Diabetes Self-Management Questionnaire Research Articles

The Effect of Telemedicine on Self-Care Activities of Patients with Type 2 Diabetes Mellitus and Patient Satisfaction During the Coronavirus-19 (COVID-19) Pandemic: A Repeated Cross-Sectional Study

Introduction: Patients with diabetes require regular follow-ups to achieve optimal glycemic targets. The coronavirus- 19 (COVID-19) pandemic resulted in interruptions in healthcare delivery placing greater importance on patient’s self-management of their condition. Telemedicine bridged the gap between the physician and patient that was created by community quarantines. Objective: To determine if there is a difference in patient’s self-care activities before and after using telemedicine using the Diabetes Self-Management Questionnaire (DSMQ). Methodology: A descriptive repeated cross-sectional study of patients with type 2 diabetes mellitus at the University of Santo Tomas Hospital who consulted via telemedicine using different available platforms were included. Self-care was measured using the DSMQ. Patient satisfaction with telemedicine was also assessed using a patient satisfaction survey. Results: An improvement in self-care practices was seen as significantly higher mean DSMQ scores after telemedicine consultations (6.79 ± 1.33 to 7.32 ± 1.21, p = 0.0015), with the highest scores on dietary control and physical activity. There was a statistically significant reduction in HbA1c on follow up (8.37 ± 2.31 to 7.31 ± 1.36; p<0.00001). Those with well-controlled diabetes (n = 14) at baseline remained to have good control while the proportion of those with poorly controlled diabetes (n = 34) showed improved glycemic control on follow up (p = 0.0045). Most patients were highly satisfied with telemedicine. Conclusion: The use of telemedicine by patients with diabetes showed numerical improvement in both self-care practices and glycemic control. These findings imply that telemedicine may be mainstreamed as part of diabetes care among Filipinos. Keywords: COVID-19, telemedicine, diabetes, self-care activities

IJCM_194A: Diabetes distress and associated factors among adult patients residing in an urban resettlement colony in Delhi

Background: Diabetes distress “refers to the negative emotional or affective experiences resulting from the challenge of living with the demands of diabetes.” The American Diabetes Association recommends routinely screening for distress. Presently, this does not take place and distress remains undiagnosed. Objectives: This study aimed to determine the prevalence of diabetes distress, its associated factors and the relationship between glycemic control and distress. Methodology: This community-based, cross-sectional study was conducted in a resettlement colony in Delhi. The participants were selected using simple random sampling and included adults diagnosed with DM. The sample size calculated was 433 (prevalence: 42%, absolute precision: 5%, non-response rate: 10%). The questionnaire included Diabetes Distress Scale 17 and Diabetes Self-Management Questionnaire. Fasting blood sugar (FBS) was tested for all the participants. Logistic regression was used to determine the factors associated with distress as well as the association between glycemic control status and the presence of distress. Results: 412 adults were included in the study, of which 35.4% had clinically significant distress. The factors found to be associated with diabetes distress on multivariable logistic regression were: female sex, belonging to the lower socio-economic status, having self-reported comorbidities, being diagnosed with diabetes 10 or more years ago, being on treatment from a private or government hospital as compared to not being on treatment and having an unmet need for social support. There was a positive association between physician contact and distress. Those with poor glycemic control had higher odds of distress, regimen related distress and emotional burden, as compared to those who had adequate glycemic control. Conclusion: In this study, distress was prevalent among 35.4% of adults with diabetes. The factors determined to be associated with distress may provide a targeted approach to address distress, which ought to be screened for in routine clinical settings and be addressed, to help improve disease control.

