groups, mean HbA1c decreased by 0.20% (p = .52, SD = 0.99) and 0.13% (p = .68), respectively. General diet (p = .03, M change: 1.32, SD = 1.71) and blood glucose monitoring (p < .05, M change: 0.50, SD = 0.74) scores improved among those in the intervention group. General diet scores also improved in the EUC group: mean change: 1.77, p = .08, although changes were not statistically significant. Changes in diabetes distress scores differed based on the number of sessions attended, with a significant decrease in those attending 7 to 12 sessions (n = 7), >50%, (p = .003, M change: -5.71, SD = 3.20). Implementing a peer-led DSMS program for Black men was feasible, adopted, and led to positive changes in outcomes. Scaling up the intervention and assessing sustainability is warranted.

Classroom as the Site for Type 1 Diabetes Self-Care Activities

Classroom as the Site for Type 1 Diabetes Self-Care Activities

Psychosocial Self-efficacy and its Association with Selected Potential Factors Among Adults with Type 1 Diabetes: A Cross-Sectional Survey Study.

The management of type 1 diabetes, a non-preventable chronic disease, leads to a high physical and psychological burden on the individual. Digital health technology can improve a person's psychosocial self-efficacy and thereby contribute to improved diabetes self-care. The aim of this study was to explore associations between psychosocial self-efficacy and demographic-, disease specific-, well-being as well as digital health technology (DHT) related factors among adults with type 1 diabetes. A primarily web-based cross sectional survey was conducted among adults with type 1 diabetes in Sweden (n = 301). Psychosocial self-efficacy was assessed using the Swedish version of the Diabetes Empowerment Scale, Swe-DES-23. The survey also contained questions related to demographic-, disease specific-, well-being as well as digital health technology related variables. Higher well-being scores and lower HbA1c levels were associated with higher psychosocial self-efficacy in multiple linear regression analysis. In multivariate analysis, gender, body mass index, well-being scores, and HbA1c levels showed association with psychosocial self-efficacy. None of the DHT factors were found associated with psychosocial self-efficacy. In this study, higher well-being score and lower self-reported HbA1c levels were associated with higher psychosocial self-efficacy in both univariate- and multivariate analysis and accounted for 30% of the variation in psychosocial self-efficacy in the regression model. Thus, measures to improve psychosocial self-efficacy in adults with type 1 diabetes may help maintain their psychological well-being and blood glucose control.

Implementation and evaluation of the centering pregnancy group prenatal care model in pregnant women with diabetes: a convergent parallel mixed methods study protocol

BackgroundDiabetes during pregnancy has negative effects on both mothers and their fetuses. To improve perinatal outcomes and women’s experience of care, the World Health Organization (WHO) suggests implementing health system interventions to enhance the use and quality of antenatal care. The main goal of this study is to implement and evaluate the outcomes of the Centering Pregnancy group care model for pregnant women with diabetes.Methods/designThe study will consist of three phases: a quantitative phase, a qualitative phase, and a mixed phase. In the quantitative phase, a randomized controlled trial will be conducted on 100 pregnant women with diabetes receiving prenatal care in Tabriz City, Iran. The Summary of Diabetes Self-Care Activities (SDSCA) questionnaire will also be validated in this phase. The qualitative phase will use qualitative content analysis with in-depth and semi-structured individual interviews to explore pregnant women’s understanding of the impact of the Centering Pregnancy group care model on their care process. The mixed phase will focus on the degree and extent of convergence between quantitative and qualitative data.DiscussionThe implementation of the Centering Pregnancy group care approach is anticipated to empower women in effectively managing their diabetes during pregnancy, resulting in improved outcomes for both mothers and newborns. Furthermore, adopting this approach has the potential to alleviate the financial burden of diabetes on healthcare system.Trial registrationIranian Registry of Clinical Trials (IRCT): (IRCT20120718010324N80/ Date of registration: 2024-01-03). URL: https://irct.behdasht.gov.ir/trial/74206.

Goal change and goal achievement for emerging adults across the pilot FAMS-T1D intervention for type 1 diabetes.

