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Engaging the Disengaged Patient: Strategies for Successful Diabetes Self-ManagementSelf-care practices for better diabetes outcomes -
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Diabetes Care , 18 3 — Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Saurabh RamBihariLal Shrivastava. SRS wrote the first draft of the article and performed intensive review of literature. PSS edited the article continuously.
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Abstract Diabetes mellitus DM is a chronic progressive metabolic disorder characterized by hyperglycemia mainly due to absolute Type 1 DM or relative Type 2 DM deficiency of insulin hormone.
Self-Management in Diabetes Chapter © Healthy Lifestyles for the Self-Management of Type 2 Diabetes Chapter © Use our pre-submission checklist Avoid common mistakes on your manuscript. Introduction Diabetes mellitus DM is a chronic progressive metabolic disorder characterized by hyperglycemia mainly due to absolute Type 1 DM or relative Type 2 DM deficiency of insulin hormone[ 1 ].
Addressing needs of diabetic patients One of the biggest challenges for health care providers today is addressing the continued needs and demands of individuals with chronic illnesses like diabetes[ 12 ].
Self-care in diabetes Self-care in diabetes has been defined as an evolutionary process of development of knowledge or awareness by learning to survive with the complex nature of the diabetes in a social context[ 20 , 21 ]. Diabetes self management education Though genetics play an important role in the development of diabetes, monozygotic twin studies have certainly shown the importance of environmental influences[ 34 ].
Diabetes self-care activities Diabetes education is important but it must be transferred to action or self-care activities to fully benefit the patient. Compliance to self-care activities Treatment adherence in diabetes is an area of interest and concern to health professionals and clinical researchers even though a great deal of prior research has been done in the area.
Barriers to diabetes care The role of healthcare providers in care of diabetic patients has been well recognized. Recommendations for self-care activities Because diabetes self-care activities can have a dramatic impact on lowering glycosylated hemoglobin levels, healthcare providers and educators should evaluate perceived patient barriers to self-care behaviors and make recommendations with these in mind.
Implications for practice A clinician should be able to recognize patients who are prone for non-compliance and thus give special attention to them. Implications for future research As most of the reported studies are from developed countries so there is an immense need for extensive research in rural areas of developing nations.
Conclusion To prevent diabetes related morbidity and mortality, there is an immense need of dedicated self-care behaviors in multiple domains, including food choices, physical activity, proper medications intake and blood glucose monitoring from the patients.
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Richard R. Rubin; Sdlf-care Self-Care Effective Fat Burner People With Diabetes. Diabetes Spectr 1 April ; 14 Outcomws : 55— Why is diabetes Self-caee so difficult for most Self-care practices for better diabetes outcomes with putcomes, and what can we as health care providers do about it? These questions probably cross your mind numerous times every day. The answer to the first question is pretty clear—diabetes is a demanding disease. It is there all the time, 24 hours a day, days a year or days a year on Leap Year, as an 8-year-old patient recently pointed out to me.
Self-care practices for better diabetes outcomes -
in every meal and avoid refined cereal products like white bread, noodles, white rice, etc. Diet formulated with special ingredients like complex carbohydrates, vitamins and anti-oxidants help to manage the steady release of glucose.
It can be included in our breakfast, lunch or dinner as a partial meal replacement. Exercise is the most overlooked self-care, but should be considered in relation with the drug regimen. HbA1C Hemoglobin A1C is a simple blood test to measure our average blood sugar levels that shows how diabetes is managed over time.
It is important to get this test done either twice a year or once in three months, depending on how well your diabetes is controlled. Adhering to the prescribed medication at the recommended amount and schedule is important for having good diabetic control.
Missing medication can increase the risk of suffering from several diabetes-related health complications. Common complication of diabetes is known as diabetic dyslipidemia, where good cholesterol or HDL levels decrease and increase triglyceride and bad cholesterol or LDL levels.
This increases the risk for heart disease and stroke. Therefore, avoid a diet high in saturated and trans fats such as fast food â burgers, pizza, fried snacks as these raise our LDL cholesterol level. Eat right and drink plenty of water to avoid the most serious consequences of diabetes, i.
Obesity is the main problem for type 2 DM patients that escalates other complications. Dietary intervention and exercise are key elements for weight reduction in the management and treatment of obesity.
Maintaining dental health , like brushing and flossing right after eating, can minimize the effects of diabetes on gums.
