Diabetes Self-Management Questionnaire Research Articles

Managing Depression in Diabetes Mellitus: A Multicentric Randomized Controlled Trial Comparing Effectiveness of Fluoxetine and Mindfulness in Primary Care: Protocol for DIAbetes Mellitus ANd Depression (DIAMAND) Study.

Background:Suboptimal management of depression in type 2 diabetes mellitus (T2DM) often translates into poor glycemic control, medical complications, and impaired quality of life. Feasibility and effectiveness of collaborative care models of depression in diabetes in low- and middle-income countries (LMICs) remain unexplored. DIAbetes Mellitus ANd Depression (DIAMAND) study, a multicentric single-blind randomized controlled trial (SBRCT) comparing effectiveness of fluoxetine and mindfulness in primary care settings, addresses this gap in scientific literature.Methods:This trial conducted in diverse geographic settings of New Delhi, Bengaluru, and Bhubaneswar will comprise module-based training of primary care providers (PCPs) for screening, diagnosing, and managing depression in diabetes in phase I. Phase II will involve four-arm parallel group RCT on 350 participants with T2DM with comorbid depressive episode randomly allocated to receive fluoxetine, mindfulness therapy, fluoxetine plus mindfulness therapy, or treatment as usual at primary care settings. Interventions would include fluoxetine (up to 60 mg/day) and/or sessions of mindfulness for 16 weeks. Primary outcomes on standardized rating scales include depression scores (Hamilton Depression Rating Scale), treatment adherence (Adherence to Refill and Medication Scale), self-care (Diabetes Self-Management Questionnaire), diabetes-related distress (Diabetes Distress Scale), and glycemic control. Secondary outcomes include quality of life (World Health Organization Quality of Life Brief version [WHO-QOL BREF]) and mindfulness (Five Facets Mindfulness Questionnaire).Discussion:This RCT will investigate the effectiveness of module-based training of PCPs and feasibility of collaborative care model for managing depression in T2DM in primary care settings in LMICs and effectiveness of fluoxetine and/or mindfulness in improving diverse outcomes of T2DM with major depression.

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 and 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.

A comparison of self-care activities and diabetes distress among type II diabetic patients in urban and rural field practice area: a cross-sectional study

Background: Diabetes is a challenging disease that is considered to be hard to live with as it encompasses a lot of restrictive instructions. Self-care diabetes has been defined as an evolutionary process of development of knowledge or awareness by learning to survive with the complex nature of diabetes. Diabetic distress refer to an emotional state where people experience feelings such as stress, guilt or denial that arise from the living with diabetes and the burden of self-management. The emotional distress facing people with diabetes due to such life style restriction. The objectives were to evaluate self-care activities related to diabetes among type II diabetic patients using diabetes self-management questionnaire and to assess and compare the diabetes distress score using diabetes distress scale among urban and rural type II diabetic patient.Methods: A cross-sectional study was conducted in 140 urban and 70 rural study participants in field practice area of SNMC, Bagalkot. Diabetic self-care activities and diabetic distress were analyzed.Results: Our study showed most of the study participants had poor self-care activities. Our study showed 60% of rural participants screen positive for moderate diabetic distress where as 52.1% of urban participants showed positive for high diabetic distress.Conclusions: To combat the stress associated with diabetes, it is important to educate the patient to adapt with change in their life style following the diagnosis of diabetes.

Resilience and diabetes self-management among African-American men receiving primary care at an urban safety-net hospital: a cross-sectional survey

