Diabetes Self-Management Scale Research Articles

Development and psychometric evaluation of the type 1 diabetes mellitus self-management scale for parents.

Diabetes has become a global epidemic, necessitating effective self-management strategies. This is particularly crucial for parents of children with type 1 diabetes mellitus, as they must make numerous daily decisions and perform complex care activities. Therefore, the aim of this study was to develop a comprehensive diabetes self-management scale specifically for parents of children with type 1 diabetes. This scale aims to holistically address behaviors impacting diabetes self-management and to evaluate its psychometric properties. A methodological, correlational, and cross-sectional study was conducted with a sample of 190 parents of children with type 1 diabetes mellitus. The scale items were reviewed by five experts to ensure they adequately covered the parents' evaluation of their children's diabetes self-management. Following this, a Turkish language expert assessed the draft scale for language accuracy, comprehensibility, and grammar. The data were analyzed using descriptive statistics (numbers and percentages), Cronbach's α reliability coefficient, factor analysis, and correlation analysis. The Cronbach's alpha for the overall scale was 0.893, and the Cronbach's alpha for the subscales was between 0.757 and 0.845. The item-total score correlations ranged between 0.408 and 0.660 (p < .05). The exploratory factor analysis showed that the scale explained 61.427% of the total variance, and the factor loadings of items ranged from 0.574 to 0.859. The confirmatory factor analysis also showed that the factor loadings of the scale items ranged from 0.574 to 0.859. The validity and reliability analyses revealed that the scale is a valid and reliable measurement tool for the Turkish culture.

Psychometric Properties of the Revised Self-Efficacy for Diabetes Self-Management Scale among Spanish Children and Adolescents with Type 1 Diabetes.

A longitudinal design was used to examine the psychometric properties of the Self-Efficacy for Diabetes Self-Management (SEDM) for children and adolescents with a diagnosis of type 1 diabetes (T1D). The SEDM was adapted to Spanish and the best factorial solution was selected to test the invariance of the measures of age and gender. Individuals between the ages of 10 and 19 years old with a diagnosis of T1D completed a self-reported questionnaire (167 at Time 1 [mean age = 14.49, SD = 2.76; 56.9% boys] and 122 at Time 2 [mean age = 14.77, SD = 2.58; 56.6% boys]). Two unifactorial solutions were tested. The psychometric properties of the scale were validated. The proposed validation obtained excellent reliability indices (χ2 (26) = 25.59, p > 0.49, RMSEA = 0.00, 95% CI [0.00, 0.07], CFI = 1.00, GFI = 0.96, AGFI = 0.92, TLI = 1.00, and CMIN = 0.98), and it appeared to be invariant for gender and for age groups. The Cronbach's α was 0.85. The test-retest reliability was high (r = 0.69 [p < 0.001]). Convergent, discriminant, and external validity were proven. The nine-item SEDM is a brief measure with satisfactory structural validity. From our knowledge, this study provides the first reliable tool to assess self-efficacy in the management of T1D for Spanish children and adolescents.

Classifying self-management clusters of patients with mild cognitive impairment associated with diabetes: A cross-sectional study.

This study aims to propose a self-management clusters classification method to determine the self-management ability of elderly patients with mild cognitive impairment (MCI) associated with diabetes mellitus (DM). MCI associated with DM is a common chronic disease in old adults. Self-management affects the disease progression of patients to a large extent. However, the comorbidity and patients' self-management ability are heterogeneous. A cross-sectional study based on cluster analysis is designed in this paper. The study included 235 participants. The diabetes self-management scale is used to evaluate the self-management ability of patients. SPSS 21.0 was used to analyse the data, including descriptive statistics, agglomerative hierarchical clustering with Ward's method before k-means clustering, k-means clustering analysis, analysis of variance and chi-square test. Three clusters of self-management styles were classified as follows: Disease neglect type, life oriented type and medical dependence type. Among all participants, the percentages of the three clusters above are 9.78%, 32.77% and 57.45%, respectively. The difference between the six dimensions of each cluster is statistically significant. This study classified three groups of self-management styles, and each group has its own self-management characteristics. The characteristics of the three clusters may help to provide personalized self-management strategies and delay the disease progression of MCI associated with DM patients. Typological methods can be used to discover the characteristics of patient clusters and provide personalized care to improve the efficiency of patient self-management to delay the progress of the disease. In our study, we invited patients and members of the public to participate in the research survey and conducted data collection.

