Diabetes Self-management In Patients Research Articles

Validation of the Arabic version of the diabetes self-management questionnaire in patients with type 2 diabetes mellitus: a cross-sectional study

BackgroundThe number of instruments available for measuring diabetes self-management activities in Arabic countries has been limited to date. To our knowledge, no multidimensional instrument suitable for measuring diabetes self-management is currently available in Arabic. This study assessed the validation of the Arabic version of the Diabetes Self-Management Questionnaire (A-DSMQ) in patients with type 2 diabetes mellitus (T2DM).MethodsThis cross-sectional study was conducted from May to August 2022 at primary healthcare centers within the Riyadh region of Saudi Arabia. Four steps were followed during the translation and adaptation of the DSMQ: forward translation, consulting an expert panel, backward translation, and pilot testing on the target population. The data were collected using a convenience sample of 154 patients with T2DM. Cronbach’s α coefficient, criterion validity, and known-group validity were determined.ResultsCronbach’s α coefficient for internal consistency was 0.76. The A-DMSQ “sum scale” scores were negatively correlated with glycosylated hemoglobin (HbA1c) levels (Pearson’s r = − 0.48, p < 0.01) and body mass indices (r = − 0.29, p < 0.01) and positively correlated with Self-Rated Health Scale scores (r = 0.41, p < 0.01). Mean A-DSMQ “sum scale” scores differed significantly among groups with adequate, partially adequate, and inadequate glycemic control (F = 23.193, p < 0.001).ConclusionsThese results indicate that the A-DSMQ is a reliable and valid tool for measuring diabetes self-management in patients with T2DM. The A-DSMQ can be used by researchers and healthcare providers interested in assessing diabetes self-management in this population. Healthcare providers should remain alert for suboptimal diabetes self-management, which may lead to significant economic costs in emergency and healthcare utilization.

Diabetic Self-Management and Correlated Factors: A Cross-Sectional Study

Prevention of diabetes complications has an important role in decreasing mortality and morbidity in diabetes patients. Self-management in diabetic patients (DSM) is a recommended strategy to increase the quality of life in diabetes patients. Several factors are related to self-management in diabetic patients. This study aims to discover factors related to self-management in diabetic patients. This is a cross-sectional study performed on 42 diabetic patients. Respondents were given a Diabetes Knowledge Questionnaire (DKQ-24) and a self-management behaviour questionnaire in Diabetes Mellitus (SMDM). Data was analyzed using SPSS version 26. This study had no significant relation between age and self-management (p = 0.987). There was also no statistically significant relationship between gender, education level, and knowledge level with p-value of 0.651, 0.559, and 0.558, respectively. Moreover, there was no correlation between participation in chronic disease management programs and self-management with p = 0.559. This study concluded no correlation between age, gender, education level, knowledge level, and participation in chronic disease management programs with self-management of diabetic patients.

The relationship between spiritual intelligence and self-management in patients with diabetes type 1

BackgroundDiabetes is widely recognized as one of the most pressing public health concerns globally. To manage blood glucose levels and reduce subsequent complications and mortality rates, self-management mechanisms have been found to be effective in controlling diabetes. This study aimed to investigate the association between spiritual intelligence and diabetes self-management in patients with type 1 diabetes in Qazvin, Iran.MethodsThis cross-sectional study included 220 adults with type 1 diabetes aged 18–35 years who referred to an outpatient diabetes clinic of a tertiary hospital in Qazvin province, and were selected through a convenience sampling method in 2022. Two valid and reliable questionnaires were used for data collection, including the 24-item questionnaire of spiritual intelligence and self-management of type 1 diabetes for adolescents (SMOD-A). To analyze the data, correlation coefficients and multiple linear regression analysis were used.ResultsThe total score of spiritual intelligence was 57.24 ± 10.77, and self-management was 77.14 ± 8.92. Among different subscales of spiritual intelligence, critical thinking obtained the highest score. In self-management, the highest score was achieved for communication.Findings also revealed that spiritual intelligence could predict 7.2% of changes in self-management among diabetes patients, and its relationship with diabetes self-management was estimated at 0.27.ConclusionThe growing prevalence of diabetes worldwide underscores the significance of self-management of the disease in the well-being of patients. This study demonstrated that spiritual intelligence played a crucial role among young adults with diabetes and assisted them in coping with stressful situations. As such, placing greater emphasis on the spiritual aspects of care is necessary, especially in the healthcare of young adults who are dealing with diabetes and its complex conditions.