ABSTRACT Background Resilience is the ability to adapt to adverse life events. Studies that explore diabetes self-management interventions integrating resilience in African-Americans with diabetes include few African-American men, who have higher diabetes-related mortality and complication rates compared to African-American women. Design We conducted a cross-sectional study of African-American men with uncontrolled diabetes living in diabetes hotspots. We measured resilience levels using the General Self Efficacy Scale (GSES), adherence to diabetes self-management behaviors using the Diabetes Self-Management Questionnaire (DSMQ), and incarceration history by phone survey. We categorized participants as higher or lower resilience level and higher or lower adherence to diabetes self-management behaviors. Using multivariable logistic regression, we examined the relationship between resilience and adherence to diabetes self-management behaviors. Our model accounted for potential confounders, including age, incarceration history, and socioeconomic factors. Results Of 234 patients contacted by mail and phone, 94 (40.2%) completed the survey. Mean age was 60.6 years, 59.5% reported an annual household income of less than $20,000, and 29.8% reported a history of incarceration. The mean unadjusted GSES score was 25.0 (sd 5.2; range: 0–30, higher scores indicate greater resilience), and the mean DSMQ score was 7.34 (sd 1.78; range: 0–10, higher scores indicate greater adherence to diabetes self-management behaviors). In multivariable analyses, higher levels of resilience were associated with higher adherence to diabetes self-management behaviors (aOR = 9.68, 95% CI 3.01, 31.12). History of incarceration was negatively associated with higher adherence to diabetes self-management behaviors (aOR = 0.23, 95% CI 0.06, 0.81). Conclusions Resilience and personal history of incarceration are associated with adherence to diabetes self-management behaviors among African-American men residing in diabetes hotspots. Future interventions should incorporate resilience training to improve diabetes self-management behaviors. At a societal level, social determinants of health that adversely affect African-American men, such as structural racism and mass incarceration, need to be eliminated.

Diabetes Self-Management and the Associated Factors Among Adult Omanis with Type 1 Diabetes.

ObjectivesThis study aimed to assess and explore factors affecting diabetes self-management (DSM) among Omani adults with type one diabetes mellitus (T1DM).MethodsThis cross-sectional study was conducted from May to November 2018. Convenience sampling was used to recruit participants from three referral hospitals in Oman. Data were collected using the Diabetes Self-Management Questionnaire, Empowerment Scale (short form), Medical Outcome Study Social Support Scale, Diabetes Knowledge Test and glycosylated haemoglobin test results. Linear multiple regression analysis was used to explore possible predictors of DSM.ResultsA total of 210 people participated in the study (response rate: 87.5%). The majority of participants were female (70.5%) with a mean age of 26.82 ± 8.25 years. The mean score for DSM was 6.8 ± 1.4, which represents 68% of the total maximum score. More than one-third (36.2%) of the participants had poor glycaemic control. The predictors of high levels of DSM were being employed (P = 0.049), earning a low monthly income of less than 300 Omani rials (P = 0.014), having other chronic diseases (P = 0.029), a high diabetes self-efficacy (DSE; P = 0.003) and high social support (SS; P = 0.006).ConclusionAccording to the findings of this study, Omanis with T1DM have suboptimal DSM levels. Factors such as diabetes knowledge, DSE and SS are modifiable factors that can be targeted by interventions from different healthcare professionals to enhance DSM.

Dietary self-management practices among persons with T2DM: An exploratory qualitative study from western-coast of India

BackgroundDiabetes is a significant public health challenge for India. Self-management, including dietary management, physical activity, stress management, and adherence to medication, is critical in glycaemic control. Though data concerning self-management, in general, are available among persons with Type 2 Diabetes Mellitus (T2DM), exclusive research on dietary self-management was limited. AIMSA qualitative study to explore the knowledge, current dietary practices, and the barriers and enablers for dietary self-care management in persons with T2DM. MethodsIn this qualitative study, in-depth interviews were conducted among 35 participants with T2DM who scored minimally and optimally in the Diabetes Self-Management Questionnaire (DSMQ). Interviews were conducted using a validated interview guide. In-depth interviews were audio-recorded, transcribed to verbatim and thematically analysed. ResultsThe study included 20 males and 15 females. The three major themes derived in the study. Firstly, “Knowledge, Interpretation and Information” the majority of the participants have understood the influence of diet on control of blood glucose level includes food choices and quantum of food. Secondly, “Current Dietary Practices-Preferences, Availability of food and Convenience influence dietary practices’: All participants had their own belief on the side effects and benefits of certain food items. Most of the participants followed a three-meal pattern: breakfast, lunch and dinner. Finally, Barriers and Enablers in dietary self-management practice. Knowledge, physical and emotional factors, behaviour, planning were the intrinsic factors. Elements of the research, social support, season and climate, food environment were the extrinsic factors and communication, and financial management was the intermediate influences observed. ConclusionThe themes generated by this research provide insight into self-management and patient expectations in dietary matters. It would be desirable for physicians and health care providers to be aware of these practices when advising people with T2DM on dietary self - management.