Turkish Validity and Reliability of Comprehensive Diabetes Self-Management Scale.

A self-care approach is very important in diabetes management. In this study, it was aimed to make the Turkish validity and reliability of the Comprehensive Diabetes Self-Management Scale (CDSMS), which examines the behaviors of diabetes patients. The study is of methodological type. CDSMS, which was translated into Turkish from its original version and tested for language validity, was first included in the pilot application and then in the main study. The validity of the scale was evaluated by the Cronbach's alpha coefficient. Then, a Receiver Operating Characteristic (ROC) analysis was performed to determine the cut off score. The mean age of the study participants was 57.10 ± 11.20 years and the mean disease duration was 9.96 ± 7.79 years. The internal consistency of CDSMS was 0.73, which was measured using Cronbach's alpha. After the ROC analysis, the optimal cut-point score of CDSMS to predict good glycemic control was determined as 21.17 points. With this study, it was found that the Turkish version of CDSMS is valid and reliable for use in the Turkish population. It is thought that CDSMS will be beneficial to physicians working in the clinic in terms of showing the disease management skills of diabetic patients.

Character Strengths Use in Diabetes Self-management Scale: Development and psychometric testing.

To develop and psychometrically test Character Strengths Use in Diabetes Self-management Scale in people with type 2 diabetes. Cross-sectional design. Based on literature reviews and examination by experts, a 20-item scale was developed and administered to 350 participants with type 2 diabetes who were enrolled from two endocrine clinics by convenience sampling in Taiwan. Item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), concurrent and predictive validity as well as reliability were used to examine the psychometric characteristics of the scale. Data were collected from November 2021 to March 2022. EFA and CFA supported a 12-item scale with three factors, namely learning proactively, taking on challenges and thinking positively, fit the data well. The total score of the 12-item scale significantly and positively correlated with diabetes-specific quality of life, and significantly and negatively correlated with baseline and 9-month haemoglobin A1c levels. Cronbach's α for overall scale and subscales ranged between .78 and .91. The 12-item Character Strengths Use in Diabetes Self-management Scale demonstrated satisfactory validity and reliability in people with type 2 diabetes. Nurses could apply this new scale to identify the degree of using character strengths in self-management in people with type 2 diabetes; accordingly, character strength-based interventions could be provided to improve self-management in such patients with diabetes. Furthermore, the 12-item Character Strengths Use in Diabetes Self-management Scale has the potential to be used to measure the effectiveness of strength-based interventions in people with Type 2 diabetes. Five patients with type 2 diabetes were invited to take the original 20-item scale to evaluate the clarity, readability and comprehensiveness of the 20 items.

NURSE AND PATIENT PERCEPTION IN SELF-MONITORING OF DAWN EFFECT TO ENHANCE SELF-MANAGEMENT IN DIABETES MELLITUS PATIENT’S: A QUALITATIVE CASE STUDY