The Effect of the Extended Parallel Process Model on Self-efficacy of Type 2 Diabetic Patients

Background: WHO reported that, diabetes is a silent killer among chronic diseases, and the prevalence of this disease increases with age. Self-efficacy (SEEF), as one of the constructs of health models, plays an essential role in improving the health and self-management of diabetic patients. Objectives: This study evaluated the effect of the extended parallel process model (EPPM) on the SEEF of type 2 diabetic patients. Methods: This experimental study was conducted on 60 patients randomly divided into two tests (30 people) and control (30 people) groups. The data collection tool was the SEEF questionnaire. In the test group, training was conducted based on EPPM structures in six sessions (45 - 60 minutes) once a week. Routine training was also performed in the control group. The data were analyzed by descriptive statistics (frequency, mean and standard deviation) and inferential statistics (covariance, two independent-samples t-test, paired sample t-test, Fisher and chi-square). Results: Two independent-sample t-test showed no significant difference between the test and control groups before the intervention regarding SEEF (P = 0.45). Meanwhile, a significant difference was observed between the test and control groups regarding SEEF (P &lt; 0.01) after the intervention. The covariance test showed a significant relationship between the effect of EEMP and the SEEF of diabetic patients by removing the pre-test effect (Eta = 0.63, P &lt; 0.01). Conclusions: Based on the results, the developed parallel process model (EEMP) increases SEEF in diabetic patients. This health model is considered an effective and low-cost care method.

Development of a high-performance liquid chromatographic glycated albumin assay using finger-prick blood samples.

Home blood glucose monitoring can be effective for the self-management of diabetic patients. Hemoglobin A1c (HbA1c) is a widely used marker that reflects the average blood glucose within 1-2months but does not sensitively respond to behavioral changes. Self-monitoring of blood glucose, continuous glucose monitoring, and flush glucose monitoring are sensitive; however, the cost and invasiveness of these tests prevent their widespread use. We focused on glycated albumin (GA), which reflects the average blood glucose levels over 1-2weeks, and established a GA measurement method for self-sampling, finger-prick blood, which may be submitted for testing through postal service to receive weekly results. A high-performance liquid chromatography assay was established to measure GA levels in finger-prick blood samples from 103 diabetic patients and the results were compared with venous blood measurements using an enzymatic method. Furthermore, conditions for sending blood samples by mail were evaluated. Under these conditions, samples from 27 healthy and 32 patient volunteers sent through postal service were compared with samples stored in the laboratory. GA levels were measured in samples containing>20μg albumin, which resulted in a CVless than0.3%. The correlation between the GA levels of finger-prick blood measured using HPLC and the GA levels of venous blood measured using the enzymatic method was R2=0.988 with the slope∼1.0, suggesting that the two were nearly equivalent. GA levels were stable for four days at 30°C and two days at 37°C. Mail-delivered samples exhibited a high correlation with samples that were not sent (R2>0.99). We established a method to measure GA levels in self-sampled, finger-prick blood sent through postal service in Japan. The method is applicable for weekly feedback of GA levels, which is potentially useful for motivating behavioral changes. In addition to markers such as HbA1c and blood glucose, GA can be used as a marker for assessing dietary and physical activities. This study highlighted the importance of GA monitoring by developing a suitable measurement method for weekly monitoring of GA levels.

Effect of educational intervention based on PRECEDE model on lifestyle modification, self-management behaviors, and hypertension in diabetic patients