The validity of the diabetes self-management questionnaire (DSMQ) in Hungarian patients with type 2 diabetes

BackgroundA wide range of measuring instruments are available for diabetes self-management. According to several studies, a relatively new instrument, the diabetes self-management questionnaire (DSMQ), shows a consistent relationship with outcomes of diabetes treatment as well, such as glycated hemoglobin (HbA1c). Furthermore, the questionnaire is short, but covers the main aspects of diabetes management. Given the increasing prevalence of diabetes in Hungary, our goal was to adapt this user-friendly questionnaire and analyze its validity.MethodsAfter the standard translation process, we analyzed a sample of 221 people. The construct validity of the questionnaire was tested with HbA1c and body mass index. Morisky Medication Adherence Scale-8 values were tested via Pearson correlations. Known-groups validity of the DSMQ in relation to groups based on glycemic control levels was investigated using one-way ANOVA.ResultsThe “sum scale” of the questionnaire and the HbA1c values show an inverse relationship (r = − 0.253, p < 0.01). Body mass index was related to the “sum scale” (r = − 0.214, p < 0.01) and to the “physical activity” (r = − 0.219, p < 0.01), while questionnaire results reflecting medication adherence correlated with the “glucose management” (r = − 0.291, p < 0.01), “health-care use” subscale (r = 0.236, p < 0.01) and the “sum scale” (r = 0.281, p < 0.01). A significant difference (F = 6.225, p = 0.002) was found between the DSMQ mean scores of the three groups, defined by good, medium, and poor glycemic control levels.ConclusionsThe Hungarian version of the DSMQ was considered a valid tool for the measurement of diabetes self-management. With its help, problematic areas of self-management could be uncovered, and interventions can be improved.

Construct validity, ecological validity and acceptance of self-administered online neuropsychological assessment in adults

Objective: The goal of this project was to explore the initial psychometric properties (construct and ecological validity) of self-administered online (SAO) neuropsychological assessment (using the www.testmybrain.org platform), compared to traditional testing, in a clinical sample, as well as to evaluate participant acceptance. SAO assessment has the potential to expand the reach of in-person neuropsychological assessment approaches.Method: Counterbalanced, within-subjects design comparing SAO performance to in-person performance in adults with diabetes with and without Chronic Kidney Disease (CKD). Forty-nine participants completed both assessment modalities (type 1 diabetes N = 14, type 2 diabetes N = 35; CKD N = 18).Results: Associations between SAO and analogous in-person tests were adequate to good (r = 0.49-0.66). Association strength between divergent cognitive tests did not differ between SAO versus in-person tests. SAO testing was more strongly associated with age than in-person testing (age R2=0.54 versus 0.23), while prediction of education, HbA1c, and estimated glomerular filtration rate (eGFR) did not differ significantly between test modalities (education R2=0.37 versus 0.30; HbA1c R2=0.20 versus 0.12; eGFR R2 = 0.41 versus 0.33). Associations with measures of everyday functioning were also similar (Functional Activities Questionnaire R2=0.08 versus 0.07; Neuro-QoL R2=0.14 versus 0.16; Diabetes Self-Management Questionnaire R2=0.19 versus 0.19).Conclusions: The selected SAO neuropsychological tests had acceptable construct validity (including divergent, convergent, and criterion-related validity), and similar ecological validity to that of traditional testing. These SAO assessments were acceptable to participants and appear appropriate for use in research applications, although further research is needed to better understand the strengths and weaknesses in other clinical populations.

Frequency and factors associated with inadequate self-care behaviors in patients with type 2 diabetes mellitus in Najran, Saudi Arabia. Based on diabetes self-management questionnaire.