Manajemen Diri Pada Pasien Diabetes Melitus Tipe 2 Di Puskesmas Dinoyo Malang

Proper self-management is crucial for individuals living with Type 2 Diabetes Mellitus (T2DM). T2DM is a metabolic disorder characterized by high levels of insulin production, decreased insulin activity, or both. The aim of this research was to assess the self-management practices of T2DM patients at the Dinoyo Primary Health Center in Malang. Descriptive analysis was employed as the research method. The study population comprised 44 T2DM patients, of whom 40 were selected as research samples using simple random sampling. Data were collected through a self-completed questionnaire, specifically the Diabetes Self-Management Questionnaire. The findings indicate that the majority of respondents at the Dinoyo Primary Health Center in Malang, namely 30 individuals (75.0%), demonstrated poor self-management practices in managing their T2DM. Future research endeavors should aim to identify additional factors contributing to poor self-management abilities among T2DM patients, such as the level of family support and blood sugar control.

PERAWATAN KOMUNITAS AGREGAT USIA DEWASA DENGAN DIABETES MELITUS MENGGUNAKAN INTERVENSI DIABETES SELF-MANAGEMENT EDUCATION (DSME)

Diabetes mellitus requires long-term treatment, can cause complications that can be life-threatening and affect the lives of diabetes mellitus patients. Self-management actions include glucose management, diet control, physical activity, and the use of health care can minimize complications. Lack of knowledge can make self-management ineffective. This case study aims to apply a community nursing care through the implemention of Diabetes Self-Management Education (DSME) in adult population using flip sheets and leaflets. A community nursing assessment conducted on nine patients and a nursing diagnosis of the ineffective health self-management was established based on the assessment data. The nursing care plan was prepared and focused on health education about self-management of diabetes mellitus using flip sheets and leaflets. Before and after the implementation of nursing, tests were carried out using the Diabetes Self-Management Questionnaire (DSMQ). The evaluation results showed significant changes in self-management after the intervention (100% of respondents were in a good category). The average percentage increase in self-management status is 48.55%. The conclusion was that counseling for the aggregate of adults with diabetes mellitus positively influenced self-management status. It is recommended for community nurses to provide health education in the community, especially for adults with diabetes mellitus.

The Impact of the COVID-19 Pandemic on Diabetes Self-Management in Saudi Arabia.

The COVID-19 pandemic disrupted healthcare worldwide, potentially impacting disease management. The objective of this study was to assess the self-management behaviors of Saudi patients with diabetes during and after the COVID pandemic period using the Arabic version of the Diabetes Self-Management Questionnaire (DSMQ). A cross-sectional study was conducted in patients aged ≥18 years diagnosed with type 2 diabetes mellitus who had at least one ambulatory clinic visit in each of the specified time frames (Pre-COVID-19: 1 January 2019-21 March 2020; COVID-19 Time frame: 22 March 2020 to 30 April 2021) utilizing the DSMQ questionnaire, with an additional three questions specifically related to their diabetes care during the COVID pandemic. A total of 341 patients participated in the study. The study results revealed that the surveyed patients showed moderately high self-care activities post-COVID-19. Total DSMQ scores were significantly higher in patients aged >60 years versus younger groups (p < 0.05). Scores were significantly lower in patients diagnosed for 1-5 years versus longer durations (p < 0.05). Patients on insulin had higher glucose management sub-scores than oral medication users (p < 0.05). Overall, DSMQ scores were higher than the pre-pandemic Saudi population and Turkish post-pandemic findings. DSMQ results suggest that, while COVID-19 negatively impacted some self-management domains, the Saudi patients surveyed in this study upheld relatively good diabetes control during the pandemic. Further research is warranted on specific barriers to optimize diabetes care during public health crises.