Interventions for emerging adults (EAs) with type 1 diabetes (T1D) focus on goal setting, but little is known about how goal achievement relates to intervention outcomes. We examined how goals change, how goal achievement relates to diabetes outcomes, and identified barriers and facilitators to goal achievement. EAs with T1D (N=29, M age=21.6 years, 57% female) were coached monthly to set a behavioral goal across a 3-month feasibility trial. Coaching notes were qualitatively coded regarding type, complexity, and changes in goals. Goal achievement was measured via daily responses to texts. HbA1c, self-efficacy, diabetes distress, and self-care were assessed pre- and post-intervention. EAs frequently set food goals (79%) in combination with other goals. EAs overwhelmingly changed their goals (90%), with most increasing goal complexity. Goal achievement was high (79% of days) and not affected by goal change or goal complexity. Goal achievement was associated with increases in self-efficacy and self-care across time. Qualitative themes revealed that aspects of self-regulation and social-regulation were important for goal achievement. Meeting daily diabetes goals may enhance self-efficacy and self-care for diabetes. Assisting EAs to reduce self-regulation challenges and enhance social support for goals may lead to better diabetes outcomes.

Exploring T2DM Patients’ Motivation in Diabetic Self-care: a Qualitative Study

Motivation refers to the larger mental processes that guide individual behaviours. Self-care behaviours are crucial in aiding disease adaptation by improving treatment adherence, disease control, quality of life, and self-perceived health status. Diabetic patients have been shown to have fewer concerns about their health. Thus, this study aimed to explore the motivating factors of diabetes self-care (DSC) among people with Type 2 Diabetes Mellitus (T2DM). A qualitative approach was adopted to explore and better understand the motivation behind self-care among diabetic patients. In-depth interviews (IDI) were conducted with 21 patients from two government healthcare facilities in Selangor, namely Hospital Tengku Ampuan Rahimah, Klang and the Meru Health Clinic from November to December 2019. All the qualitative data were managed using the NVivo software and thematically analysed. In general, this study identified two major types of motivation: self-motivation and social- motivation. Under self-motivation, there were six significant sub-themes, i.e. perceived better health condition having received DM exposure, perceived importance of diet and medication, self or personal experience, fear of diabetes complications, perceived importance of lifestyle modification, and positive thinking. In addition, the results revealed five significant sub-themes in terms of social-motivation: family support, community support, others’ experiences, financial support, and employer support. Our findings demonstrated the importance of various motivating factors in providing self-care support to diabetic patients. A well-planned diabetes management programme should incorporate motivational support to encourage patients to better manage their conditions.

Compliance to Recommended Prevention and Management Practices among Type 2 Diabetes Patients in Morogoro Municipality, Tanzania

Introduction: Diabetes-related complications are the significant causes of morbidity and mortality among type 2 diabetes patients. The complications can be reduced by practicing and maintaining several preventive measures. The present study aims to assess compliance and factors associated with recommended management practices and prevention of complications among type 2 diabetes patients in selected health facilities in Morogoro Municipality, Tanzania. Methods: A hospital-based cross-sectional study was conducted from February to May 2023 among 140 patients, including patients who were diagnosed with diabetes for at least three months prior to the study. Data were collected through face-to-face interviews using a structured questionnaire, which included patients’ characteristics and a previously validated Summary of Diabetes Self-care Activities questionnaire to assess patients' compliance with recommended practices. A multivariable regression analysis was employed to identify factors associated with compliance with recommended practices. Results: The mean age of the respondents was 59 ±12.08 years and 65% were females. Among 140 patients, 91.4% (n=128) had poor or unsatisfactory self-care practices with an overall mean of 3.81± 2.08 days per week for diabetes management. The recommended practices with good or satisfactory performance were non-smoking, non-alcohol drinking and prescribed medication. In contrast, unsatisfactory performance was observed for self-monitoring of blood glucose with a mean of physical activity. Multiple regression analysis showed that co-morbidity (AOR 4.5; 95% CI:1.14-18.02) and being employed (AOR 4.4; 95% CI:1.25-15.44) independently predict self-care practices. Conclusion and recommendation: Compliance with self-monitoring of blood glucose, physical exercise and dietary practices were found to be low among type 2 diabetes patients, which could increase the risk of complications. Nutritional and lifestyle counselling and the use of peer groups should be emphasized to improve compliance with recommended practices.

Cardiovascular Risk Awareness, Exercise Practices and Metabolic Outcomes among Patients with Diabetes Mellitus in Northern Nigeria: A Cross-sectional, Multicentre Study.