If gum diseases develop, they have the potential to contribute to blood glucose irregularity. Visiting a dentist twice a year can help catch early symptoms.
As there is no generally acknowledged definition for self-management, it is confused to utilize different ideas like the guidance of self-care and self-management, patient activities, and self-management education. Self-management education conveyed as a short plea, enables the patient to recollect and have a better blend of information that enhances control of Type2 DM.
A multidisciplinary team involving educational supporters from hospitals and clinics, and the direct involvement of healthcare professionals is essential for the education program.
Self-care support system also includes family and friends to provide practical or emotional support. Family and friends play a crucial role in encouraging diabetic patients to adapt to the devastating situation, perform self-care activities and manage diabetes.
Peer and parental support can decrease the stress and encourage young people with Type2 DM to perform self-care practices and adapt according to the diabetes diagnosis. Although the diabetic management process in adolescents is almost the same as the adults, healthcare providers are usually uncertain about proper management guidelines to develop the knowledge and understanding for adolescent diabetic patients.
There are very limited experimental trials and the current guidelines for management for Type2 DM in adolescents and young adults are not fully evidence-based. Successful outcomes have been noticed for both Type 1 and T2DM in all age groups through a supportive team that recognizes the importance of social support to encourage diabetes self-care behaviors to lessen the burden of long-term complications.
Sreeja Dutta. Self-Care Practices in Diabetes Management. Feb 14, accessed Feb 14, Anita Ramesh. Stroop Effect. The total mean of days of conducting foot care practices is 2. These results are similar to the previous study results of [10] [15] [17], which showed that low mean score of foot care.
In contrast to the Bariyyah et al. On the other hand, the results of the current study are lower from what has been reported by Dedefo et al. Moreover, the results of the current study are lower from what has been revealed by Al Johani et al.
Low level of foot care among patients in the current study could be attributed to the large proportion of patients who are illiterate The current study results revealed that the mean of days in which the patients take recommended diabetes medication is 6.
The total mean of days of following medication practices is 5. The level of compliance of following medication practices by the patients is considered very well, this could be attributed to the fact that the patients are afraid of not taking their medication due to its fatal complication if not taken.
These results are somewhat consistent with the results of Al Johani et al. The patients in general especially not educated understand that the management of disease is only by taking medication.
In the current study, taking medication was the most commonly practiced form of self-care reported among patients, which clearly reflects a high level of dependence on medication.
The current study results were consistent with the study of Alsomali [22] in Saudi Arabia, which showed that taking of medication among people with type 2 DM was prioritized over other diabetes self-care activities, as it is an easy task, and patients face fewer challenges taking medication.
Regarding self-care management of testing blood glucose practices, the current study results revealed that the mean of days in which the patients test their blood glucose is 3.
The total mean of days of testing blood glucose is 2. These results are higher than what has been revealed by Dedfo et al.
The largest group of respondents was those who did not test blood glucose on any of the previous seven days On the other hand, the current study results are lower from what has been revealed by Alsomali [22], which revealed that more than half of the patients tested their blood sugar on two days in the last week or less.
These low levels, which revealed in the current study, could be explained by the absence of recommendations from healthcare providers regarding testing blood sugar, or a recommendation on the frequency of testing their blood sugar.
Similar studies suggest that blood sugar testing levels are generally low among diabetes patients, despite this being an essential part of diabetes control [15]. The patients in the current study are aware of the importance of testing their blood sugar level to manage their diabetes, and participants tested their blood sugar at times when they had eaten too much or were not sure if they had taken the correct medication dose.
An explanation of this low adherence level regarding testing blood glucose could be the difficulties in using the glucometer at home; many patients have technical difficulties in testing their blood sugar levels, especially those aged 50 and above. Another explanation could be attributed to the expensive status of the glucometer especially its sticks which prevent the patients from buying these sticks.
The current study results revealed that more than half meaning that 8. These results are lower from what has been by Noubiap et al. Low level of smoking among patients in the current study could be attributed to the Islamic approach within Saudi Arabia, in which smoking is forbidden in Islamic culture and religion.
Moreover, low percentage of smoking among patients in the current study could be attributed to the health education received by the patients and their health literacy in recent years since smoking interferes with insulin resistance and aggravates the micro- and macro-vascular complications of diabetes mellitus [26].
The study results revealed that the level of self-care management practices among patients with type 2 DM is not satisfactory, except in the medication domain.
In addition, healthcare providers need to provide guidance and a treatment plan uniquely suited to each individual patient. This can be achieved by health education presentations for the families of patients in order to improve their awareness about DM management.