BackgroundInappropriate lifestyle and poor self-management in diabetic patients lead to many complications including hypertension and increased disease burden. Because of insufficient studies on Effect of educational interventions on lifestyle, self-management and hypertension in diabetic patients, the present study aimed to evaluate the Effect of educational intervention based on PRECEDE model on lifestyle, self-management, and hypertension of diabetic patients.MethodsThis clinical trial was conducted on 300 diabetic patients with hypertension. The patients were selected using simple random sampling and divided into 2 groups of intervention (150 people) and control (150 people). The intervention group was trained through ten 50–55 min sessions on lifestyle skills, self-management, and hypertension control based on the PRECEDE model. Before and after the intervention, lifestyle skills, self-management, and PRECED model constructs were evaluated using a standard questionnaire. Data were analyzed by SPSS 20 software using t-test, Kolmogorov–Smirnov, and Chi-Square tests (P < 0.05).ResultsIn the intervention group, the mean score of different dimensions of lifestyle and self-management significantly increased from 110.45 ± 18.78 to 172.58 ± 186.66 and 64.33 ± 15.24 to 144.32 ± 15.82, respectively (P = 0.001). Mean systolic and diastolic blood pressure also decreased from 148.5 ± 5.39 to 123.54 ± 5.32 and 95.41 ± 3.12 to 72.24 ± 3.06 (P < 0.001). Moreover, the mean score of all the PRECEDE model constructs significantly increased after the intervention. In the control group, the mean score of the PRECEDE model constructs, the dimensions of lifestyle, self-management, and systolic and diastolic blood pressure did not change significantly before and after the intervention (P > 0.05).Conclusion‌ Based on the study's results, the PRECEDE model was found to be a non-invasive, non-pharmacological, cost-effective method without any complication and as a complementary action along with other methods in the treatment of diabetic patients.

Diabetes Distress Among Type 1 Diabetic Adolescents in a Tertiary Care Hospital in Pakistan.

Diabetes distress, a term used to describe negative emotions associated with diabetes, is the key factor responsible for the elevated risk of psychological burden and compromised self-management. The aim of this study is to determine the prevalence of diabetes-related distress among adolescent patients with type 1 diabetes (T1D) and to ascertain various factors associated with it. In this cross-sectional study, 117 T1D patients with age 12-20 years visiting a diabetic clinic in the Department of Endocrinology and Metabolism,Services Hospital Lahorefrom February 2022 to August 2022 were enrolled. The patient's demographic and clinical details were noted in a pre-designed proforma. T1D distress scale (T1DDS) was utilized as the tool for measuring diabetes distress and distress was classified as severe, moderate, and no/little distress. Of the total 117 T1D patients, 34.2% (n=40) had diabetes-related distress, out of which 31.6% had moderate and 2.6% had severe distress. The average total distress score was 1.73 ± 0.52 and higher mean scores were of powerlessness, negative social perception, and eating distress. Distress was higher among females, in those with the onset of diabetes in teens rather than in childhood. There is a significant impact of glycated hemoglobin (HbA1c) on the severity of diabetes distress as demonstrated by Pearson's correlation (r=.570, n= 117, p = <.001) Conclusion:The present study highlights the association of diabetes distress in adolescents with various factors, most significantly poor glycemic control, and therefore emphasizes the need for developing psychological interventional strategies in routine diabetes care to improve the mental well-being and self-management of diabetic patients.

Analisis Multifaktor yang Berhubungan dengan Self-Management pada Pasien Diabetic Foot Ulcer (DFU)

This study aims to analyze self-management factors in Diabetic Foot Ulcer (DFU) patients. This research uses the literature review method with keywords in EBSCO Host, Willey, Pubmed, Science Direct, and Research Gate databases. The study results obtained that the stress factor is the factor that most influences self-management in diabetic patients. Stress can be overcome by having a good level of spirituality in patients, as encouragement and motivation in carrying out good self-management. External support factors and the support of those closest to them can also motivate DFU patients to carry out self-management. Cultural and spiritual factors also influence DFU patients in carrying out and undergoing self-management in everyday life. In conclusion, stress factors, education, foot care self-care behavior, duration of DM, culture, and spirituality have a relationship to self-management of diabetic foot ulcer patients (DFU).&#x0D; &#x0D; Keywords: Diabetic Foot Ulcer, Self Management

Self-management Effectiveness on the Quality of Life of Type 2 Diabetes Mellitus Patients during the COVID-19 Pandemic in Aceh, Indonesia