Objectives:To investigate the frequency and factors associated with inadequate self-care behaviors in patients with type 2 diabetes mellitus (T2DM).Methods:A cross-sectional study was conducted on a sample of 355 patients with T2DM, using multistage cluster sampling, attending the Najran University Hospital and Primary health care centres in Najran, Saudi Arabia, from January to May 2019. The assessment of self-care behaviors was conducted using the 16-item diabetes self-management questionnaire (DSMQ).Results:The majority (85.1%) of the patients with T2DM were uncontrolled, 42% were obese, and 5.9% were morbidly obese. Based on DSMQ criteria, the majority of patients (90.1%) had poor self-care behaviors. The mean sum of DSMQ was 5.04 out of 10. Among the DSMQ subscales, health care use had the highest mean score of 5.63, followed by glucose management with a score of 5.12, while dietary control had lower mean scores of 4.96 and physical activity had 4.46, all were inadequate. Being married (OR=2.178, p=0.035) and having DM for more than 5 years (OR=2.711, p<0.006) were the significant independent factors associated with poor self-care behavior.Conclusion:Inadequate self-care behavior is widely prevalent in Najran city, Saudi Arabia. All the DSMQ subscales were poorly managed by most of the diabetic patients. Furthermore, being married and having a longer DM duration are the significant independent factors associated with poor self-care behaviors.

SELF-MANAGEMENT BEHAVIOR AND ITS IMPACT TO GLYCATED HEMOGLOBIN AMONG CLIENTS MEDICALLY DIAGNOSED WITH DIABETES MELLITUS: A CORRELATIONAL STUDY

Background: The Center for Disease Control and Prevention in 2016 identified and further classified Diabetes Mellitus as one of the chronic diseases, a leading cause of morbidity, and considered a major health problem in the Asia Pacific. Hence the quality of life as the optimum goal of any person is only achieved through appropriate self-care management. The person is a major key player of the nursing paradigm plays a crucial task in self-care since his/her responsibility is to assure balance between behavioral and environmental dynamics.&#x0D; Objective: To examine the self-management behaviors of clients medically diagnosed with Diabetes Mellitus and evaluate the correlation between self-management behaviors and glycated hemoglobin (HbA1c).&#x0D; Methods: The study utilized the validated Diabetes Self-Management Questionnaire (DSMQ) tool to 600 adults from the lower district of Khong Khlong, Kamphaengphet, Thailand. Through descriptive design, the investigation focused on major behavioral categories such as glucose management, physical activity, health care use and dietary control on at-risk stroke clients with DM aging 35 years old and above. Respondents with absolute complications of Diabetes Mellitus like stroke, blindness, undergoing dialysis even amputation are excluded to participate.&#x0D; Results: The findings revealed that most clients with DM are married female, ages 51-60 years old and is diagnosed of living with the disease for 6-10 years. Further, the respondents are generally aware on self-management activities for DM, however not all of them submitted for glucose monitoring program. On one hand, the respondents have high regard on controlling dietary intake to avoid the increase of blood glucose during scheduled tests while results also show that most of the respondents are having poor engagement on physical activities.&#x0D; Conclusion: It is concluded that self- management behaviors are strongly associated with HbA1c. Nonpharmacologic and identified independent nursing actions proven to aid clients with diabetes mellitus should be advocated in combating the disease.

Web-Based and mHealth Technologies to Support Self-Management in People Living With Type 2 Diabetes: Validation of the Diabetes Self-Management and Technology Questionnaire (DSMT-Q).

BackgroundA growing number of web-based and mobile health (mHealth) technologies have been developed to support type 2 diabetes self-management. Little is known about individuals’ experiences with these technologies and how they support self-management. Appropriate tools are needed to understand how web-based and mHealth interventions may impact self-management.ObjectiveThis study aimed to develop an instrument, the Diabetes Self-Management and Technology Questionnaire (DSMT-Q), to assess self-management among people living with type 2 diabetes who use web-based and mHealth technologies.MethodsA total of 36 candidate questionnaire items, drafted previously, were refined using cognitive debriefing interviews (n=8), expert consultation, and public patient involvement feedback. Item reduction steps were performed on survey data (n=250), and tests of validity and reliability were subsequently performed.ResultsFollowing amendments, patients and experts found 21 items relevant and acceptable for inclusion in the instrument. Survey participants included 104 (41.6%) women and 146 (58.4%) men. Two subscales with high construct validity, internal consistency, and test-retest reliability were identified: “Understanding individual health and making informed decisions” and “Confidence to reach and sustain goals.”ConclusionsAnalyses confirmed good psychometric properties in the DSMT-Q scales. This tool will facilitate the measurement of self-management in people living with type 2 diabetes who use web-based or mHealth technologies.