The risk of causing diabetes mellitus in the adult to elderly age group

Introduction: Indonesia is the fifth country with the highest number of Diabetes Mellitus (DM) sufferers in the world and is expected to reach 28.57 million in 2045. Diabetes Mellitus is a non-communicable disease that can affect anyone where knowledge, lifestyle and quality of life contribute to its incidence. the severity of the effects of the disease. The research objective was to determine knowledge, lifestyle, and quality of life of DM sufferers in rural areas. Methods: The design of this research is descriptive research. The sample of this study were 85 DM sufferers who were obtained using the technique purpossive sampling. Retrieval of data using Diabetes Knowledge Questionnaire (DKQ-24), Diabetes Self-Management Questionnaire (DSMQ), and WHOQOL-BREF. Results: The results of this study indicate that the respondents' knowledge about diabetes mellitus is good (89.4%), the lifestyle of people with diabetes mellitus is good (87.1%), and the quality of life of people with diabetes mellitus is good (92.9%). Conclusions: This shows the knowledge, lifestyle and quality of life in diabetics is quite good. Based on the results of the study it was concluded that the knowledge, lifestyle and quality of life of DM sufferers were in the good category.

A Cross-sectional Study of Factors Affecting Quality of Life of People with Type 2 Diabetes

Diabetes is a chronic illness that negatively impacts quality of life. However, the quality of life of people with type 2 diabetes could be improved with sufficient literacy and abilities to perform self-management, such as managing blood glucose, maintaining a healthy diet, and proper exercise. This descriptive cross-sectional study aimed to describe the relationships among health literacy, self-management, and quality of life and to determine the predictors of quality of life of people with type 2 diabetes. Data were collected through purposive sampling from 218 individuals with type 2 diabetes in Manado City, Indonesia, between July and October 2021. We used the European Health Literacy Survey Questionnaire, Diabetes Self-management Questionnaire, and Diabetes Quality of Life Questionnaire. Data were analyzed using descriptive statistics, Pearson’s product-moment correlation, and hierarchical regression analysis. The study revealed that health literacy was significantly associated with self-management and quality of life. Furthermore, age, occupation, health literacy, and self-management were significant predictors and collectively explained 25.3% of the variance in quality of life. Hence, higher health literacy and improved self-management practices were linked to a higher quality of life for people with type 2 diabetes. Since the explained variance of quality of life in this study is only 25.3%, further studies should include other factors such as social and family support and communication with health care providers to predict quality of life. Nevertheless, nurses can use this study to design interventions to improve self-care management skills and health literacy levels, which may enhance quality of life. However, testing the effectiveness is needed.

Clinical impact of an integrated e-health system for diabetes self-management support and shared decision making (POWER2DM): a randomised controlled trial