Background: A phenomenon in diabetes mellitus patients is called dawn effect, the condition of hyperglycemia suddenly increasing insulin requirement in the morning caused by nonattendance of nighttime hypoglycemia. Self-monitoring can be minimizing the impacts of dawn effect. Self-management can be actualized to oversee the blood glucose levels fluctuation in diabetes mellitus patients. Objective: to gain self-monitoring influencing factors of dawn effect phenomenon, and increase self-management in diabetic patient and nurse knowledge in Temanggung, Central Java Methods: A qualitative study design was used in this research with semi-structured interviews and open-ended questions. Participants were selected using purposive sampling technique from primary healthcare and secondary healthcare of both nurse and patient. Twelve participants consisted of senior nurse (n=5), patients with type 2 diabetes mellitus (n=7). Information of psychometric diabetes self-management scale and blood glucose monitoring were day by day collected within the morning. Result: Nurses' perception of the dawn effect is still relatively low due to a lack of knowledge and competence in self-management of diabetes patients. They followed the doctor's advice. In addition, the patient's perspective of blood glucose monitoring was taken into account, despite the fact that they did not have a glucometer from a mobile device (lack of self-management and dawn effect). Furthermore, all participants (n=7) increase in blood glucose level in the morning. Invasive glucometer has a high accuracy, but inducing finger discomfort, uncomfortable, and increase risk of infection when it checked daily. Conclusion: Perceptions of nurse and patient about self-monitoring can improve patient self-management and prevent the occurrence of dawn effects.

Translation and Psychometric Evaluation of the Partners in Health Scale Among Iranian Adults With Chronic Diseases

Objectives: Characterizing the psychometric attributes of the Persian variant of partners in health (PIH) in multiple sclerosis (MS), Diabetes, and Low Back Pain (LBP) patients. Methods: In this cross-sectional study, 183 MS, diabetes, and LBP patients (70 male, 113 female) were treated with PIH post-forward-backward translation. Confirmatory factor analysis was used for studying the factor structure. Cronbach’s α and McDonald’s Ω coefficients were used to analyze PIH internal consistency. We used an interclass correlation coefficient to evaluate test-retest reliability. Criterion validity was determined by studying the correlation of PIH and Short Form (36) Health Survey (SF-36), Diabetes Self-Management Scale (DSMS), and Self-Efficacy in Chronic Disease Self-Management (SES6G). Results: The median age of the participants was 49.73±15.16 years, 113 (61.75%) of them were female, 64 (35.0%) had MS, 66 (36.1%) had diabetes, and 53 (29.0%) had LBP. Content validity was determined across all areas (clarity, relevancy, simplicity) by a content validity index ≥0.82. Additionally, all items were confirmed via a content validity ratio ≥0.78. The outcome of CFA depicts that the statistics presented as model fit were as follows: CFI= 0.938, NFI= 0.899, and RMSEA= 0.085. All PIH items exhibited valid internal consistency (0.886-0.893). The PIH showed sufficient test-retest reliability regarding its corresponding subscales (0.554-0.679). The construct validity was confirmed by the total scores of PIH correlated with the total score of SF-36, SES6G, and DSMS. Discussion: The Persian variant of the PIH showed sufficient validity and reliability as a measure to assess self-management in patients suffering from chronic disease (MS, diabetes, and LBP).

The effect of web based type 2 diabetes education on diabetes self management.

This study is a control group intervention study to determine the effect of web-based education on diabetes self-management in individuals with type 2 diabetes. The study was conducted in the Training and Research Hospital Diabetes Education Unit of Hitit University. The study was completed with 75 people (intervention 38, control 37). The data were obtained in the web site through patient identification form, self-management perception scale in diabetes, diabetes attitude, self-care scale and HbA1c, HDL, LDL values were followed by providing training and counseling. The values followed were viewed at the third and sixth months. Written permission was obtained from ethics committee and participants. The data of the study were evaluated with number, percentage, mean, pearson chi-square, independent t-test, repetitive analysis and variance analysis. Statistically significant decrease in HbA1c and LDL values, diabetes self-management scale, diabetes attitude scale and self-care scale scores were found to be significantly different between the intervention and control groups. Web-based education and follow-up studies are effective in decreasing HbA1c values in increasing diabetes self-management skills of individuals with type 2 diabetes. It is recommended to use as a complementary tool in health care services for type 2 diabetes management.

Rasch and Confirmatory Factor Analyses of the Arabic Version of the Diabetes Self-Management Scale (DSMS): An Intercultural Approach.