The Relationship between Motivation and Self-Management in Patient with DM in Internist Polyclinic RSUD Kabupaten Tangerang

Introduction: Diabetes Mellitus (DM) is a disease who characterized by high or low blood glucose values who caused by the inability pancreas to produce insulin, so self-management behavior is very important either for treatment or DM – Related complication preventions, but some DM patient has low motivation to doing self-management. The purpose of this study to was known the relationship between Motivation and Self-Management in Patient with DM in RSUD Kabupaten Tangerang. Methods: The design of this study used analytic observational with a Cross-Sectional approach. Sample taking technique used consecutive sampling with a total sample as much as 74 respondents. The instrument in this study used Treatment Self-Regulation Questionnaires (TSRQ) and the Diabetes Self-Management Questionnaire (DSMQ). Results: The result showed that low motivation with a bad self-management category has 20 respondents (66.7%), while for high motivation with good self-management category has 28 respondents (63.6%). Conclusion: The result of the statistic Chi-Square test showed that the relationship between Motivation with Self-Management in Patients with DM with scoring. Therefore it should be for health providers especially nurse able to increase the motivation of DM patients to do self-management and able to evaluate how the patient's motivation in applying self-management behavior in their life. Keywords: Diabetes Mellitus, Motivation, Self-Management.

868-P: Live Coaching Improves Glycemic Control and DSMQ Scale in People with Type 2 Diabetes

People with diabetes face numerous challenges to effective self-management of blood glucose (BG) including access to diabetes education and support. This study explores how a coaching program structured around the AADE7 Self-Care Behaviors™ and evidence-based behavior change strategies optimized for remote interaction between the coach and participant can improve glycemic control. Certified Diabetes Educator coaches used a care management platform, Welkin Health, that displays BG test results from integration with the OneTouch Reveal diabetes mobile app. Welkin supports communication methods with patients including email, SMS and telephone communication. The software platform also uses logic to prioritize patients who need attention so the coach can better manage their relationship with the participant. Adult participants with type 2 diabetes and HbA1c ≥8.0% received an AccuBase A1c mail-in test kit at baseline and weeks 12 and 24 to measure their HbA1c levels. Each participant used a OneTouch Verio Flex glucose meter connected by Bluetooth to OneTouch Reveal app. After 12 weeks (n=67), mean HbA1c declined by 0.85% from 9.19% to 8.34% (p&amp;lt;0.05) and 65% of subjects had an HbA1c decrease of &amp;gt;0.5%. After 24 weeks, mean change in HbA1c was still 0.78% less than baseline (p&amp;lt;0.05) with 51% of participants experiencing a decline of &amp;gt;0.5%. The decline in HbA1c occurred without any increase in hypoglycemic events. There was a 14.1% increase in % of results in range (p&amp;lt;0.05). Improvement in HbA1c came without any substantial change in testing frequency. In addition, there were various positive changes in the Diabetes Self-Management Questionnaire (DSMQ) scale. In conclusion, live coaching using the Welkin Patient Relationship Management technology in conjunction with the OneTouch Reveal diabetes app resulted in significant improvement in glycemic control in participants with type 2 diabetes who were in relatively poor control. Disclosure L.B. Katz: Employee; Self; LifeScan, Inc. K.D. Neland: Research Support; Self; LifeScan, Inc. D.J. Rolando: None. D.M. Shearer: None.

