Diabetes Self-Management Questionnaire Research Articles

Diabetes Self-Management Among Healthcare Providers in King Abdulaziz Medical City, Riyadh: A Cross-Sectional Pilot Study.

BackgroundDiabetes mellitus (DM), a chronic metabolic disease, is a rising global concern with significant social, economic, and health implications. Proper glycemic control is crucial to guarantee protection against these implications such as micro and macrovascular complications. To achieve proper glycemic control, patients' self-management is probably the most essential component, and the development of appropriate self-management behaviors which include medication adherence and lifestyle modifications improves the prognosis and the incidence of DM complications.ObjectiveThe aim of the study is to examine diabetes self-management and control of diabetic healthcare providers from different specialties working at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia.Design and settingThis is a cross-sectional pilot study carried out in King Abdulaziz Medical City, Riyadh, Saudi Arabia, using a pre-validated self-administered questionnaire that was “Diabetes Self-Management Questionnaire” (DSMQ), which examined diabetes management and control within the last two months. The questionnaire was distributed to the healthcare providers of all specialties at the site of the study. Correlations and descriptive analyses were carried out using the Statistical Package for Social Science (SPSS) software version 23 (IBM Corp, Armonk, USA).ResultsThe total number of participants was 370 healthcare providers (100% response rate). It was found that 26 (7%) of them had diabetes (92.3% of them with type 2 diabetes). The diabetic participants’ mean age was 48.58±7.3 years old. 42.3% were applied medical sciences specialists, with 38.5% having years of experience between 16 to 20 years old. 26.3% were Saudi nationals. The mean HbA1c levels among diabetic patients were 6±1.03%, ranging between (5.1%-9%). There was a significant inverse relationship between each section's scores and total scores with the HbA1c levels (p-value<0.05). Total scores for adherence were significantly higher among the age group (51 to 60) (p-value=0.03) and physicians (p-value=0.035). Dietary control was significantly better among age group (51 to 60) (p-value=0.015), and type 2 diabetes (p-value=0.022). Physician contact was significantly higher in the age group (51 to 60) (p-value=0.027). Physical activity was significantly higher among physicians (p-value=0.030). Blood glucose monitoring was significantly better among the age group (above 60) (p-value=0.026), males (p-value=0.03), and physicians (p-value=0.039).ConclusionThe findings suggest the glycemic control and adherence to treatment among diabetic healthcare providers in KAMC-Riyadh are adequate the findings suggest the glycemic control and adherence to treatment among diabetic healthcare providers in KAMC-Riyadh are adequate. Future studies with an adequate sample size are essential to assess diabetes self-management and identify if there is any obstacle toward better compliance in healthcare providers.

The effect of model-based telephone counseling on HbA1c and self-management for individuals with type 2 diabetes: A randomized controlled trial

AimsThis study was conducted to examine the effect of telephone counseling based on the Information, Motivation, Behavioral Skills (IMB) Model on HbA1c and self-management in patients with type 2 diabetes mellitus (T2DM). MethodsThis study was conducted between January 2019 and September 2019 with a total of 63 (31 interventions, 32 controls) T2DM patients. The intervention group was followed-up for a total of 12 weeks, after 45−60 min of patient training based on IMB, a weekly reminder message and a phone call every two weeks. No intervention was made to the control group. Data were collected at the beginning of the study and at the end of the 12th week. The data were obtained using a Patient Information Form, the Type 2 Diabetes Self-Efficacy Scale, the Diabetes Self-Management Questionnaire (DSMQ), the Perceived Diabetes Self Management Scale (PDSMS) and glycemic control (HbA1c). ResultsParticipants were on average 54 years old and the majority were female (58.1%). According to the results of the covariance analysis (ANCOVA), there was a statistically significant difference between the pre-post-test HbA1c (F:13.589; p < 0.001), weight (F:32.176; p < 0.001) and systolic blood pressure (F:7.109; p = 0.01). However, there was no significant difference in diastolic blood pressure between the intervention and control groups (F:2.686; p = 0.106). Also, after three months of follow-up, self-efficacy (F:26.632; p < 0.001), self-management (F:44.487; p < 0.001) and self-management perceptions (F:71.132; p < 0.001) were significantly higher in the intervention group. ConclusionThe researchers concluded that telephone counseling based on the IMB model could be a suitable method to improve glycemic control and self-care behaviors in patients with type 2 diabetes.