Physical exercise helps to mitigate cardiovascular risks in people with diabetes mellitus (DM), but there are limited data in Nigeria. This study aimed to assess cardiovascular risk awareness, exercise practices and metabolic outcomes among Nigerians with diabetes. We conducted a cross-sectional study at five tertiary hospitals using questionnaire interviews and clinical assessments. Participants' knowledge of cardiovascular risk factors and knowledge of exercise were assessed on 12- and 5-item scores, while exercise practices were classed as adequate if performed regularly on 3 or more days weekly for a total of 150 min or more based on the American Diabetes Association recommendations. Mean body mass index (BMI), blood pressure (BP), fasting blood glucose, serum haemoglobin A1C (HbA1c), lipid profile, urea, creatinine and uric acid were then compared among participant groups. We studied 426 participants with DM, 58.7% females. The mean age was 52.9 ± 13.1 years, with males significantly older than females (54.6 ± 12.2 vs. 51.8 ± 13.5 years; 95% confidence interval: 0.27-5.28, P = 0.03). The mean age at diabetes diagnosis was 44.8 ± 11.7 years, and the median duration of diabetes was 84 months. There was low knowledge of cardiovascular risk factors and low knowledge of exercise (mean scores of 2.94 and 2.31, respectively). Forty-three per cent of participants reported adequate exercise, which was significantly associated with younger age (P = 0.007), male gender (P = 0.001) and formal education (P = 0.021). Participants with adequate exercise had lower systolic BP and serum urea compared to those with inadequate exercise, but there were no significant differences in BMI, fasting glucose, HbA1c, serum lipids, creatinine or uric acid. Participants had low knowledge of cardiovascular risks and the appropriate exercise practices for diabetes patients. There is a need for better patient education on diabetes self-care and exercise at clinic visits.

Factors of Influence on Diabetes Awareness in Older People With Chronic Obstructive Pulmonary Disease Comorbid With Type 2 Diabetes Mellitus.

Type 2 diabetes mellitus (T2DM) is a common comorbidity in patients with chronic obstructive pulmonary disease (COPD) and has been associated with an increased risk of mortality in this population. This study was designed to investigate the predictive factors of diabetes awareness (DA), including diabetes knowledge (DK), and diabetes care behaviors (DCB) among older people with both COPD and T2DM. This was a cross-sectional descriptive correlation study. One hundred thirty-three older-age patients with COPD comorbid with T2DM receiving treatment at a chest hospital were enrolled as participants. Both DK and DCB were utilized to measure DA. The Diabetes Knowledge Questionnaire was utilized to measure DK, and the Summary of Diabetes Self-Care Activities was used to evaluate DCB. The average glycated hemoglobin (HbA1c) was 7.68% ( SD = 1.55%), with 74 (55.6%) participants having a level > 7%. The average DA was 46.46% ( SD = 13.34%), the average DK was 53.42% ( SD = 18.91%), and the average DCB was 39.50% ( SD = 16.66%). In terms of demographic variables, age, diabetes education, diabetes shared care, and HbA1c were all significantly associated with DA, DK, and DCB (all p s < .05). The overall variance in DA was significantly explained by diabetes education and HbA1c (all p s < .05). The overall variance in DK was significantly explained by age, diabetes education, and HbA1c. The overall variance in DCB was significantly explained by diabetes education and HbA1c (all p s < .05). Our study findings indicate that older adult patients with COPD comorbid with T2DM are at elevated risks of poor glycemic control and low DA. Healthcare professionals should be aware of these issues and develop appropriate DA plans to prevent poor glycemic control in this population. Providing accurate information on diabetes to older adults with COPD comorbid with T2DM is important to improving their DK and promoting better DCB.

IJCM_165A: Selfcare practises and its association with glycaemic indices among diabetes mellitus patients in a rural community in Karnataka.