645-P: Diabetes Pueblo: A Community Health Worker–Led Educational Intervention for Latinos with T2D

In the U.S., Latinos have the highest proportion of type 2 diabetes (T2D) of any racial/ethnic group. Addressing cultural barriers and limited access to diabetes education may improve diabetes care and outcomes in this population. Diabetes Pueblo (DP) is an 11-week, culturally tailored, diabetes self-management education and support (DSMES) program led by Latinos in the community (Promotores). The program has two modules, diabetes fundamentals (DF) and insulin success. A pilot study was conducted to evaluate the feasibility of DP through class attendance and participant satisfaction. Additional endpoints included biometric data, HbA1c, the Diabetes Self-Management Questionnaire (DSMQ), and the Insulin Treatment Appraisal Scale (ITAS). Participants were 25 Latinos with T2D (20 completers) with a mean age of 55.8±10.5 years (64% female, 92% born in Latin America, 39% completed high school). Class attendance averaged 82%. Small nonsignificant improvements were observed in HbA1c, DSMQ, and ITAS positive appraisal at the completion of the program. ITAS negative appraisal scores improved significantly from 43 to 38 (p=0.02). Participant feedback reported improvement in distinguishing between diabetes and prediabetes (p=0.01). Post-class focus groups revealed very high satisfaction with the program, including improved understanding of how behaviors impact health and that insulin initiation does not indicate personal failure. There were no significant changes in biometrics possibly due to the short study duration. These results demonstrate the program’s feasibility through high attendance, program approval, improved diabetes self-management knowledge and acceptance of insulin therapy. This highlights the importance of using a culturally appropriate education program taught by community health workers for higher attendance and engagement. Future research may include larger-scale evaluations of the program with long-term follow-up to detect changes in biometric data. Disclosure J. Creason: None. C. Axelrod: None. M.M. Conneely: None. C. Landeros: None. M. Diaz-Rea: None. A.D. Xi: Employee; Self; Eli Lilly and Company. R. Paczkowski: Employee; Spouse/Partner; Amgen. Employee; Self; Eli Lilly and Company. B. Reed: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. F. Gelsey: Employee; Self; Lilly Diabetes. Stock/Shareholder; Self; Lilly Diabetes. K.N. Castorino: Research Support; Self; Abbott, Dexcom, Inc., Medtronic, Mylan, Novo Nordisk Inc. Funding Eli Lilly and Company

2247-PUB: Shared Education Visits for Adolescents with Type 1 Diabetes

Introduction: Deterioration in glycemic control often occurs during adolescence in children with type 1 diabetes (T1D). Shared appointments have been shown to improve quality of life scores and treatment adherence in children with chronic illnesses. Objective: To examine the impact of combined individual visits and shared education appointments in adolescents with T1D on diabetes control, self-management, and diabetes related distress. Methods: Adolescents ages 11-19y with T1D for over 1y and poor control/adherence defined by HbA1C &amp;gt; 9%, 2 or more DKA episodes in the past year or 2 missed appointments were enrolled in a 6 month DKA prevention program consisting of monthly individual visits followed by an hour long shared education visit. HbA1C levels were obtained every 3 mo. Participants completed a diabetes distress score (DDS) and diabetes self-management questionnaire (DMSQ) prior to participation and at the 6th visit. Participants were followed for an additional 6 months after completion of the program. Those who attended 2 or more session were included in the analysis. Results: Ten adolescents (8 female, average age 13.9 y, diabetes duration from 1-11 y, average A1C 10.6% SD 2.0) were enrolled. None of the 10 participants had DKA during the program. There was no statistically significant change in A1C. No changes were noted in the DDS; however there was improvement in dietary control on DMSQ from 4.0 to 5.7 (p value 0.058). Six attended 5 or more of the sessions. Those 6 participants had a decrease in average A1C by 0.3% over 6 mo with no DKA episodes within 6 mo of completion. The 4 participants who attended 2-4 sessions had an increase in average A1C of 0.85% over the same period and 3 had DKA episodes within 6 mo after completion. Conclusions: Shared education visits may be a valuable approach to the care of adolescents with diabetes. No episodes of DKA and no significant changes in glycemic control were noted in 6 mo; however larger long-term studies are needed to explore whether continued shared visits can improve glycemic control. Disclosure M. Wilkes: None. T. Murphy: None. A. Aluf: None. D. Sperber: None. A. Sherry: None. S. Sethuram: None. L. Choleva: None. R. Rapaport: None.