Evaluation of the relationship between different factors of self-management and control of diabetes in diabetic patients group

Introduction: Diabetes is one of the most common chronic diseases that severely affects the quality of life. Self-Management and glycemic control minimize the development and progression of diabetes’s complications. Objectives: We aimed to evaluate self-care behaviors and their relationship with hemoglobin A1c (HbA1c) level in patients with type 2 diabetes, using the Diabetes Self-Management Questionnaire (DSMQ). Patients and Methods: This is a cross-sectional study conducted on type 2 diabetic patients referred to the Shahid Beheshti hospital of Qom. A total of 325 patients with type-2 diabetes participate in the study. Diabetes self-management parameters were assessed using the translated (Persian) version of the DSMQ. Results: The mean score of self-management (±SD) in patients was 26.82 (±9.43). In addition, the mean HbA1c and fasting blood sugar (FBS) levels of the participants respectively were 8.35 (±1.97) and 187.25 (±77.51). There was a significant inverse correlation between self-management score metabolic control indices. (P&lt;0.001). Health care use subscales have been best associated with better glycemic control (P&lt;0.001) and physical activity had the least effect on it (P&lt;0.001). Conclusion: The findings of this study revealed that there is a significant relationship between self-management indicators and control of diabetes.

The effect of the COVID-19 pandemic on self-management in patients with type 2 diabetics

AimsThe research was conducted with the aim of determining the effect of the COVID-19 pandemic on levels of self-management in individuals with type 2 diabetes. MethodsThis cross-sectional descriptive type of study was conducted between 21 December 2020 and 1 April 2021. It was performed with 378 individuals with type 2 diabetes attending the endocrinology clinic and outpatients’ department of a government hospital who agreed to participate in the research. In the collection of data, a Patient Identification Form, Visual Analog Scales (an Anxiety VAS and a Stress VAS), and the Diabetes Self-Management Questionnaire (DSMQ) were used. The Wilcoxon test, Independent Sample t test, One-Way Anova and binary logistic regression were used in the analysis of data. ResultsThe Diabetes Self-Management Questionnaire (DSMQ) total mean score of the individuals with type 2 diabetes participating in the study during the COVID-19 pandemic was 5.25 ± 1.04. Their anxiety total mean score was 0.32 ± 1.56, and their total mean stress score was 7.06 ± 1.62. Being male, over the age of 65, married and having a diagnosis of diabetes for 6–11 years, increased smoking, the COVID-19 pandemic, reduced physical activity (not walking) and support obtained from health professionals, and increased anxiety and stress levels were found to be risk factors affecting diabetic self-management. ConclusionsThe findings show that the COVID-19 pandemic has had a negative effect on the self-management levels of individuals with type 2 diabetes.

The Effect of Attitude to Death on Self-Management in Patients With Type 2 Diabetes Mellitus During the COVID-19 Pandemic.

This study was conducted to examine the effect of attitude to death on self-management in patients with Type 2 Diabetes Mellitus during the COVID-19 pandemic. This study was carried out in a descriptive and correlational type with the participation of n = 103 type 2 diabetes mellitus patients registered in the Internal Medicine Unit at a University Hospital. Personal Information Form, Death Attitude Profile-Revised (DAP-R), Diabetes Self-Management Questionnaire and Fear of COVID-19 Scale were used in data collection. According to the results of the study, it was determined that diabetes patients' fear of COVID-19 increased their fear of death and self-management. Similarly, neuropathy and nephropathy developed in these patients. In addition, it was determined that the diabetic patients who worked 6–7 days a week outside the home had higher levels of fear. It was found that those with high fear were more attentive to social distancing, wearing masks and hand sanitizer use. Staying at home is also not always possible for patients with chronic diseases, and people struggle with COVID-19 by working in crowded workspaces. It is necessary to recognize the struggle of patients with chronic diseases and provide social, economic and psychological support.