The current study was designed to validate the Arabic version of the Diabetes Self-Management Scale (DSMS) using Rasch and confirmatory factor analyses. This included person and item fit, separation, and reliability; rating scale functionality to evidence substantive validity; unidimensional structure to evidence structural validity; and item technical quality to evidence content validity. The study was conducted between September 2021 and March 2022. Utilizing AMOS-based confirmatory factor analysis (CFA), the study also assured the dimensionality of the DSMS. The participants were 103 diabetic patients in Saudi Arabia with a mean age of 44.72 years (standard deviation = 17.35). The analysis was performed using a trichotomous rating scale, and only one item exhibited a misfit (DSMS14). The item difficulty range was -1.0 to +1.0 logits, while the person's ability range was -3.0 to +3.0 logits. The first construct proved one Rasch dimension, which was explained and further analyzed using AMOS-CFA for the one-factor model. The DSMS was shown to be beneficial as a screening instrument for patient-reported diabetes self-management, despite several flaws that need to be addressed to improve the scale further.

EATING DISORDERS, SELF-MANAGEMENT, AND ANXIETY DISORDERS IN DIABETICS DURING THE COVID-19 PANDEMIC: A CROSS-SECTIONAL STUDY

Objective: This study aimed to determine the frequency of eating disorders and symptoms, anxiety and self-care management status, and factors that have an impact on eating disorders in diabetics during the COVID-19 pandemic. Method: This cross-sectional web-based study used a survey comprising a socio-demographic information form, the Bulimic Investigation Test of Edinburgh (BITE), Perceived Diabetes Self-Management Scale (PDSMS), and Generalized Anxiety Disorder Scale (GAD-7). Independent samples t Test, Mann Whitney U Test, Chi Square Test, Pearson correlation analysis, and Simple Regression Analysis were applied to the variables. Results: Totally, 110 (52 Type 1, 58 Type 2) diabetics aged 18-65 participated in the study. BITE total score was determined as 20.92±7.99 (Min:8; Max:32). Eating disorder frequency was 29.1% while anxiety disorders frequency was 30.9%. Perceived Diabetes Self-Management Scale point is 24.80±3.85 (Min:8; Max:40). Married individuals and diabetics with anxiety disorder mostly had eating disorders (p&amp;lt;.005). There was no significant relationship between anxiety disorder, eating disorder and PDSMS scores of the participants and socio-demographics (p&amp;gt;.05). Anxiety was a significant predictor of eating disorders in diabetics (R=.45; R2 =.20; F (1.108)=28.61, p&amp;lt;.001). Conclusion: Eating disorder symptoms and severity of diabetics, and their coping styles with anxiety should be determined during the pandemic by diabetes care and specialist. Family eating habits and the presence of anxiety disorders should be taken into account to reduce eating disorders. People with diabetes can be emotionally and self-management empowered through online training and counseling.

Features of self-management of type 2 diabetes mellitus: assessment results of qualitative and quantitative parameters

Objective. To assess the features and current status of diabetes self-management and to identify the driving factors responsible for behavior shaping related to diabetes.Materials and methods. To study the behavioral features of 206 patients with 2 type diabetes mellitus (DM), we used the experimental and psychological methods (Diabetes Self-Management Questionnaire – DSMQ – and a random questionnaire). A qualitative and correlational analysis of the obtained data was also conducted.Results. The median score of diabetes self-management according to the DSMQ scale was 5.48 (4.64; 6.04) (10 was the maximum point). The analysis of other subscales was as follows: “Glucose self-monitoring” – 7.33 (6.00; 8.00) (p-value: &lt; 0.001); “Dietary self-monitoring” – 5.00 (3.33; 5.83) (p-value: &lt; 0.001); “Self-monitoring of physical activity” – 4.44 (2.22; 5.56) (p-value: &lt; 0.001); “Skill in using qualified medical care” – 5.56 (3.33; 6.67) (p-value: &lt; 0.001). The answers to the 16th question “My diabetes self-management is low” were as follows: “Applies to me extensively” – 27.20 %; “Applies to me to a considerable degree” – 4.76 %; “Applies to me to some degree” – 33.80 %; “Does not apply to me” – 34.27 %. Furthermore, a correlational analysis was carried out between the DSMQ subscales and the duration of the disease, age of the patients, degree of cognitive impairment, and the average hemoglobin A1c value.Conclusion. According to the data of the validated DSMQ diabetes self-management scale, the questionnaire and the average HbA1c value, the external locus of control prevails among the patients with 2 type DM. Low self-management levels were revealed for the three indicators: “Dietary self-monitoring” – 5.00, “Self-monitoring of physical activity” – 4.44, “Skill of using qualified medical care” – 5.56.