Impact of Diabetes-related Self-management on Glycemic Control in Type II Diabetes Mellitus.

Introduction: Self-care activities are behaviors adopted in order to enhance one’s health. Self-care behaviors and activities are studied in their role to enhance glycemic control, reduce diabetes-related complications, and contribute to enhancing overall quality of life in people with diabetes. The aim of this observational study was to evaluate the impact of diabetes self-care activities and behaviors on glycemic control in people with diabetes.Methods: This observational, cross-sectional study was conducted at the outpatient department of a secondary care hospital in Karachi, Pakistan from 1st September 2019 till 30th November 2019. Patients with known type II diabetes of age ≥45 years visiting the hospital for routine follow-up visit were included. Diabetes Self-Management Questionnaire (DSMQ) in Urdu version was used to assess their status of self-management. For data entry and statistical analysis SPSS for Windows version 21.0 was used.Results: There were 174 (54.9%) males and 152 (47.9%) were of age 45-60 years. Glycemic control was good (HbA1c <7%) in 125 (39.4%) and poor (HbA1c ≥7%) in 192 (60.6%) patients. Patients with good glycemic control scored significantly better on DSMQ overall (5.53 ± 0.35 vs. 4.32 ± 0.61; p<0.0001), and on three sub-scales - dietary control (4.24 ± 1.04 vs. 3.63 ± 0.98; p<0.0001), physical activity (4.16 ± 0.56 vs. 3.47 ± 1.17; p<0.0001), and healthcare use (4.22 ± 0.78 vs. 3.98 ± 0.65; p=0.003). Conclusions: The self-care activities that impact glycemic control in patients with diabetes include dietary control, physical activity, and healthcare use.

Self-Management Status in Patients with Diabetes and Disease Control Indicators in Lamerd City, Iran

Background: Diabetes is a global epidemic with serious complication and there is a clear need for paying special attention to self-management as the cornerstone to optimal control of the disease. Objectives: This study aimed to assess the self-management status and its correlation to disease control indicators in people with diabetes. Methods: In a descriptive cross-sectional study, 220 patients were selected from the list of the referred patients available in Lamerd public health network from December 2014 to June 2015. In the first step, data about demographic information and disease control were collected from the patients’ records. In the second step, the self-management status of each patient was assessed by the Diabetes Self-Management Questionnaire developed by Schmitt et al. To analyze the data, independent sample t-test and Pearson correlation coefficient were used. Results: The mean age of the male and female participants was 56.43 ± 13.50 and 56.46 ± 10.49 years old, respectively. The mean duration of the disease was 6.67 ± 4.72 years for men and 7.07 ± 5.30 years for women. Twenty-one (25.9%) men and 60 (43.7%) women had a history of smoking. The results of the Pearson correlation coefficient showed that there was an inverse and statistically significant relationship between diabetes self-management status and weight, body mass index (BMI), waist circumference, glucose tolerance test (GTT), LDL, and cholesterol. The results of the t-test did not show significant differences between the level of HbA1C (HbA1C7) and self-management scores of the patients (P &gt; 0.05). Conclusions: Patients with better self-management status were in a better disease control condition with respect to weight, BMI, waist circumference, GTT, LDL, and cholesterol levels. Special attention to the control and management of LDL, cholesterol, HbA1C, BMI, and blood pressure levels is recommended in planning for these patients.