538-P: Adult Women with T1D with Clinically Elevated Depression in Need of Intervention to Improve A1C

Psychosocial screening is not standard care in adults with T1D despite ADA recommendations. Depression interferes with daily life and physical health outcomes. The purpose of this study was to examine depressive symptoms, self-management behaviors, and A1C in adults with T1D.Adults with T1D (N=899; 65% females; 25±14 years of age; 18-95 years) completed the Patient Health Questionnaire-8 (PHQ-8; □15 clinically elevated) and the Diabetes Self-Management Questionnaire (DSMQ); A1C was self-reported. DSMQ Total score and subscales with higher scores indicating higher engagement in self-management.Women were significantly more likely to have clinically elevated symptoms of depression (10% men and 16% women; P=0.02). Higher PHQ-8 scores were associated with lower DSMQ Total score and subscales in both men and women, but A1C only in women. There was a significant sex by PHQ-8 interaction for A1C and the DSMQ Glucose Management subscale (Table).Women with clinically elevated depressive symptoms had an average A1C that was 1.3% higher than women without elevated symptoms. Women with T1D with higher levels of depressive symptoms do not meet ADA recommended A1C <7% and they reported less frequent engagement in self-management behaviors. There is a critical need for intervention studies targeting glucose checking and insulin dose consistency, particularly, in women with T1D to improve self-management and A1C.View largeDownload slideView largeDownload slide DisclosureC. Geno rasmussen: None. J. K. Snell-bergeon: Stock/Shareholder; Self; GlaxoSmithKline plc. H. K. Wise: None. V. Shah: Advisory Panel; Self; Medscape, Sanofi, Research Support; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk, Sanofi, vTv Therapeutics. K. A. Driscoll: None. FundingNational Center for Advancing Translational Sciences (UL1TR002535)

48-LB: Associations between Health Literacy and Patient Perceptions of Care in Poorly Controlled Diabetes

Background: Low health literacy (HL) is a barrier to improving health outcomes in patients with type 2 diabetes (T2DM). The Newest Vital Sign (NVS) is a validated, short questionnaire for assessing HL. The relationship between NVS HL and patient-reported diabetes behavioral and patient-provider interaction measures, particularly among patients with poor glycemic control, is currently unknown. Methods: Cross-sectional analysis of baseline data of 248 Veterans with poorly controlled T2DM (maintenance of hemoglobin A1c (HbA1c) ≥8.5% despite engagement with diabetes care) from a randomized trial of a telehealth intervention. NVS was collected at baseline, along with other demographic, clinical, and psychosocial metrics. We used multivariable regression with restricted cubic splines for continuous covariates to explore associations between baseline NVS and four measures (Diabetes Knowledge Questionnaire (DKQ), Diabetes Self-Management Questionnaire (DSMQ), Perceived Competence Scale (PCS), and Healthcare Climate Questionnaire (HCCQ)). Results: The sample had a mean age of 58.1 (SD = 8.3) years, was 78.6% male and 76.2% non-White. Average HbA1c was 9.8 (SD = 1.5) and average NVS was 3.4 (SD = 2.0). After adjusting for demographic, clinical, and psychosocial factors, NVS was significantly associated (linearly) with DKQ and PCS scores, but not DSMQ or HCCQ scores. For every 1-point increase in NVS, the DKQ score increased by 0.33 (95% CI 0.13, 0.52, P = 0.0010) and PCS score decreased by 0.11 (95% CI -0.21, -0.0081, P = 0.034), indicating that higher HL is associated with higher diabetes knowledge and lower perceived competence. Conclusions: The direct association of NVS HL with DKQ scores is consistent with literature using other HL metrics among general T2DM populations; however, the indirect association of NVS HL with PCS scores is less intuitive, suggesting a possible misplaced confidence among patients with higher HL yet poor glycemic control despite diabetes care engagement. Disclosure E. A. Kobe: None. J. German: None. D. Soliman: None. A. Alexopoulos: None. A. S. Jeffreys: None. D. Edelman: None. C. Coffman: None. M. Crowley: None. Funding National Center For Advancing Translational Sciences (TL1TR002555 to E.A.K.); U.S. Department of Veterans Affairs (IIR 16-213 to M.C.)