Background: Self-care is a complex and natural decision-making process for maintaining health, especially in chronic patients, such as patients with Type 2 Diabetes Mellitus. Identifying the contribution of each self-care behavior to glycaemic control in patients with type 2 diabetes becomes an integral part. Objective: To determine the association of self-care in Diabetes Mellitus patients and blood sugar levels in a rural community in Karnataka. Methodology: A cross-sectional study was conducted at a health institution in a rural area affiliated with a private medical college in Karnataka, India, from March to April 2023. The Diabetes Self-care Questionnaire (DSMQ) was used to examine diabetes patients’ self-care practices. Quantitative data was expressed in mean, standard deviation, median, or interquartile range. Qualitative variables were expressed in percentages and proportions and analyzed using SPSS 20.0. The Chi-square test/Fischer’s exact test determined the association between DSMQ and Blood sugar levels Results: Among 142 Diabetes mellitus patients, the mean age was 55.32±12.89 years. 118(82.5%) were married and were Diabetic since 4(2-6) years.106(74.6%) experienced chronic complications, of which 34(23.9%) primarily had foot and leg problems. Medication adherence was seen in 97(68.3%). Sulfonylureas use was seen in 115(82.7%) followed by Biguanides in 80(56.3%). The median blood sugar level was 208.5(161.5-273.5)mg/dl. Using the DSMQ, Optimal glucose management was seen in only 35(24.5%). Suboptimal glucose management was associated with age more than 50 and self-reported obesity. Conclusion: Among the study population, one-fourth had effective glucose management and physical activity. Suboptimal glucose management was associated with age more than 50 and self-reported obesity.

IJCM_302A: Perceptions related to lifestyle modifications among Diabetes Mellitus (DM) patients in tertiary care hospitals in Mangalore

Background: Diabetes is a chronic lifestyle disease which can be kept under control by some simple lifestyle modifications like blood sugar monitoring, dietary modification and exercise pattern. Diabetes mellitus (DM) appears to be a global epidemic and an increasingly major non-communicable disease threatening both affluent and non-affluent sections of the society. Methods: A cross-sectional study was conducted in tertiary care hospitals in Mangalore involving 109 participants. The study utilized the Summary Diabetes Self-Care Activities questionnaire to collect data. Practices were categorized as good or poor based on an average score, with scores above 75% indicating good and lower scores indicating poorer practices. Data analysis was performed using SPSS version 16.0. Results: The dietary modifications were good in 7.3% of the subjects, exercise behavior in 14.67%, foot care practices in 12.6% and sugar monitoring in only 1% of the subjects. Being male and married was associated with better self-care behaviors. People belonging to low socio-economic status had better dietary modification habits. Conclusion: Self-care activities with respect to diet and sugar monitoring are poor in the population studied. The self-care activities relating to exercise behavior and foot care are good. Improving self-care behavior among patients with diabetes in India should start with adequate targeted health education.

59 Mild cognitive impairment among older adults with diabetes: A pilot study in San Juan, Puerto Rico

OBJECTIVES/GOALS: Research on mild cognitive impairment (MCI) risk factors in type 2 diabetes mellitus (T2DM) is scarce; however, MCI is a concern in T2DM as it can adversely impact self-care behaviors. This study aims to estimate the proportion of MCI and describe its sociodemographic, clinical, psychosocial, and lifestyle characteristics in older adults with T2DM. METHODS/STUDY POPULATION: Cross-sectional pilot study of 60 adults (aged ≥50yrs) with a diagnosis of T2DM will be recruited at a diabetes center located in San Juan, Puerto Rico. Data on sociodemographic, clinical, psychosocial (depressive symptoms and social support), and lifestyle characteristics related to diabetes self-management (diabetes self-care activities and activities of daily living) will be collected through face-to-face interviews using validated questionnaires. Our primary outcome will be MCI assessed via the Spanish-language version of the Montreal Cognitive Assessment (MoCA-S). The proportion of adults with MCI (MoCA-S score&lt;26) will be estimated, and the sociodemographic, lifestyle, psychosocial, and clinical characteristics of older adults will be compared across MCI status using bivariate analysis. RESULTS/ANTICIPATED RESULTS: Expected results include an estimate of the proportion of MCI among older adults with T2DM, which we hypothesize will be higher in our study than in Puerto Rico’s older adult population (previously reported as 17%). Additionally, we will describe the sociodemographic, clinical, psychosocial, and lifestyle characteristics that significantly differ by MCI status in older adults with T2DM. We expect that those with MCI will be more likely to be females, have lower education and annual income, longer time with a diabetes diagnosis, worse psychosocial profiles (higher levels of depressive symptoms and lower levels of social support), and worse lifestyle profiles (poorer glycemic control and lower activities of daily living score) than those without MCI. DISCUSSION/SIGNIFICANCE: This pilot study is a first step to understanding MCI among older adults with T2DM in Puerto Rico, a Hispanic population with a higher prevalence of T2DM than their US non-Hispanic White counterparts. Its findings can guide the design and implementation of a larger epidemiological study aimed at understanding MCI risk factors among adults with T2DM.