Background: Type 2 Diabetes Mellitus (DM) is a comorbid factor with a double risk of increased morbidity and mortality due to COVID-19. Therefore, diabetic patients need to prevent COVID-19 seriously. However, they also need to regularly check their condition in health care services, such as hospitals and community health centers, making them more vulnerable to Covid-19 infection. One factor playing a significant role in controlling diabetes is self-management. Self-management activities can increase independence in caring for and controlling the health of diabetic patients. Then, it also enhances self-efficacy to improve the quality of life among diabetic patients. This study aimed to examine the effect of self-management on quality of life among patients with type 2 DM.&#x0D; Method: Fifty patients with type 2 DM consented to participate in the study. The patients were assigned to either the control group receiving standard care or the experimental group receiving standard care and self-management. The program was constructed using Kanfer’s three self-management steps, including self-monitoring, self-assessment, and self-reinforcement. The effect of the intervention was measured by the WHO Quality of Life Questionnaire (WHOQOL-BREF), consisting of 26 statement items on a 5-point Likert scale and a self-management intervention evaluation checklist. Data were analyzed using an independent sample t-test.&#x0D; Results: The results showed a significant difference between the pre and post-intervention in the experimental group's quality of life of type 2 DM patients (p=0.000 and α = 0.01).&#x0D; Conclusion: This study found that self-management effectively increases the quality of life among diabetic patients. The health care providers, especially the nurses interested in community and family health nursing, are suggested to improve the self-management of diabetic patients to prevent complications and improve the quality of life of the patients.

Glucose sensing on screen-printed electrochemical electrodes based on porous graphene aerogel @prussian blue.

As one of the three major chronic diseases, diabetes often causes many complications, which can affect various parts of the body and even threaten the life of the patients. At present, the situation of diabetes in the world is quite serious. Accurate detection of blood glucose is very important for the diagnosis, treatment and medication of diabetes as well as the self-management of diabetic patients. In this paper, an electrochemical glucose biosensor was developed based on screen-printed electrode (SPE) modified with composite material of graphene aerogel (GA) and Prussian blue (PB) (denoted as GA@PB), which was fabricated via chemical reduction using L-ascorbic acid as a reducing agent through a freeze-drying process. Glucose was specifically captured by glucose oxidase (GOx) which were immobilized into the GA@PB by chitosan. The structure and performance of the sensor were characterized by scanning electron microscopy (SEM), Raman spectroscopy measurements, Fourier transform infrared spectrometer (FTIR), cyclic voltammetry (CV) and amperometric detection. The sensor exhibited a linear range of 0.5-6.0mmol·L-1 with limit of detection (LOD) of 0.15mmol·L-1, indicating that the combination of graphene aerogel and Prussian blue possess well conductivity and catalytic performance.

Hubungan Ketakutan akan Hipoglikemia dengan Manajemen Diri Pasien Diabetes Melitus Tipe 2 di RSD dr. Soebandi Jember

Hypoglycemia is a complication of diabetes that causes unpleasant symptoms and fear for recurrence. This fear can influence diabetes management and patient metabolic control. The study aimed to analyze the relationship between fear of hypoglycemia and self-management of type 2 DM patients at dr. Soebandi Jember general hospital. The fear of hypoglycemia variable was measured using the Fear of Hypoglycemia Scale questionnaire (FH-15) and the variable of diabetes self-management was measured by the Diabetes Self-Management Questionnaire (DSMQ). The sample was 84 respondents that recruited using consecutive sampling method. Data was analyzed using the Spearman correlation test with α = 0.05. The results showed that patients did not experience fear of hypoglycemia (78.6%) and self-management of diabetic patients showed a good category (77.4%). There is a significant and positive correlation between the two variables (p-value = 0.012 and r = 0.272) which means that the more fearful the patient the more self-management gets worse, and conversely the less afraid of the patient the better self-management of diabetes. Family involvement is support for patients in controlling their fears, recognizing signs of hypoglycemia and as a reminder in managing proper diabetes. Diet control is an indicator of diabetes management that must be considered for patients to improve their health status by optimizing nutrition to prevent recurrent hypoglycemia.

Portable and Intelligent Urine Glucose Analyzer Based on a CdTe QDs@GOx Aerogel Circular Array Sensor.

Diabetes is a public health problem characterized by hyperglycemia, high mortality, and morbidity. A simple, rapid, and sensitive glucose detection method for diabetes screening and health self-management of patients with diabetes is of great significance. Therefore, an attractive urine glucose (UG) analyzer with advantages of fastness, sensitivity, and portability was developed. A cadmium telluride quantum dots (CdTe QDs)@glucose oxidase (GOx) aerogel circular array sensor can emit visible red fluorescence when excited by a 365 nm ultraviolet light source inside the analyzer. When urine samples containing glucose were dropped onto the sensor, glucose was oxidized by GOx to produce hydrogen peroxide (H2O2), which quenched the red fluorescence of CdTe QDs. The fluorescence images of the sensor were obtained using a CCD camera, and the linear relationship between the glucose concentration and the gray value of the fluorescence image was established. The analyzer shows good sensitivity (LOD, 0.12 mM) with a wide linear range of 0.12–26 mM. Based on the linear relation, the software of the analyzer was written in the C++ language, which can automatically give the gray value of the image and the corresponding glucose concentration. The UG analyzer was used for the detection of a large number clinical samples and compared with a variety of UG test papers, which all showed good detection performance. The novel analyzer we proposed has an important significance in the screening of diabetes and the self-management of diabetic patients.