Aims/hypothesisThere is a lack of e-health systems that integrate the complex variety of aspects relevant for diabetes self-management. We developed and field-tested an e-health system (POWER2DM) that integrates medical, psychological and behavioural aspects and connected wearables to support patients and healthcare professionals in shared decision making and diabetes self-management.MethodsParticipants with type 1 or type 2 diabetes (aged >18 years) from hospital outpatient diabetes clinics in the Netherlands and Spain were randomised using randomisation software to POWER2DM or usual care for 37 weeks. This RCT assessed the change in HbA1c between the POWER2DM and usual care groups at the end of the study (37 weeks) as a primary outcome measure. Participants and clinicians were not blinded to the intervention. Changes in quality of life (QoL) (WHO-5 Well-Being Index [WHO-5]), diabetes self-management (Diabetes Self-Management Questionnaire – Revised [DSMQ-R]), glycaemic profiles from continuous glucose monitoring devices, awareness of hypoglycaemia (Clarke hypoglycaemia unawareness instrument), incidence of hypoglycaemic episodes and technology acceptance were secondary outcome measures. Additionally, sub-analyses were performed for participants with type 1 and type 2 diabetes separately.ResultsA total of 226 participants participated in the trial (108 with type 1 diabetes; 118 with type 2 diabetes). In the POWER2DM group (n=111), HbA1c decreased from 60.6±14.7 mmol/mol (7.7±1.3%) to 56.7±12.1 mmol/mol (7.3±1.1%) (means ± SD, p<0.001), compared with no change in the usual care group (n=115) (baseline: 61.7±13.7 mmol/mol, 7.8±1.3%; end of study: 61.0±12.4 mmol/mol, 7.7±1.1%; p=0.19) (between-group difference 0.24%, p=0.008). In the sub-analyses in the POWER2DM group, HbA1c in participants with type 2 diabetes decreased from 62.3±17.3 mmol/mol (7.9±1.6%) to 54.3±11.1 mmol/mol (7.1±1.0%) (p<0.001) compared with no change in HbA1c in participants with type 1 diabetes (baseline: 58.8±11.2 mmol/mol [7.5±1.0%]; end of study: 59.2±12.7 mmol/mol [7.6±1.2%]; p=0.84). There was an increase in the time during which interstitial glucose levels were between 3.0 and 3.9 mmol/l in the POWER2DM group, but no increase in clinically relevant hypoglycaemia (interstitial glucose level below 3.0 mmol/l). QoL improved in participants with type 1 diabetes in the POWER2DM group compared with the usual care group (baseline: 15.7±3.8; end of study: 16.3±3.5; p=0.047 for between-group difference). Diabetes self-management improved in both participants with type 1 diabetes (from 7.3±1.2 to 7.7±1.2; p=0.002) and those with type 2 diabetes (from 6.5±1.3 to 6.7±1.3; p=0.003) within the POWER2DM group. The POWER2DM integrated e-health support was well accepted in daily life and no important adverse (or unexpected) effects or side effects were observed.Conclusions/interpretationPOWER2DM improves HbA1c levels compared with usual care in those with type 2 diabetes, improves QoL in those with type 1 diabetes, improves diabetes self-management in those with type 1 and type 2 diabetes, and is well accepted in daily life.Trial registrationClinicalTrials.gov NCT03588104.FundingThis study was funded by the European Union’s Horizon 2020 Research and Innovation Programme (grant agreement number 689444).Graphical

Telemedicine-assisted structured self-monitoring of blood glucose in management of T2DM results of a randomized clinical trial

BackgroundThis prospective study aimed to compare telemedicine-assisted structured self-monitoring of blood glucose(SMBG) with a traditional blood glucose meter (BGM) in adults of type 2 diabetes mellitus (T2DM).MethodsAdult participants with T2DM were assigned to an intervention group or a control group. The patients in the intervention group received a connected BGM with real-time data submission as well as individual needs-based tele-coaching to address and improve motivation and daily diabetes self-management. The patients in the control group received a traditional BGM. Changes in glycated hemoglobin(HbA1c), low blood glucose index(LBGI), and diabetes self-management behaviors were analyzed.ResultsThe study demonstrated the superiority of the telemedicine-assisted structured SMBG versus the traditional BGM for improving HbA1c. Additionally, the telemedicine-assisted SMBG reduced the risk of hypoglycemia and enhanced diabetes self-management behaviors, as differences in the LBGI and the Diabetes Self-Management Questionnaire(DSMQ) results between the groups after 6 months were found to be significant.ConclusionsTelemedicine-assisted structured SMBG helps physicians and patients to achieve a specific level of glycemic control and reduce hypoglycemia. The use of coaching applications and telemedicine-assisted SMBG indicated beneficial effects for T2DM self-management, which may help limit disease progression.Trial registrationChinese Clinical Trail Registry No: ChiCTR2300072356 on 12/06/2023. Retrospectively registered.

The Mediation Effect of Attitude on the Association Between Knowledge and Self-Management Behaviors in Chinese Patients With Diabetes.