Assessment of Self-Care Practices among Type 2 Diabetes Mellitus Patients attending Health Care Centres of Urban Area of Hyderabad, India

Introduction: As per the International Diabetic Federation Atlas, 2021, 3 in 4 adults with type 2 diabetes mellitus live in low and middle income countries. This represents a tremendous burden on the healthcare system of these countries. Self-care practices can mitigate the disease burden. Objectives: To assess the self-care practices among the type 2 patients using Summary of Diabetes Self-Care Activities (SDSCA). Method: A facility based cross sectional study was undertaken among adults aged 25-60 years using a modified SDSCA, validated in Indian settings to study the self-care practices in diabetic patients. The modified domains included practices on dietary modifications, regular physical activity, foot care, regular blood glucose monitoring, drug adherence and addictions. Mean scores of these domains in SDSCA were compared with HbA1c measurements. Statistical tests performed included unpaired T test and chi-square. Results: Mean age of the patients was 49.60+ 11.13 Years. There were about 117(54.4%) patients with controlled HbA1c measurements. There was a statistically significant association of dietary modifications, regular physical activity, foot care, drug adherence and addictions with controlled HbA1c measurements. (p value=0.05) Conclusion: Self-care practices can significantly alter diabetes control and prevent complications. Regular glucose monitoring was lacking in several patients and led to poor glycemic controls. These results can inform clinical practice and patient care for better management of the type 2 diabetes mellitus.

SELF-CARE MANAGEMENT AND SOCIAL SUPPORT AMONG PEOPLE WITH TYPE 2 DIABETES ATTENDING SELECTED DIABETES CLINICS IN POKHARA

Background: Social support plays a significant role in determining the self-care management of individuals with diabetes. In the developing countries, the association between two factors has not been adequately explored. This study assessed the level of self-care management and social support among individuals with type 2 diabetes and identify associations between self-care management, social support, and selected variables. Methods: In this multisite cross-sectional study, 158 individuals with type 2 diabetes who attended selected diabetes clinics in Pokhara Nepal, were selected using a nonprobability purposive sampling technique from February 10 to March 10, 2021. Data collection was conducted through interviews using a modified summary of diabetes self-care activities and a multidimensional scale of perceived social support as instruments. A descriptive analysis followed by an inferential statistical test was performed to assess the association between variables. Results: More than half (53.2%) of respondents had satisfactory levels of diabetes self-care management, and most of them received high levels of social support. Levels of self-care management were significantly associated with the levels of social support. Marital status, family income, residency, educational status, disease duration, regular follow-up visits, A1C goal, and co-morbidity were significantly associated with self-care management. Gender, marital status, and follow-up visits were significantly associated with the level of social support. Conclusions: Focusing on enhancing social support, including the self-care management of individuals with diabetes, can force diabetes management more successful. Health professionals should implement programs for individuals with diabetes, including peer support groups, family education, and community-based initiatives.

Factors of Self-Care Agency in Patients with Inflammatory Bowel Disease in Japan

Introduction: Currently, no self-care measurement tool specific to inflammatory bowel disease (IBD) exists in Japan. The Instrument for Diabetes Self-care Agency (IDSCA) is a reliable and valid self-care measurement tool for patients with diabetes. Factors affecting self-care ability assessed by IDSCA appear to meet the requirements for patients with IBD. Therefore, we created a self-care ability measurement tool adapted from IDSCA as an original draft for the Instrument for IBD Self-care Agency and extracted factors and items required to measure the self-care ability of patients with IBD. Methods: An anonymous questionnaire survey was distributed among 226 patients. Exploratory factor analysis examined the relationship of factors from multiple perspectives, identified factors based on their content, and confirmed their internal consistency. Statistical analyses were performed using JMP® 14.0.0. Results: Five factors with 23 items were extracted from the IDSCA, including ability to build a human support system, ability to acquire knowledge, ability to maintain self-care, ability to self-manage, and ability to self-assess. Cronbach’s alpha was 0.765–0.861 for each factor and 0.904 for the entire scale. Conclusion: We could identify the self-care agencies of patients with IBD, including 5 factors and 23 items. Focusing on these self-care factors may provide critical information to guide nurses’ self-care interventions.