The Effect of Self-Efficacy in Self-Management on Diabetes Distress in Young People with Type 2 Diabetes.

To understand the relationship among glycemic control, self-efficacy in diabetes management, and diabetes distress in young people with type 2 diabetes, a cross-sectional descriptive study with convenience sampling was designed. A total of 60 young people who had type 2 diabetes (T2D), with 24 (40%) males and 36 (60%) females were included. The mean age was 17.2 and ranged from 10.5 to 24.5 years, and they completed a Perceived Diabetes Self-Management Scale, the Problem Areas in Diabetes Scale and their pharmacologic management and life adjustment. Glycated hemoglobin (HbA1c) was routinely drawn before the outpatient visit. HbA1c and diabetic distress were positively correlated. Self-efficacy was negatively correlated with HbA1c and diabetic distress. In the hierarchical multiple regression analysis, only the duration of illness and self-efficacy remained significant in the final model. The variance for the overall model was 64%, with self-efficacy alone explaining 30% of the variance. In addition, 31.6% of participants had extremely high levels of psychological distress. Conclusions: T2D is an early onset chronic disease, and the young people may have had other health problems, which made the diabetes management a complex process. Nursing staff should regularly assess both the confidence and ability to manage treatment regimen of young people with type 2 diabetes and their psychological distress.

The Thai version of diabetes self-management scale instrument, and assessment of its psychometric properties: a multi-center study

Aim: The objective of this study was to translate and evaluate the psychometric properties of the Thai version of the Diabetes Self-Management Scale (T-DSMS). Design: A cross-sectional study. Methods: This study was performed in two phases: 1) a forward-backwards translation of the existing version of the Diabetes Self-Management Scale (DSMS); and 2) evaluation of its psychometric properties using confirmatory factor analysis. Between February to June 2016, a total of 700 type 2 diabetes mellitus (T2DM) patients were recruited from outpatient diabetes clinics of both community and university hospitals in Khon Kaen and Bangkok province Thailand, using a self-administered questionnaire. Results: The results, based on confirmatory factor analysis using Unweighted Least Squares, confirmed the construct validity of the T-DSMS (CFI = 0.985; RMSEA = 0.258; TLI = 0.981; SRMR = 0.040). The T-DSMS contains 13 items across four domains: Diet, Blood, Exercise, and Foot care. Conclusion: We translated and appropriately validated the DSMS in Thai T2DM patients. The T-DSMS was shown to have good psychometric properties, including content validity and criterion validity. The T-DSMS is an adequate instrument with which to assess diabetes self-management in Thai T2DM patients, and can provide valuable insights into the epidemiology of diabetes self-management, and enable evaluation of prevention programs for diabetes self-management in T2DM patients.

Effects of a health education technology program on long-term glycemic control and self-management ability of adults with type 2 diabetes: A randomized controlled trial

AimsThis study aimed to explore the effects of a health technology education program on long-term glycemic control and the self-management ability of adults with type 2 diabetes (T2D). MethodsThe study was a randomized controlled trial with repeated measures design. The experimental group (n = 53) received a novel health technologies education program plus focus groups and routine shared care, the control group (n = 55) received routine shared care. Glycosylated hemoglobin (HbA1c) level and self-management ability were the primary and secondary outcomes. Subject self-management ability was evaluated using the Chinese version of Perceived Diabetes Self-Management Scale (PDSMS). A linear mixed-effect model for repeated measures was used to analyze changes in HbA1c level and self-management ability after controlling for pretest effects. ResultsThe mean HbA1c levels in the experimental group decreased by 0.692% (7.564 mmol/mol) and 0.671% (7.332 mmol/mol) at 3 and 6 months after the intervention (p < 0.05) while the mean increase in the PDSMS scores at 3 and 6 months after the intervention were significantly higher than those in the control group (p < 0.05). ConclusionThe health technology education program was more effective than routine shared care alone in lowering HbA1c and increasing self-management ability in T2D patients.