Objective: This study aims to investigate the level of knowledge, attitude and self-management behaviors of diabetic patients, to explore the mediating role of attitude in the relationship between knowledge and self-management behaviors. Methods: 900 diabetes patients were randomly selected from the eastern, central and western regions of Shandong Province, China, and recovered 863 valid questionnaires. Path analysis was used to examine the mediating role of attitude in the relationship between knowledge and self-management behaviors in patients with diabetes. Results: The mean score (SD) of the diabetes self-management questionnaire (DSMQ) in this study was 35.01 (6.87). The direct effect value of knowledge level on self-management behaviors was 0.357, accounting for 62.09% of the total effect. The indirect effect value of knowledge on self-management behaviors through attitude was 0.218, accounting for 37.91%. Conclusion: Level of knowledge has a significant direct impact on self-management behaviors and an indirect impact on self-management behaviors through attitude. Therefore, it is necessary to strengthen health education on diabetes to improve awareness, ameliorate attitudes toward diabetes, and change self-management behaviors.

Association between sleep variability and time in range of glucose levels in patients with type 1 diabetes: Cross-sectional study

ObjectiveSleep and circadian disturbances emerge as novel factors influencing glycemic control in type 1 diabetes (T1D). We aimed to explore the associations among sleep, behavioral circadian parameters, self-care, and glycemic parameters in T1D. MethodsSeventy-six non–shift-working adult T1D patients participated. Blinded 7-day continuous glucose monitoring (CGM) and hemoglobin A1C (A1C) were collected. Percentages of time-in-range (glucose levels 70-180 mg/dL) and glycemic variability (measured by the coefficient of variation [%CV]) were calculated from CGM. Sleep (duration and efficiency) was recorded using 7-day actigraphy. Variability (standard deviation) of midsleep time was used to represent sleep variability. Nonparametric behavioral circadian variables were derived from actigraphy activity recordings. Self-care was measured by diabetes self-management questionnaire-revised. Multiple regression analyses were performed to identify independent predictors of glycemic parameters. ResultsMedian (interquartile range) age was 34.0 (27.2, 43.1) years, 48 (63.2%) were female, and median (interquartile range) A1C was 6.8% (6.2, 7.4). Sleep duration, efficiency, and nonparametric behavioral circadian variables were not associated with glycemic parameters. After adjusting for age, sex, insulin delivery mode/CGM use, and ethnicity, each hour increase in sleep variability was associated with 9.64% less time-in-range (B = −9.64, 95% confidence interval [−16.29, −2.99], p ≤ .001). A higher diabetes self-management questionnaire score was an independent predictor of lower A1C (B = −0.18, 95% confidence interval [−0.32, −0.04]). ConclusionGreater sleep timing variability is independently associated with less time spent in the desirable glucose range in this T1D cohort. Reducing sleep timing variability could potentially lead to improved metabolic control and should be explored in future research. Data availability statementData are available upon a reasonable request to the corresponding author.

Promoting Diabetes Self-Management in a Psychiatric Hospital.

Type 2 diabetes and psychiatric illnesses have a bidirectional association, influencing each other in direct but independent ways. People with psychiatric illnesses are more likely than the general population to develop type 2 diabetes, in part because antipsychotic medications affect the metabolic system, disrupting glucose metabolism, and also because they lack diabetes self-management education and self-care skills. This study assessed the effectiveness of diabetes self-management education and support (DSMES) in patients with mental illness and diabetes using the Diabetes Self-Management Questionnaire. Analysis of paired responses to the pre- and post-DSMES survey questions showed a statistically significant increase in diabetes self-management knowledge after participation in the education sessions. These results emphasized the importance of DSMES in strengthening patients' knowledge and skills, with additional support from their psychiatrist and medical team.

Patients With Diabetes Mellitus in Rural Area: Knowledge, Lifestyle, And Quality Of Life

Indonesia is the fifth country with the highest number of Diabetes Mellitus (DM) sufferers in the world and is expected to reach 28.57 million in 2045. Diabetes Mellitus is a non-communicable disease that can affect anyone where knowledge, lifestyle and quality of life contribute to its incidence. the severity of the effects of the disease. The research objective was to determine knowledge, lifestyle, and quality of life of DM sufferers in rural areas. The design of this research is descriptive research. The sample of this study were 85 DM sufferers who were obtained using the technique purpossive sampling. Retrieval of data using Diabetes Knowledge Questionnaire (DKQ-24), Diabetes Self-Management Questionnaire (DSMQ), and WHOQOL-BREF. The results of this study indicate that the respondents' knowledge about diabetes mellitus is good (89.4%), the lifestyle of people with diabetes mellitus is good (87.1%), and the quality of life of people with diabetes mellitus is good (92.9%). This shows the knowledge, lifestyle and quality of life in diabetics is quite good. Based on the results of the study it was concluded that the knowledge, lifestyle and quality of life of DM sufferers were in the good category.