Living with type 2 diabetes: A social cognitive perspective on adherence

ObjectiveThis mixed methods study examines the relationship between outcome expectations, self-efficacy, and self-care behaviors in individuals with type 2 diabetes (T2DM). It also explores the personal values motivating these behaviors through in-depth interviews. MethodsAdults with T2DM (n = 108, M age = 57 years, 58% female, 48% Black) completed questionnaires and participated in in-depth interviews using a laddering technique. ResultsOrdinary least squares regression models were used to analyze the relationships between self-efficacy, outcome expectations, and four self-care behaviors (physical activity, dietary choices, blood glucose monitoring, and medication usage). The findings indicate that self-efficacy is significantly and positively associated with diet and physical activity. Both outcome expectations for blood glucose testing and self-efficacy are significantly and positively associated with self-reported monitoring. However, neither outcome expectation nor self-efficacy is associated with medication usage. The in-depth interviews revealed three common values related to self-care behaviors: maintaining health and longevity, agentic values of self-control, achievement, and self-esteem, and a sense of belonging. ConclusionsThis study sheds light on the complexity of diabetes self-management, offering insights into individuals' values, behavioral strategies, and the influence of control perceptions on this relationship, revealing both differences and commonalities in stated values. Practice implicationsBy understanding how personal values drive diabetes self-care behaviors, practitioners can assist patients in establishing meaningful connections between their values and the challenges of living with diabetes.

Interactive virtual assistance for mental health promotion and self-care management in elderly with type 2 diabetes (IVAM-ED): study protocol and statistical analysis plan for a randomized controlled trial

BackgroundWith one in five individuals aged 65 or older living with type 2 diabetes worldwide, it is crucial to acknowledge and address the challenges faced by this population. In this context, our study aims to evaluate the efficacy of a behavioral intervention model delivered through a smart speaker on mental health and diabetes self-care in the elderly with diabetes.MethodsThis is a single-center, pragmatic, parallel two-arm open randomized clinical trial involving elderly patients with type 2 diabetes. We plan to enroll a total of 112 individuals who will be randomized 1:1 to receive the Smart Speaker EchoDot 3rd Gen device (Amazon Echo®) for home use (intervention arm) or to maintain usual care (control arm). The primary outcome is mental distress, assessed using the 20-item Self Reporting Questionnaire (SRQ-20) after a 12-week intervention period. Secondary outcomes include quality of life, adherence to diabetes self-care behaviors, perception of stress, glycemic control, blood pressure, and lipid profile. Analysis of covariance (ANCOVA) will be used to evaluate the effects of the intervention on the outcomes.DiscussionThis study assesses the effectiveness of an interactive virtual assistance system for enhancing mental health and glycemic control among elderly individuals with type 2 diabetes. The findings may introduce smart speakers as a valuable tool for promoting diabetes-related self-care in this population.Trial registrationClinicalTrials.gov NCT05329376. Registered on 15 April 2022. Enrollment began on 20 June 2023 and the last update of protocol was on 13 December 2023.

Pathways linking health literacy to self-care in diabetic patients with physical disabilities: A moderated mediation model.

Health literacy is widely considered to be a determinant of self-care behavior in people with diabetes. However, the mechanisms underlying how health literacy is linked to self-care behaviors have not been clearly elucidated. The aim of the present study was to explore the mediating roles of access to healthcare, provider-patient interaction, motivation, self-efficacy in the effect of health literacy on diabetes self-care behaviors among diabetic patients with physical disabilities and investigate the moderating effect of age in a moderated mediation model. The online survey was participated by a total of 214 diabetic patients with physical disabilities from November to December 2021. The moderated mediation analysis was examined using the Hayes' PROCESS macro modeling tool based on the bias-corrected bootstrapping method. After controlling for education, the results yielded a significant indirect effect of health literacy on diabetes self-care through motivation and self-efficacy. A partially mediating relationship also was confirmed, as there is a positive direct effect of health literacy on diabetes self-care. Furthermore, age groups (i.e., age <40 and ≥ 40) functioned as a moderator of the mediating effects of motivation and self-efficacy between health literacy and diabetes self-care. This study emphasized the important role of motivation and self-efficacy which play in linking health literacy and self-care behavior, especially for younger diabetic patients with physical disabilities. In the light of these findings, a health-literacy tailored motivation and self-efficacy enhancing program may be key targets for interventions promoting diabetes self-care behaviors in people with physical disabilities.