Promoting food literacy in type 2 diabetes: a systematic review

Abstract Background Diabetes is one of the major global health threats whose burden is sharply increasing. Food literacy is proved to be relevant to optimize self-management in diabetic patients. The present review aims to map the current literature on educational interventions to promote food literacy in type 2 diabetes, with a particular focus on the concept of patient engagement. Methods Five databases were queried using the Population-Intervention-Context-Outcome (PICO) model. Individual study quality was assessed using the Quality Criteria Checklist for primary research provided by the American Diabetes Association. Data were summarized using descriptive statistic and a comparison between intervention carried out by a multidisciplinary team versus a single professionist was performed adopting a Chi-square test (p &amp;lt; 0.05 was deemed as statistically significant). Results Of 1580 articles, 28 were finally included. Outcome categories were narratively labelled as “clinical”, “psychological”, “behavioural” and “literacy”. When the provider was a multidisciplinary team (25% of studies) improvement in self-management occurred in 86% of cases while in single-provider intervention the percentage was 71%, but the difference was not significant (p = 0.45). In the 10.7% of articles the use of technologies was reported, but generically descripted as the use of webpages, email or social media. Globally, an improvement in food literacy was reported in 75% of the interventions. Conclusions Nowadays, the use of a technology proxy is recognized as an efficient support in boosting patients' education, but the evidence in improving food literacy is scarce and difficult to compare. Public health programs improving food literacy are effective at different levels. These findings should encourage decision makers to allocate resources in this kind of programs. Key messages Engaging people in the management of their disease by increasing food literacy level may represent a first step to reach the “health in all policies” approach. When planning a public health intervention, allocating resources for improving individual’s education is essential to achieve better health outcomes.

A cross-sectional study on the telemedicine usage and glycemic status of diabetic patients during the COVID-19 pandemic

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic disrupts selfmanagement in diabetic patients in Indonesia. This study aimed to determine the telemedicine usage and factors contributing to glycemic control in type 2 diabetes mellitus (T2DM) patients during the pandemic.&#x0D; METHODS A cross-sectional study was conducted in T2DM patients aged 25–54 years. The questionnaire included general characteristics, diabetes conditions, consultation factors, and self-care management. Glycemic status was evaluated using glycated hemoglobin (HbA1c) levels, which was categorized into poor (HbA1c≥7%) and good glycemic control (HbA1c&lt;7%). Data were analyzed using chi-square and binary logistic regression.&#x0D; RESULTS Of 264 patients, only 19.2% used telemedicine and 60.2% had poor glycemic control during the pandemic. Overweight or obesity (odds ratio [OR] = 5.740 [95% confidence interval [CI] = 2.554–12.899]; p&lt;0.001), insulin injection (OR = 3.083 [95% CI = 1.238–7.677]; p = 0.016), and frequent fried food consumption (OR = 5.204 [95% CI = 1.631–16.606]; p = 0.005) were the factors contributing to poor glycemic control. The risk is lower if exercised regularly (OR = 0.036 [95% CI = 0.007–0.195]; p&lt;0.001) and consulted with a doctor using telemedicine (OR = 0.193 [95% CI = 0.044–0.846]; p = 0.029) or in-person visits (OR = 0.065 [95% CI = 0.016–0.260]; p&lt;0.001).&#x0D; CONCLUSIONS Glycemic control was not optimal during the COVID-19 pandemic. Therefore, keeping a healthy lifestyle and staying connected with a doctor are important to ensure optimal blood glucose control and reduce the risk of diabetesrelated complications.