A New Self-management Scale with a Hierarchical Structure for Patients with Type 2 Diabetes

The aims of this study were to develop a new instrument for measuring self-management with a hierarchical structure [the Diabetes Self-Management Scale(DSMS)] in patients with type 2 diabetes, and evaluate its psychometric properties. The DSMS instrument was developed in three phases: (1) conceptualization and item generation; (2) content validity and pilot testing; and (3) field testing of its psychometric properties. A convenience sample of 473 participants was recruited in three university hospitals and one regional health center, South Korea. Exploratory and confirmatory factor analyses yielded two second-order component models explaining the common variance among six first-order factors. Principal axis factoring with a varimax rotation accounted for 60.88% of the variance. Confirmatory factor analysis of the hierarchical structure revealed the following fit indices: χ2/df=1.373, standardized root-mean-square residual=.050, goodness-of-fit index=.935, incremental fit index=.975, comparative fit index=.974, and root-mean-square error of approximation=.039. All Cronbach' α values for internal consistency exceeded the criterion of .70. All of the intraclass correlation coefficients for test-retest reliability exceeded .70 except that for the taking-medication subscale. The components of the DSMS were moderately correlated with the comparator measures of self-efficacy and health literacy administered for convergent validity. The DSMS is a new instrument for measuring the complex nature of self-management in patients with type 2 diabetes, comprising 17 items scored on a five-point Likert scale. The DSMS exhibits satisfactory psychometric properties for five reliability and validity metrics, and so is a suitable instrument to apply in both research and clinical practices.

825-P: Effects of Family-Related Factors on Diabetes Self-Management Behaviors

Many diabetes self-management behaviors (DSMB) take place in family settings, which highlights the importance of examining family-related factors associated with DSMB. Most current research has focused on the impact of family support on DSMB. Yet, how multiple family-related factors collectively affect DSMB remains unknown. The purpose of our study is to examine effects of positive family support, attitudinal familism, and perceived role demands associated with house chores and caregiving responsibilities on DSMB among a group of Chinese adults with type 2 diabetes mellitus (T2DM). A convenience sample of 210 patients with T2DM was recruited from a community health center in Beijing, China. Instruments included Diabetes Self-management Scale, Self-efficacy Scale for Patients with T2DM, Perceived Role Demands Scale, Attitudinal Familism Scale, and Diabetes Family Behavior Checklist-II. Findings from structural equation modelling showed that attitudinal familism, perceived role demands associated with house chores and caregiving responsibilities, and self-efficacy had direct impacts on DSMB. Attitudinal familism and positive family support both also had indirect effects on DSMB through self-efficacy (X2=3.31, p&amp;gt;0.05; RMSEA=0.022, CFI=0.998, SRMR=0.013). The indirect effect of positive family support on DSMB was 0.24, Bootstrap standard error=0.13, z=5.08, p&amp;lt;0.001; The indirect effect of attitudinal familism on DSMB was 0.15, Bootstrap standard error=0.04, z=3.44, p&amp;lt;0.01. Our findings suggest that it will be beneficial to improve patients’ self-efficacy in order to achieve optimal DSMB, especially for those who have less family support and lower attitudinal familism scores. It also indicates that more perceived role demands associated with house chores and caregiving responsibilities leads to less adherence to DSMB, and this relationship cannot be mediated by self-efficacy. Other strategies should be developed to help those with heavy role demands to achieve optimal DSMB. Disclosure K. Lin: None. L.T. Quinn: None.

The Relationships Among School Nurse to Student Ratios, Self-Efficacy, and Glycemic Control in Adolescents With Type 1 Diabetes.