Self-Reported Treatment Adherence in Patients of Diabetes Mellitus Type 2: A Cross-Sectional Study in Lahore, Pakistan

Objectives: Suboptimal adherence to therapy due to neglected self-care behavior in chronic diseases is a global crisis. The aim of this research was to gauge the prevalence of adherence and to assess the effect of age, sex, education level and socioeconomic status on adherence to self-care strategies. Methods: A cross-sectional study was conducted at Diabetes Management Centre, Services Hospital Lahore. 357 patients were administered a standardized questionnaire, the Diabetes Self-Management Questionnaire. A cut off value of 7 on a 0-10 scale was labeled as good adherence. The influence of age, sex, education and income on adherence was examined by multiple logistic regression analysis.

Assessing the relationship between low-calorie sweetener use and quality of life measures in adults with type 1 diabetes

BackgroundTo evaluate use of low-calorie sweeteners (LCS) among adults with type 1 diabetes (T1D) and its impact on quality of life (QOL).MethodsIn this single center, cross-sectional survey study with 532 adults with T1D, Food related QOL (FRQOL), LCS specific questionnaire (LCSSQ), Diabetes Self-Management Questionnaire (DSMQ), Food Frequency Questionnaire (FFQ), Audit of Diabetes-Dependent QOL (AddQOL), Type 1 Diabetes and Life (T1DAL) questionnaires were administered through RedCAP, a secure, HIPAA-compliant web-based application. Demographics and scores of adults who used LCS in last month (recent users) and others (non-users) were compared. Results were adjusted for age, sex, diabetes duration and other parameters.ResultsOf 532 participants (mean age 36 ± 13, 69% female), 99% heard LCS before, 68% used them in the last month, 73% reported better glucose control with LCS use and 63% reported no health concerns about LCS use. Recent LCS users were older and had a longer diabetes duration and more complications (hypertension, or any complication) than non-users. However, A1c, AddQOL, T1DAL, FRQOL scores did not differ significantly between recent LCS users and non-users. DSMQ scores, DSMQ management, diet, health care scores did not differ between two groups; however, recent LCS users had lower physical activity score than non-users (p = 0.001).ConclusionsMost of the adults with T1D have used LCS and perceived that LCS use improved their QOL and glycemic control; however, these were not verified with questionnaires. There was no difference in QOL questionnaires except DSMQ physical activity between recent LCS users and not users with T1D. However, more patients in need to increase their QOL may be using LCS; therefore, associations between the exposure and outcome can be bi-directional.