534-P: Psychosocial Health Assessment by Sex and Age in Adults with Type 1 Diabetes

Psychosocial health of adults is often overlooked but is crucial to a person’s overall wellbeing and especially in the maintenance of type 1 diabetes (T1D). Increased depressive symptoms, anxiety, and diabetes distress may be associated with worse glucose management and higher risk of complications in adults with T1D. The purpose of this study was to assess symptoms of depression and anxiety, and T1D distress in adults with T1D. Eight hundred ninety-nine adults with T1D (65% female; age=25±14 years; T1D duration=38±8.6 years) completed the Patient Health Questionnaire-8 (PHQ-8), Generalized Anxiety Disorder-7 (GAD-7), Type 1 Diabetes Distress Scale (T1-DDS), and the Diabetes Self-Management Questionnaire (DSMQ) including the Health Care, Physical Activity, Diet and Glucose Management subscales. HbA1c was self-reported. Women had a higher prevalence of elevated PHQ-8 (≥15), GAD-7 (≥15), and T1-DDS (>3); higher HbA1c; and lower DSMQ Total score than men (Table). Adults 18-25 years had higher prevalence of elevated PHQ-8, GAD-7, and T1-DDS), and significantly higher HbA1c, and lower DSMQ Total score and on all subscales except Physical Activity when compared to older adults. This examination shows that there are increased psychosocial issues that should be addressed for patients with T1D. Providers should routinely address mental health in attempts to mitigate the psychosocial impacts on patients with T1D.View largeDownload slideView largeDownload slide DisclosureH. K. Wise: None. C. Geno rasmussen: None. V. Shah: Advisory Panel; Self; Medscape, Sanofi, Research Support; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk, Sanofi, vTv Therapeutics. K. A. Driscoll: None. J. K. Snell-bergeon: Stock/Shareholder; Self; GlaxoSmithKline plc.FundingColorado Clinical and Translational Sciences Institute

8-OR: Depression and Diabetes Distress in African American and Latino Parents of Children with Type 1 Diabetes (T1D)

Introduction: Parents of young children experience high levels of depression and diabetes distress immediately post-diagnosis. However, there is a limited understanding of these factors later in the disease course, especially among parents from racial/ethnic minority groups who face management difficulties and persistent T1D health disparities (i.e., higher HA1c). This study described parental depressive symptoms, diabetes distress and adherence among African American and Latino parents of children with T1D duration &amp;gt; 1 year. Methods: African American (n = 39) and Latino (n = 26) parents of children age 5-10 years (M 9.0 ± 1.7 yrs; M HA1c = 9.0 ± 1.9; M T1D duration = 3.7±2.2 yrs) were enrolled in a behavioral intervention trial. At baseline they reported on demographics, treatment adherence (Diabetes Self-Management Questionnaire, DSMQ), diabetes distress (Problem Areas in Diabetes Revised for parents, PAID-PR), and depressive symptoms (Center for Epidemiological Studies-Depression, CES-D). HA1c was extracted from the medical record. Results: Over one-quarter (27%) of African American (M CES-D = 13.6 ± 9.5) and 42% of Latino (M CES-D = 14.1 ± 8.8) parents reported moderate/severe depressive symptoms. Nearly half (49%) of African American (M PAID-PR = 56.7 ± 19.7) and 38% of Latino (M PAID-PR = 50.2 ± 17.8) parents reported diabetes distress above a clinical cutoff. Both African American and Latino parents reported high levels of adherence (M DSMQ = 25.9 ± 4.7 and 26.7 ± 4.3, respectively, out of 35). Conclusions: Substantial proportions of African American and Latino parents of school-aged children who have been managing T1D for at least 1 year experience serious mood concerns, both diabetes-specific and general. High levels of T1D adherence indicate resilience in the face of such challenges. Supporting parental psychosocial functioning should be a high priority for diabetes care providers, especially among minority families who may be experiencing elevated challenges. Disclosure S. A. Carreon: None. J. N. Jones: None. A. Reyes garcia: None. K. S. Peters: None. K. K. Christopher: None. M. E. Hilliard: None. A. Butler: None. Funding National Institutes of Health (1DP3DK113236)

The Relationships Between Diabetes Self-Care, Diabetes Time Management, and Diabetes Distress in Women With Type 2 Diabetes Mellitus.