Knowledge, attitude, and practice towards self-management among diabetic patients at Debre Tabor General Hospital chronic diseases follow-up clinic, Northwest Ethiopia

Self-management in diabetic patients is vital to keep the illness under control and avert any long term complications. Effective management of diabetes is a difficult task without an adequate understanding of the existing level of knowledge, attitude, and practice related to self-management. Knowing the level of knowledge, attitude, and practice towards self-management may help to provide information for health policy-makers to design and implement effective interventions to reduce diabetes-related morbidity and mortality. To assess the level of knowledge, attitude, and practice towards self-management among patients with diabetes at Debre Tabor General Hospital chronic diseases follow up clinic. An institution-based cross-sectional study was conducted from February to March 2016. A systematic random sampling technique was employed to select 206 patients. A structured pretested interviewer-administered questionnaire was used to collect data. The data were entered and analyzed using SPSS version 20. More than half of the study participants 114 (55.3%) had poor knowledge about diabetic self-management. Poor attitude of diabetic self-management was detected among 109 (52.9%) of studied patients. Nearly two-thirds 136 (66.0%) of the study participants had poor practice towards self-management. More than half of the participants had poor knowledge and attitude towards self-management and nearly two-thirds of them had poor practice. It is better to emphasize the importance of the patient as the key person in diabetic management.

SAT-637 Patient-Centered Glycemic Management of Type 2 Diabetes with Mobile Applications

BACKGROUND: Ehealth apps have 3.7 billion downloads yearly. The accessibility of diabetes mobile applications allows for patient self-management of diabetes. Renal and cardiovascular complications,1 which play a role in diabetic patient outcomes, are newly highlighted by the 2019 American Diabetes Association’s Standards of Medical Care in Diabetes.2 Purpose: To evaluate free Android mobile apps using the Diabetes Self-Management Education and Support (DSMES) and the 2019 American Diabetes Association (ADA) guidelines for renal and cardiovascular complications. Methods: Using the search term “diabetes,” Google Play store was accessed. Inclusion criteria: 1) Apps with downloads 1M-100,000; 2) free; 3) DSMES criteria; and 4) medication adherence. Exclusion criteria: 1) Purely educational factual apps on diabetes; 2) no ranking or download information. Google displayed a list of 10 free apps in 2019. The 2019 apps were analyzed for DSMES criteria, renal and cardiovascular complications (ADA 2019), and medication adherence via push notification. Results: The top 10 mobile apps in descending order were: 1) mySugr, 2) Onetouch Reveal, 3) OneDrop Diabetes Management, 4) Diabetes: M, 5) Diabetes, 6) Ontrack Diabetes, 7) Health2Sync, 8) Diabetes Connect, 9) Glucose Buddy Diabetes Tracker, 10) Blood Glucose Tracker. All of the mobile apps had the functionality of tracking blood glucose levels. 8/10 had the ability of tracking HbA1C levels. The percent of DSMES incorporation within the apps ranged from 18.2%-81.8%. None of the apps used all the DSMES guidelines or 2019 ADA. Only 1/10 of the mobile apps had the ability to track the presence of heart palpitation and retina/eye issues recommendations. None of the apps had the ability to track cardiovascular and renal complications. 7/10 of the apps had medication reminders (sound notification) and 4/10 of the apps had push notifications. Conclusion: eHealth mobile apps could be a powerful tool for patient self-management of diabetes. Currently, none of the apps incorporate all of the DSMES or ADA guidelines regarding comorbidities and complications of diabetes. Despite these shortcomings, these apps provide an introduction to the concept of patient-centered tracking of health data. We look for future improvements as more physicians use the apps and provide feedback to the app developers and eHealth commerce space.

Psychological distress and diabetes self-management in patients with type 2 diabetes and comorbid serious mental illness

Diabetes mellitus is a chronic disease of the endocrine system characterized by abnormal glucose metabolism, the most common variety being type 2 diabetes (T2DM), which usually occurs in adults. The WHO estimates that 422 million people have diabetes and there is an increasing global prevalence (W.H.O., 2016). Uncontrolled T2DM may be associated with the development of complications such as macrovascular disease peripheral neuropathy and retinopathy that may induce quality-adjusted life-years decrements in patients (Shao, Yang, Fonseca, Stoecker, & Shi, 2019).