Pengetahuan dan Self -Management dengan Pencegahan Komplikasi Diabetes Melitus

Background: The number of people with diabetes mellitus in the world reached 425 million aged 20-79 years in 2017. The high number of people with diabetes mellitus is caused by a low level of knowledge and awareness in early detection of diabetes mellitus which is not good. Based on data from the top 10 diseases at Mergangsan Health Center on October 2021, it shows that diabetes mellitus is included in the top 10 diseases in 3rd place, namely Type 2 Diabetes Mellitus Non-Insulin-Dependent as many as 894 people .Methods: This study used quantitative methods. The research samples were 80 people with diabetes mellitus without complications of diabetes mellitus. The data collection technique used purposive sampling. The instrument used for data collection was the DKQ (Diabetes Knowledge Questionnaire) and DSMQ (Diabetes Self Management Questionnaire) questionnaires. Analysis of data processing using Chi Square Test and the research design is cross sectional.Results: Based on the results of the Chi-Square test, the knowledge variable with the degree of error used = 0.05 and n = 80, it can be assessed with a significant p-value of 0.025. The results showed that the p value of 0.05 means that Ha was accepted and Ho was rejected, which means that there was a correlation between the knowledge variable and the prevention of diabetes mellitus complications and the diabetes mellitus self-management variable, with a significant p-value of 0.000. These results indicated that a p-value of 0.05 means Ha was accepted and Ho was rejected, which means that there was a correlation between the self-management variable and the prevention of complications of diabetes mellitus.Conclusion: There is a significant correlation between knowledge and self-management of diabetes mellitus with the prevention of complications of diabetes mellitus at Mergangsan Health Center, Yogyakarta City.

Assessment of Self-Care Activities Using Diabetes Self-Management Questionnaire in Diabetes Patients

One of the non-communicable diseases found in all regions of the world, including rural areas, is Diabetes Mellitus, caused by a chronic metabolic disorder characterized by increased glucose levels in the blood due to impaired insulin secretion. Diabetic neuropathy is damage to peripheral nerves or peripheral nerves commonly experienced by people with type 2 diabetes mellitus, characterized by excessive pain and decreased sensitivity to touch. The purpose of this study was to determine the self-management carried out by diabetic patients in the city of Surakarta. This study is cross-sectional with a sample of 99 respondents using a purposive sampling technique with inclusion criteria of 40-60 years of age and type 2 DM patients. The tests carried out were the inter-class intercorrelation coefficient test and the Kruskal–Wallis test using SPSS. The results of this study mean the highest interclass correlation coefficient was the diabetic foot care subclass with a value of 0.773 representing the homogeneity of the DMSQ questions and a confidence interval of 0.687-0.839 at 95% with a significance of p 0.05 in each subclass.

Validity and Reliability of the Occupational Balance Questionnaire (OBQ11) in a U.S. Sample of Adults With Type 1 Diabetes.

Although occupational balance (OB) is a construct of importance to occupational therapy, existing OB assessments have not been validated in clinical populations. To examine the validity and reliability of the 11-item version of the Occupational Balance Questionnaire (OBQ11) in U.S. adults with Type 1 diabetes. Data were analyzed from adults with Type 1 diabetes enrolled in a larger longitudinal study examining the relationships among blood glucose, emotion, and functioning. Dimensionality of the OBQ11 was assessed with item response theory (IRT); convergent validity was tested by examining whether associations between the OBQ11 and other constructs were consistent with a priori hypotheses. Three outpatient clinical sites in the United States. Data from 208 U.S. adults with Type 1 diabetes were included in the analyses (42% Latino, 29% White, 14% African American, 7% multiethnic, and 8% other). Assessments administered include the OBQ11, Patient Health Questionnaire (depression), and Diabetes Self-Management Questionnaire. Overall, results from IRT models and correlational tests supported the reliability and validity of the OBQ11. For instance, higher scores on the OBQ11 were significantly associated with better self-ratings of diabetes management behaviors (r = .28, p < .001), lower depression symptoms (r = -.53, p < .001), and greater positive affect (r = .32, p < .001). A single-factor generalized partial credit model fit the OBQ11 acceptably well, supporting its unidimensionality. The OBQ11 may be a reliable and valid measure of OB appropriate for use in clinical populations such as adults with diabetes. What This Article Adds: OB is not often formally assessed by occupational therapists in the United States, even though the contributions of OB to health and well-being are core components of the philosophy of occupational therapy. The current evidence supports the validity of the OBQ11 in a clinical population of adults with Type 1 diabetes and demonstrates significant associations between OB and health management behaviors. Study results may encourage greater consideration and assessment of OB in occupational therapy clinical practice in the United States.