Adolescents with Type 1 diabetes (T1D) experience unique self-management challenges, which can lead to poor glycemic control and sequelae. School nurses may impact student self-efficacy behaviors for T1D management in adolescents. The purpose of this study was to determine the relationships among school nurse staffing patterns, measured by school nurse to student ratios, self-efficacy, and glycemic control in adolescents with T1D. The sample consisted of 89 parent-adolescent dyads. Adolescents aged 10-16 years old with T1D completed the Self-Efficacy for Diabetes Self-Management (SEDM) Scale. Parents completed a demographic questionnaire. Higher school nurse to student ratios correlated with better glycemic control and older age. Higher SEDM scores correlated with older age, and females scored significantly higher. Findings contribute new knowledge to the paucity of literature on school nursing and adolescents with T1D, with implications for nursing practice, education, research, and policy.

Feasibility and efficacy of nurse-led team management intervention for improving the self-management of type 2 diabetes patients in a Chinese community: a randomized controlled trial.

AimThe aim of this study was to examine the feasibility and efficacy of nurse-led team management (NLTM) intervention at improving the self-management of patients with type 2 diabetes (T2D) at community settings in Changsha, Hunan, China.BackgroundChina has become the country with the largest number of patients with diabetes, and that number is growing, causing increasing pressure on the health care system. At present, the main diabetes management model in China is teamwork guided by general practitioners. However, the number of general practitioners is insufficient, and their work is overloaded, which leads to poor outcomes of diabetes management. Therefore, it is important to explore alternative methods of diabetes management, such as NLTM.Patients and methodsIn a randomized controlled trial, 171 T2D patients were randomized into the control or intervention arm. Participants in the control group received routine management from the community health service center, whereas the intervention group received 12 months NLTM intervention in addition to the standard care. The diabetes self-management scale, fasting blood sugar, and glycosylated hemoglobin A1c (HbA1c) were assessed at baseline and at 6 and 12 months after the start of the intervention.ResultsBaseline data were comparable between arms. Repeated-measurement analysis showed that self-management of the intervention group improved compared with the control group after the intervention (P<0.05). There were no significant differences in HbA1c at 6 months, whereas after 12 months of intervention, there was a significant difference in HbA1c between the two groups (F=10.114, P<0.05). The intervention had no significant effect on fasting blood sugar.ConclusionThe NLTM intervention has resulted in an impact of practical significance on T2D self-management, and was beneficial for controlling the level of HbA1c. The study has demonstrated the feasibility and efficacy of using NLTM in the management of T2D in a Chinese community.

Telemedicine-Assisted Self-Management Program for Type 2 Diabetes Patients.

Background: Lifestyle interventions with personalized self-management programs have shown benefits for patients with type 2 diabetes mellitus (T2DM), a devastating highly prevalent disease worldwide. Despite advances in drug therapy and nonpharmacological strategies achieved in the past recent years, self-management programs to be implemented in everyday life are needed. The aim of the present prospective study was to evaluate the effects, in terms of glycated hemoglobin (HbA1c) values and self-management behavior, of a telemedicine-assisted self-management program offered to T2DM patients by a large private health insurance company. Methods: Participants with T2DM included 60 adults in the intervention group (M = 59.4 years) and 55 adults in the control group (M = 58.4 years). In the beginning of the study, the intervention group was provided with a tablet computer, a glucometer, and a step counter. Additionally, they received an individual need-based telephone coaching to address and improve motivation and diabetes self-management in daily life. The control group received care as usual and were not offered additional treatment. The study examined the results of a diabetes lifestyle program after 3 months. Results: The intervention resulted in significantly greater declines in HbA1c compared with the control group. In addition, tele-assisted participants showed significant improvements in Diabetes Self-Management scale score and body mass index compared with usual care participants. Conclusions: Patients with T2DM can benefit from telemedicine-assisted self-management programs, which may offer new options for treatment and prevention of disease progression. More follow-up and research is needed to assess feasibility and effectiveness on a larger scale.

Development and validation of a comprehensive diabetes self-management scale

Development and validation of a comprehensive diabetes self-management scale