EFFECT OF PEER GROUP SUPPORT ON SELF-CARE MANAGEMENT IN DIABETES MELLITUS PATIENTS IN KEMBARAN SUB-DISTRICT

Diabetes mellitus atau biasa disebut dengan DM merupakan penyakit tidak menular yang kejadiannya cukup tinggi. Penyakit DM akan menimbulkan komplikasi apabila penderita DM memiliki self-care management yang buruk. Komplikasi dapat dicegah dengan perawatan diri yang baik seumur hidup. Peningkatan perawatan diri DM ini dapat dibantu dengan metode peer group support. Penelitian ini bertujuan untuk mengetahui pengaruh peer group support terhadap self-care management pada penderita DM di Kecamatan Kembaran. Penelitian ini menggunakan desain eksperimen semu (quasi experiment) dengan rancangan non randomized pretest-posttest with control group design. Teknik pengambilan sampel menggunakan purposive sampling. Responden penelitian ini adalah penderita DM di Puskesmas I Kembaran dan Puskesmas II Kembaran sebesar 27 responden (13 responden pada kelompok intervensi, 14 responden pada kelompok kontrol). Instrumen penelitian menggunakan Diabetes Self-Management Questionnaire. Terdapat perbedaan yang bermakna skor self-care management DM pre dan post peer group support dengan p 0,001 pada kelompok intervensi. Tidak terdapat perbedaan yang bermakna skor self-care management DM pre dan post pada kelompok kontrol. Terdapat perbedaan yang bermakna skor self-care management DM sesudah peer group support antara kelompok intervensi dan kontrol dengan p 0,001. Peer group support efektif meningkatkan self-care management pada penderita DM.&#x0D; Kata Kunci: Diabetes Mellitus, Self-Care Management, Peer Group Support

Pancreaticoduodenectomy for paraduodenal pancreatitis is associated with a higher incidence of diabetes but a similar quality of life and pain control when compared to medical treatment

BackgroundParaduodenal pancreatitis is a focal form of chronic pancreatitis that affects the groove area between the duodenum and the head of the pancreas. Consensus regarding surgical or nonsurgical management as the best treatment option is still lacking. MethodsWe retrospectively evaluated all patients managed for PP at The Pancreas Institute of the University Hospital Trust of Verona from 1990 to 2017. The outcomes of surgical vs. medical treatment with regard to pain control, quality of life and pancreatic insufficiency were evaluated through specific questionnaires. ResultsThe final study population consisted of 75 patients: 62.6% underwent surgery, and 37.4% were managed without surgery. All surgical procedures consisted of pancreaticoduodenectomy. The median follow-up from the diagnosis of paraduodenal pancreatitis was 60 (12–240) months. Patients who underwent surgery experienced a similar incidence of steatorrhea (44.7 vs. 52.6%; p = 0.4) but a significantly higher incidence of diabetes (59.6 vs. 10.7%; p < 0.01) when compared to those managed without surgery. There was no difference in terms of reported chronic pain (Graded Chronic Pain Scale, median 0 vs. 1; p = 0.1) and quality of life (Pancreatitis QoL Instrument, median 82 vs. 79; p = 0.2). However, surgical patients reported a worse level of self-care activities associated with glycemic control (Diabetes Self-Management Questionnaire, median 20 vs. 28, p = 0.02). ConclusionIn patients affected by paraduodenal pancreatitis, surgery and medical therapy seem to obtain similar results in terms of quality of life and pain control. However, surgery is associated with an increased prevalence of postoperative diabetes with consequent relevant issues with self-care management. Surgery should be considered only in selected patients after adequate medical treatment.

Self-Care Level in Diabetic Patients

Objective The present study was done with the objective of assessing the self-care practices among diagnosed type 2 diabetes mellitus patients in hospital of Islamic Azad University of Medical Sciences in Tehran, Iran. Methods In this cross-sectional study, 314 Iranian patients older than 18 years of age with type 2 diabetes were completed Diabetes Self-Management Questionnaire. Data was analyzed by ANOVA, t-test, correlation and liner regression. Results A significant association was found between the diabetes self-management sum scale and body mass index, Dietary control subscale and body mass index, Physical activity subscale and body mass index &amp; job and Healthcare use subscale and diabetes treatment (p&lt;0.05). Conclusion Due to the high BMI in respondents, Overweight and obese respondents need to be advised by health professionals on physical activities and proper diet to achieve healthy weights to avoid complications related to diabetes mellitus. Keywords Diabetes self-management, Type 2 diabetes, Diabetes Self-Management Questionnaire DOI : 10.7176/JMPB/63-02 Publication date: January 31 st 2020