The purpose of this study was to examine the relationships between and among diabetes self-care, diabetes time management, and diabetes distress in women with type 2 diabetes mellitus (T2DM). A descriptive correlational design with a total of 188 participants completed 3 valid and reliable instruments to measure the main study variables, the Diabetes Self-Management Questionnaire, the Diabetes Time Management Questionnaire, and the Diabetes Distress Scale, in an uncontrolled, natural setting using mix-mode surveys (electronic and paper). Survey responses were analyzed using several descriptive, bivariate, and multivariate analyses. Diabetes time management was the strongest, statistically significant, unique contributor to explaining self-care. The regression model showed that diabetes time management demonstrated a large effect size and that diabetes distress demonstrated a small effect size. The 2 predictor variables among diabetes self-care in women showed diabetes time management had a stronger effect size compared to diabetes distress. This is the first known study to measure the influence of diabetes time management on diabetes self-care and to examine the relationship between and among diabetes time management and diabetes distress. Diabetes time management, an understudied variable in individuals with T2DM, has the potential to be a contributor to improve patient outcomes.

English

BACKGROUND Hyperglycaemia is the main cause for diabetes related complications. Though a number of factors add to the blood glucose, it is broadly known that proper selfmanagement activities reduce the risk in diabetic patients. This study was conducted to assess the self-care activities and their adherence amongst the diabetic patients attending the RHTC, IIMSR Lucknow. METHODS This cross-sectional study involved 92 previously diagnosed diabetic patients attending the outpatient department of rural health training centre, Integral Institute of Medical Sciences and Research, Lucknow, from December 2017 to August 2018. Data was collected by personal interviews using diabetes self-management questionnaire (DSMQ). SPSS software version 16.0 was used for data analysis. RESULTS All patients were aged between 40 to 65 years and males were higher in proportion (56.0 %). About 96.3 % subjects took diabetes medication as prescribed and 88.9 % subjects recorded their blood sugar levels regularly. Nearly 77.8 % did consistent exercise to accomplish optimal blood sugar stages &amp; 96.3 percent took the dietary advice given by investigator. About two-third patients avoided physical activity although they knew that it would improve their diabetes goal. About one third patients forgot or skipped their diabetes medication. The subscales of health-care use showed negative average intra class correlation. Mean score of subscale glucose management was maximum as compared to other subscales. CONCLUSIONS This study provides evidence that the DSMQ enables an efficient assessment of selfcare activities and their adherence among diabetes patients. Adherence to the treatment of diabetes and lifestyle modifications is the need of the hour. KEY WORDS DSMQ, Diabetes, Self-Care Activities, Cross-Sectional, Intra Class Correlation

A cross-sectional study on the physical activity of selected elderly diabetics

Regular exercise may prevent or delay the development of Type 2 Diabetes Mellitus (T2DM). In addition to moderate- to vigorous-intensity exercise, daily physical activity is also important for the prevention and management of T2D. Elderly diabetics (50-70 years) were selected from the PSG Hospitals - a multi-specialty hospital. A Diabetes Self-Management Questionnaire (DSMQ) was developed to be locally relevant. The validity and reliability was checked before administration of the questionnaire. Data on glycemic control, energy expenditure, and physical activity (MET) were recorded. Physical activity from age 50-60 &amp; 60-70 years were similar as indicated by the 24hr physical activity pattern and MET values. We observed a progression of the metabolic disorder with age as shown by HbA1c values Physical activity and exercise recommendations, therefore, should be tailored to meet the specific needs of each individual.

The association between diabetes numeracy and diabetes self-management among Saudi adults with insulin-treated diabetes.