ANALYSIS OF FACTORS AFFECTING SELF MANAGEMENT IN TYPE 2 DIABETES MELLITUS PATIENTS

Background: Diabetes mellitus type 2 is a common problem that occurs in people who have metabolic disorders characterized by increased blood sugar due to decreased secretion by pancreatic beta cells or impaired insulin function. Objectives: This study aims to determine what factors are associated with self-management in Type 2 DM patients at the Buduran Health Center.Design: This study was a quantitative research. The design in this study was a cross-sectional analytic with a sample of 80 people who were carried out at the endocrine polyclinic Puskesmas Buduran Sidoarjo. Research instrument used the Diabetes Self-Management Questionnaire (DSMQ) developed by Schmitt et al (2013) to determine the self-management of type 2 DM patients and to measure the level of knowledge using the Diabetes Knoeledge Test (DKT) instrument developed by Burrough et al (2008), measure to physical activity using the Summary of Diabetes Self Care Activities (SDSCA), measure to family support using Family Support Questionairre, and measure to self efficacy using Diabetes management Self Efficacy Scale (DMSES). The sample siza with simple random sampling method, and data analysis using spearman rank test. Results: The results showed that there was a significant relationship between the level of knowledge and self-management with a coefficient value (r=0.576), a significant relationship between activity ability and self-management with a coefficient value (r=0.612), a significant relationship between family support and self-management with a value of coefficient (r=0.592) and there is a significant relationship between self-efficacy and self-management with a coefficient value (r=0.660). Conclusion: Patients DM Type 2 can be overcome by providing education in every prolanis activity program which is expected to increase knowledge, activity abilities, family support and self-efficacy, so that patients are able to improve self-management well. This intervention is highly recommended for people with Type 2 DM by increasing the frequency of health education and involving the family of diabetes mellitus patients so that patients are able to carry out self-management well.

1827-PUB: Multidisciplinary Patient-Centered Care Delivered Remotely Improves Glycemic Outcomes and Patient Reported Outcomes

Lack of access to specialized multidisciplinary teams familiar with advanced technologies for T1D care remains a barrier to achieving glycemic targets and patient-centered goals. Since launching a T1D virtual clinic in 2018, we have treated 123 adults with T1D who had previously received standard care. There was a significant improvement in glycemic indices and in validated and self-originated patient reported outcome measures at 6 and 12 months as compared to baseline (table 1). Mean baseline HbA1c was 8.1%, and this improved to 7.6% and 7.3% at 6 and 12 months respectively (p&amp;lt; 0.001). Average sensor glucose declined by 5.5% over 6 months (p&amp;lt;0.001). While TIR increased significantly by 10.4% over 12 months, TBR decreased. Diabetes Treatment Satisfaction Questionnaire scores improved significantly, as did Diabetes Self-Management Questionnaire scores. According to a 5-point scale survey, there was improved satisfaction with the availability of the physician, nurse and dietitian beyond the appointment time and with the guidance received beyond scheduled visits. Remote care was associated with improved satisfaction regarding saving time and reducing expenses by curtailing office visits. In conclusion, transitioning from a standard T1D care to a virtual clinic is associated with improved glycemic control, higher patient satisfaction and better self-care behaviors. Disclosure N.Minsky: None. A.Tirosh: Advisory Panel; Medtronic, Novo Nordisk, Sanofi, Eli Lilly and Company, Research Support; Medtronic, Sanofi, Speaker's Bureau; Medtronic, Novo Nordisk, Sanofi, Eli Lilly and Company. O.Tamir: Other Relationship; Novo Nordisk. G.Aharon-hananel: Speaker's Bureau; Eli Lilly and Company, Novo Nordisk. A.Jabarin: None. L.Arnon: None. N.Morozov: None. D.Halperin: None. M.Shalom: None. E.Tarshish: None. T.Kolobov: None. Funding European Foundation for the Study of Diabetes (9366); Israel Ministry of Health