Is diagnosis of type 2 diabetes a “teachable moment”? A qualitative study

AimsTo explore the potential of type 2 diabetes diagnosis to be a “teachable moment”. MethodsSemi-structured interviews were conducted with 23 participants (10 people with type 2 diabetes, 13 relatives of people with type 2 diabetes) in Scotland, UK. They explored cognitive, emotional and behavioural changes following diagnosis of type 2 diabetes in oneself or in a relative. Data were analysed using Framework approach. ResultsStrong emotional responses are not always related to the occurrence of a teachable moment. Risk perception and outcome expectancy were found to be teachable moment factors for patients with type 2 diabetes and their offspring, but not their partners. Change in self-concept increases the likelihood of type 2 diabetes diagnosis to be a teachable moment for patients but not for relatives. In some cases, type 2 diabetes is perceived as incompatible with current roles thus hindering diabetes self-management. Relatives often engage in caring for patients and “policing” their behaviour but did not report perceived changes in social roles. ConclusionsThe study suggests that diagnosis of type 2 diabetes is a teachable moment for some patients and their relatives. These findings have implications for interventions to address diabetes self-management in patients and primary prevention in their relatives.

Efektifitas Pemberdayaan Keluarga Terhadap Kontrol Metabolik Pada Pasien Diabetes Mellitus Tipe 2

Background : Family empowerment plays an important role in the management of diabetes mellitus experienced by family members. Because of the chronic nature of this disease, people with diabetes mellitus need long-term assistance to improve self-care and delay chronic complications from diabetes mellitus through glycemic control. Aim : To conduct a systematic review and assess the effectiveness of family empowerment for metabolic control in patients with type 2 diabetes mellitus. Method : Systematic reviews are carried out using electronic databases in article searches such as PubMed, ScienceDirect, ProQuest, Google Scholar. Results: After reviewing five articles it was found that family-based intervention or by empowering families in the care of patients with diabetes mellitus played a role in decreasing HbA1c as an indicator in glycemic control. And the most widely used instruments are the scale of self-care and diabetes activity (SDSCA), the diabetes empowerment scale (DES) and the diabetes knowledge questionnaire (DKQ). Conclusion : From the review of the article reviewed it can be concluded that families must be involved in the care of people with diabetes mellitus, diabetes education given only to individuals with type 2 diabetes limits the impact on patients, therefore empowering families will provide a large role in the management of chronic diseases that emphasize context where this disease occurs including the family's physical environment, education, and the personal needs of patients and family members. Helps develop healthy family behavior and shows self-management of diabetic patients, especially in health care programs, especially those who are able to promote various forms of social support, glycemic control and to strengthen ties between family members.Keywords : Family empowerment, metabolic control, type 2 diabetes mellitus.

Motivation for change, cornerstone of diabetes self-management in patients with type 2 diabetes

Abstract Background Personal motivation for change plays a fundamental role in creation of sustainable changes regarding diabetes self-management. The aim of this study is to assess the motivation as well as the relation between the level of patient`s motivation in relation to disease characteristics, metabolic control, behavioral determinants and the barriers patients encounter in diabetes self-management. Methods The data for this cross-sectional study were obtained by combining anthropometric measurements (body mass index-BMI), biochemical parameters (glycosylated hemoglobin-HbA1c) and by interviewing respondents using certain sub-scale of a structured Personal Diabetes Questionnaire (PDQ). Results The sample consisted of 117 respondents with T2DM. The majority (61.06%) was not motivated to make self-management changes. Non-motivated respondents were older than 65 years of age (X^2=8,046; p = 0.005) and had: a lower level of education (X^2=35.320; p = 0.000), diabetes for more than 10 years, poor glyco-regulation (90,14%) and were overweight / obese (81,7%). Motivated respondent were more physically active (X^2=6.439; p = 0.000), more adherent to anti-hyperglucemic therapy (OHAs) (X^2=9.673; p = 0,002), and more adherent to dietary regime. Average barrier scores: in the following healthy diet [t=-7.960; p = 0.000], in therapeutic adherence [t=-4.318; p = 0.000] and physical activity [t=-6.439; p = 0.000] were also statistically significantly different with the high impact in relation to respondents’ motivation. Conclusions Assessment of the motivation for changes in diabetes self-management should become an integral part of monitoring patients with T2DM in Primary Health Care (PHC). In this way, individual advisory strategies could be developed, because motivated and not motivated persons have different needs for counseling. Key messages Motivated and not motivated persons with T2DM have different needs for counseling. Assessment of the motivation for changes in diabetes self-management should become an integral part of monitoring patients with T2DM.