Objectives:To describe the association between diabetes numeracy and diabetes self-management among Saudi adults with insulin-treated diabetes.Methods:From August 2018 to January 2019, a cross-sectional study was conducted in 3 diabetes centers in Riyadh, Buraydah, and Jeddah, Saudi Arabia. Systematic random sampling was used to include 290 Saudi adults with insulin-treated diabetes. The levels of diabetes numeracy and diabetes self-management were measured by using the Diabetes Numeracy Test tool (DNT-15) and Diabetes Self-Management Questionnaire tool (DSMQ).Results:The final analysis included 279 completed surveys. The mean total score of DSMQ was 6.47. The total DSMQ score was higher among patients who had a lower level of education (p=0.02), and patients who had a higher level of diabetes knowledge (p=0.01). The mean total score of DNT-15 was 41.3%. Patients who had lower diabetes numeracy scores tended to be younger, married, have fewer years of education, have a lower monthly income(p<0.001), use insulin only, and have type 1 diabetes. Patients who achieved a total score of 82%, and higher in DNT-15 have also achieved the highest score in DSMQ (p=0.17). A linear regression analysis adjusted for level of education, diabetes knowledge, and other variables found a modest association between low diabetes numeracy and low diabetes self-management (p=0.08).Conclusion:Lower level of diabetes numeracy was associated with lower level of diabetes self-management.

The effectiveness of home-based nursing intervention in the elderly with recurrent diabetic foot ulcers: A case report.

Background: Inadequate glycemic control usually leads to peripheral neuropathy, vasculopathy, and foot deformities that leads to diabetic foot ulcer (DFU), and a 10-years history of diabetes and inadequate self-management increases the risk of reoccurring DFU. A home-based intervention program, which includes Diabetes Self-Management Education (DSME) and wound care is the most likely approach, to engage families and overcoming the barriers in self-care management. The aim of this study is to provide an overview on the effectiveness of home-based nursing intervention in the elderly patients with reoccurring diabetic foot ulcers.Design and method: In this study, a case study approach was used that presented a case related to self-management and wound care in elderly patients with reoccurring DFU. The intervention was carried out by the community health nurses for eight weeks with home visit.Results: Significant changes were reported in diabetes selfmanagement practices, blood glucose level, and wound healing. The Diabetes Self-Management Questionnaire (DSMQ) score increased from 5.62 to 8.,54 and the Summary of Diabetes Self- Care Activities (SDSCA) score increased from 3.2 to 6. The Bates Jansen Examination score decreased from 24 and 26 to 17 and 14 in six weeks.Conclusions: The results confirm that family-based interventions program are effective in improving glycemic control and wound healing. Community nursing is believed to prevent an increase in self-management behavior to prevent recurring DFU and maintain a healthy life-style about diabetes self-management education.Significance for public healthDiabetes mellitus (DM) with diabetic foot ulcer significantly contributes to the deterioration in health and financial burden on the patient. The increased risk of diabetic foot ulcers, especially in elderly patients with inadequate glycemic control tends to increase diabetes complications and mortality. Furthermore, the functional impairment, cognitive dysfunction, and poverty caused by the aging process make it difficult for elderly people to access health services. Home-based interventions carried out by community health nurses using the patient-centered care approach have advantages in improving access to services. Focusing on the self-management with Diabetes Self-Management Education (DSME) and wound care management to improve glycemic control, optimize the healing process, and also improve health promotion to prevent recurrent diabetic foot ulcers. This article provides an overview on the effectiveness of home-based nursing intervention in the elderly patients with recurrent diabetic foot ulcers.