Effectiveness of the Pasifika Women's Diabetes Wellness Program (PWDWP): Protocol for a Pilot Intervention and Feasibility Randomized Controlled Trial.

Type 2 diabetes poses public health challenges for Māori and Pasifika communities in Australia. The women of these communities face a greater burden from type 2 diabetes-related mortality and comorbidities. Lifestyle modification behaviors through previous women's wellness programs have been shown to reduce the risk of developing complications in established type 2 diabetes. The Pasifika Women's Diabetes Wellness Program (PWDWP) pilot study, co-designed with Māori and Pasifika communities, was aimed at addressing late hospital presentations from diabetes-related complications. This study (1) examines the efficacy of women with type 2 diabetes in the intervention group for improved glycated hemoglobin (HbA1c) clinical levels and diabetes self-management compared with the control group from baseline (T0) to week 12 (T1) and week 24 (T2; postintervention) and (2) assesses the cultural adaptability, acceptability, and feasibility of the pilot intervention for future studies. This study uses a quasiexperimental design that involves a 24-week intervention. We recruited 50 Māori and Pasifika women with type 2 diabetes (25 in the intervention group from the south side of Brisbane and 25 in the control group from the north side of Brisbane) using participatory talanoa methodologies. The intervention group participated in face-to-face and virtual whānau education workshops (5 weeks) and had access to individual coaching and virtual support delivered by trained Māori and Pasifika health professionals and community health workers. The control group received usual care with their identified health provider. Both groups received copies of the PWDWP journal, fact sheets, and a health check passbook with tailored motivational text messages. An advisory committee was set up to oversee the program implementation, including protocols of engagement, health checks, and data collection in community settings. The quantitative data were collected at T0, T1, and T2 with HbA1c as the primary outcome measure. Secondary outcomes measured changes in diabetes self-care and body composition (eg, BMI, waist circumference). Qualitative data will ascertain the program's feasibility and cultural adaptability using talanoa focus groups. This pilot study was approved by the Queensland University of Technology Human Ethic Research Committee (5609) and began in January 2023 after participant recruitment between July 2022 and December 2022. The final data collection including the health check, focus group, and survey data was completed in November 2023, and data analysis and reporting are expected to conclude in 2024. This study provides a blueprint for PWDWP. Collaborative partnerships with community organizations and stakeholders are crucial for program success and suggest a potential model for targeting diabetes management for Māori and Pasifika communities, emphasizing the need for culturally relevant interventions. The findings will have significant implications for policymakers and practitioners when developing and implementing public health initiatives, particularly for communities with unique cultural nuances. Australian New Zealand Clinical Trials Registry ACTRN12622001100785p; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384470&isReview=true. DERR1-10.2196/55435.

Preparedness of diabetic patients for receiving telemedical health care: A cross-sectional study.

This study evaluates feasibility of telemedicine to deliver diabetic care among different regions of the country. Medical interns affiliated with Rotaract Club of Medicrew (RCM) organized a Free Diabetes Screening Camp called "Diab-at-ease" at multiple sites across the country. Of all beneficiaries of the camp >18 years of age, patients previously diagnosed with diabetes and undiagnosed patients with a random blood sugar level of more than 200 mg/dL were interviewed regarding their knowledge, attitude, and practice regarding diabetes care and preparedness and vigilance to receiving care through telemedicine. Random blood sugar, height, weight, and waist circumference were also documented. About 51.1% (N = 223) of female patients aged 57.57 ± 13.84 years (>18 years) with body mass index (BMI) =26.11 ± 4.63 were the beneficiaries of the health camps. About 75.3% (n = 168) of them were on oral hypoglycemic agents (OHAs), 15.7% (n = 35) were on insulin preparations, and 59.6% (n = 156) and 88.5% (n = 31) of which were highly compliant with treatment, respectively. About 35% (n = 78) and 43.9% (n = 98) of them were unaware of their frequency of hypoglycemic and hyperglycemic episodes, respectively. About 64.6% (n = 144) of the patients were equipped for receiving teleconsultation. Glucometer was only possessed by 51.6% (115) of which only 46.95% (n = 54) can operate it independently. Only 80 patients (35.9%) were aware of the correct value of blood glucose levels. While a majority of the population is compliant with treatment and aware about diabetes self-care, they lack adequate knowledge and resource equipment for the same leading to very limited utilization.