The effect of education given to type 2 diabetic individuals on diabetes self-management and self-efficacy: Randomized controlled trial

AimThis study used a randomized controlled trial design and was carried out to examine the effect of education on diabetes self-management and self-efficacy in patients with type 2 diabetes. MethodsThe study was carried out between July 2016–March 2017. Data were collected using information form, Diabetes Self-Management Questionnaire (DSMQ), self-efficacy scale for patients with type 2 diabetes (DSS).The individuals in the experimental group were given education. Both groups were reminded about the control time of their metabolic values on the phone in the 3rd and 6th months. ResultsThe average age of the individuals was 59.91 ± 8.93 (n = 78), 62.8% (n = 49) were female, 92.3% (n = 72), were married, 42.3% (n = 33) were high school graduates and their diabetes duration was 7.05 ± 3.9. There was a statistically significant difference in the 6th month metabolic values in the experimental group compared to the control group. When diabetes self-management and self-efficacy were examined, a statistically significant difference was found in the experimental group compared to the control group at 3rd and 6th months (p < 0.05, p < 0.01). ConclusionIn this study, a significant increase in diabetes self-management and self-efficacy and a significant decrease in metabolic values were observed as a result of education and phone reminders given to individuals with type 2 diabetes.

Association between self-care management practices and glycemic control of patients with type 2 diabetes mellitus in Saud Arabia: A cross -sectional study.

ObjectiveIn this cross-sectional study, we aimed to determine the association of self-care management practices and glycemic control of type 2 diabetes mellitus in Saudi Arabia.MethodsA total of 352 type 2 diabetes mellitus (T2DM) patients from two public tertiary hospitals in Saudi Arabia participated in this study. All T2DM patients were recruited and interviewed by a researcher between January to April 2018 from the outpatient diabetes clinics. All respondents answered a four-part questionnaire which includes demographics data, Diabetes Self-Management Questionnaire (DSMQ). Linear Regression was performed to assess the significance of predictors and compute the coefficient of determination.ResultsThe mean age of the participants was 51.89 ± 10.94. Of the 352 participants, 52% were obese (BMI: ≥30 kgm2) and 77% of the participants had glycated haemoglobin (HbA1c) over 7%. The analysis showed that subscale of Glucose management was the strongest predictor of Hba1c levels of participants’ followed by physical activity. Gender and marital status emerged as significant predictors for their self-care management practices. Female patients had more self-care management practices than male patients (B 0.20; 95CI 0.10– 0.96 (p = 0.015).ConclusionThis study provides an evidence on the self-care management of T2DM patients in Saudi Arabia. The high self-care management found in the study highlights that the patients are aware of the severity of and possible complications associated with T2DM.

Effect of community and peer support based healthy lifestyle program (CP-HELP) on self care behavior and fasting blood glucose in patient with type 2 Diabetes Mellitus.

This study aimed to examine the effect of community and peer support based healthy lifestyle program (CP-HELP) on self-care behavior and fasting blood glucose in patient with T2DM. The research design was used quasi experimental pre and post-test design. 163 participants with T2DM were divided into two groups, 83 participants as intervention group were given CP-HELP intervention and 80 participants as control group were given usual care. Measurement of self-care behavior used Diabetes Self-Management Questionnaire (DSMQ). Furthermore, measurement of fasting blood glucose was measuredby capillary blood test. This study was used paired t test and multivariate analysis of variance. An increase of mean value of self-care behavior was occurred in both of group intervention and control. A significant different between pre-test and post-test in intervention group (p = 0.000). Results of statistical test used paired t test in control group, was not showed significantly different (p = 0.249). Improved of fasting blood glucose only occurred in intervention group (p = 0.020). Results of multivariate statistic test was showed in both outcomes obtained significant value less than 0.05, self-care behavior (p = 0.010), fasting blood glucose (p = 0.042). CP-HELP may be a promising interventional strategy to improve self-care behavior and improving of fasting blood glucose in patient with T2DM.The research results can be used as an important reference for improving self care behavior and fasting blood glucose in patient with type 2 Diabetes Mellitus.

Assessment of diabetes self-management amongst Nigerians using the diabetes self-management questionnaire (DSMQ): a cross-sectional study

Introductionself-management is probably the most important factor contributing to achieving euglycaemia. The Diabetes Self-Management Questionnaire (DSMQ) is an instrument that shows favourable prospects compared to older measures. This study aimed to investigate the association between self-management and glycaemic control using the DSMQ, and determine factors that affect glycaemic control in patients living with diabetes mellitus.Methodsa cross-sectional analytic study of 103 patients, carried out in a public tertiary health institution located in a Southern Nigerian City. An interviewer administered DSMQ was used to assess self-management among the patients. Data analysis was performed using SPSS 22.0.0, and AMOS 22.0.0 (IBM SPSS Statistics, New York, USA).Resultsfemales had significantly lower DSMQ scores compared to males (40 vs. 36, P=0.015) while median DSMQ score was highest in participants with tertiary level of education (P=0.017), and those who earned the highest annual income (P=0.007). The DSMQ´s behaviour scales showed a notable negative correlation with HbA1c (-0.565, P < 0.001). More females (80.3%) than males (56.3%) had high HbA1C (X2=6.44, P=0.016).Conclusiondiabetes self-management using DSMQ showed significant correlation with glycaemic control. Male sex, higher income, and higher level of education are associated with better self-management and glycaemic control.

Psychometric Properties of the Persian Version of the Diabetes Self-Management Questionnaire for Patients with Type 2 Diabetes in Iran.

Background:Diabetes self-management questionnaire (DSMQ) is among the relatively new tools with comprehensive structure measuring various dimensions of self-care behaviors in diabetic patients. This study was carried out to evaluate psychometric properties of Persian version of DSMQ.Methods:A cross-sectional study was carried out from January to March 2017 among patients with type 2 diabetes mellitus (T2DM) referred to urban health centers, in Kerman, southeastern Iran. Data were collected from 589 patients using DSMQ. The DSMQ was translated into Persian by forward and backward translation method. Cronbach's alpha method and intraclass correlation coefficient (ICC) were used to measure internal consistency and test-retest reliability, respectively. In addition, construct validity was assessed by confirmatory factor analysis and exploratory factor analysis (EFA).Results:The sum-scale Cronbach's α of DSMQ was equal to 0.82 for 30 participants. The mean inter-item correlation and mean item-total correlation of “Sum Scale” (SS) were equal to 0.21 (standard deviation (SD) = 0.22) and 0.53 (SD = 0.19), respectively. All items had item-total correlations higher than 0.30 except items 7, 11, and 15. For “SS,” ICC was obtained as 0.93. EFA revealed a four-factor model accounting for 62.5% of the total variance. All indices were acceptable for the modified DSMQ with four factors (χ2 = 134.33, degrees of freedom = 89, P = 0.001, comparative fit index = 0.97, root mean square error of approximation = 0.044, Tucker-Lewis index = 0.96, and normal fit index = 0.92).Conclusions:The Persian version of DSMQ was found to have acceptable reliability and validity for assessing self-management among patients with T2DM.

Prevalence of diabetes distress and its relationship with self-management in patients with type 2 diabetes mellitus.

Context:Diabetes distress (DD) in India has been studied mainly in the context of depression. Little is known about DD, its determinants, distribution, and its impact.Aims:This study aims to estimate the prevalence of DD and identify its socio-demographic and clinical determinants in type 2 diabetes mellitus patients. To assess the relationship of DD with self-management in nondepressed type 2 diabetes mellitus.Settings and Design:A cross-sectional descriptive study in noncommunicable disease clinic of a tertiary care medical center.Subjects and Methods:DD Scale was used to assess DD in 200 patients with type 2 diabetes mellitus. Diabetes Self-Management Questionnaire was used to evaluate self-management behavior. Patient Health Questionnaire 9 was used to exclude depression.Statistical Analysis Used:Sample size calculation was done as per prevailing prevalence estimates. SPSS 20.0 was used for statistical analysis. ANOVA and Independent t-tests were done to compare between groups means. Hierarchical multiple regression analysis was done, keeping self-management as a dependent variable and socio-demographic, clinical variables, and DD as independent variables.Results:The prevalence of DD was 42% in our sample. The duration of diabetes showed that a significant association with DD. DD was significantly and negatively associated with all four domains of self-management, while statistical significance was reached in three domains: dietary control (β = −0.378, P < 0.01); glucose management (β = −0.181, P < 0.01); and healthcare use (β = −0.244, P < 0.01).Conclusions:DD is widespread in our patients and harms self-management. There is a need to address DD to improve disease-specific outcomes.