Future research needs to examine the relationship between other variables and diabetes self-care practices among Saudi adults with type 2 DM by using a mixed methods approach. The study focused only on quantitative approach for describing and analysing issues pertaining to self-care management practices, mixed design often have border view than single approach.
In addition, the qualitative approach focused on the hidden issues related to self-care practices, which were not appeared in the study questionnaire. The author declares no conflicts of interest regarding the publication of this paper.
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Binary logistic regression analysis was used to identify any association between the dependent and independent variables. Variables with a p-value less than 0. In multivariable logistic regression model fitness was tested using Hosmer-Lemeshow goodness-of-fit. We checked multi-collinearity among selected independent variables via variance inflation factor VIF and none was found.
A p-value less than 0. The mean ± SD age of the respondents was 46 ± Three hundred and fifty one Five hundred and thirty seven Three hundred fifty-one The mean SD duration of DM was 6 ± 4.
A diabetes-related complication was seen in more than two-third of participants. Of the Of these who had personal glucometer majority On binary logistic regression analysis variables like age, educational status, family support, place of residency, BMI, duration of diabetes, and having personal glucometer at home were statistically associated with diabetes self-care practices.
The multivariable logistic regression analysis result showed that urban resident participants were 1. Participants who do not have any formal education were 2. In addition, patients with family or social support were also 1. Having a personal glucometer at home was also another factor associated with good self-care practices.
Patients with a personal glucometer at home were 6. Similarly, even though we hypothesized there could be an association between diabetes knowledge and self-care practice, the binary logistic regression analysis result also showed no association i.
Self-management strategies such as self-monitoring of blood glucose, dietary restrictions, regular foot care, and ophthalmic examinations have been shown to markedly reduce the incidence and progression of diabetes-related complications [ 8 , 5 ].
Self-care practices and lifestyle modification remains the mainstay treatment of T2DM [ 5 ]. This study was aimed to assess the level of self-care practices and associated factors among T2DM patients in public hospitals of the Tigray region, Ethiopia.
This study showed that less than half This was consistent with studies conducted in the Adama, Oromia region of Ethiopia, However, it was higher compared to other studies conducted in Bahir Dar, northwest of Ethiopia, which was only This difference could be due to variation in cultural, and socio-economic aspects of the society as Ethiopia is a diverse country [ 20 ].
Additionally, around one-third of participants in our study were from a rural area and they might be faced with difficulties in getting access to health care services, and opportunities for education on the management of their disease.
In the present study, self-care practice was significantly associated with the age of the participants. Similarly, a study from India [ 19 ] and Egypt [ 20 ] also showed that an increase in age was associated with good self-care practices.
This might suggest that the longer they stay with the disease, the more they become conscious and aware of their health and adjust their lifestyle. This study found that those with no formal education were more likely to adhere to diabetes self-care practice.
On the contrary, other studies found that the higher the educational status it is likely to have good self-care practice [ 10 , 13 , 18 ].
This could be because regardless of their educational status patient might adhere to self-care practices based on the information they receive from health care providers or the media. This might be also due to the social desirability bias as the questionnaire has been filled with an interviewer-administered method.
In line with this, in this study patients with a family or social support were more likely to have good diabetes self-care practice. This was supported by other studies conducted in Gondar, Ethiopia [ 21 ], and Malaysia [ 22 ].
A study conducted in Thailand on family-oriented self-management programs also showed that engaging family support for individuals with T2DM has the potential to reduce the demands on diabetes educators and health services by providing additional support and potentially reducing complications [ 23 ] which could be due to good a self-care practice.
The availability of a personal glucometer at home was very low In the present study, the odd of good self-care practices were high among patients who have personal glucometers at home.
This finding is also supported by other studies conducted in, the central zone of Tigray, Ethiopia, [ 12 ] and western Ethiopia [ 9 ]. Additionally, this study also showed that patients from urban areas were more likely to have good diabetes self-care practices compared to rural residents. This was in line with studies conducted in different parts of Ethiopia, such as Mekelle [ 24 ], Harar and Dire Dawa [ 18 ], Gondar [ 21 ], and India [ 25 ].
Previous studies have also found that, there is a misconception and poor knowledge both on the treatment and self-care practices of diabetes among patients from rural areas [ 26 , 27 ].
This variation could be explained due to easy access to information through media, the internet, and the health care facilities of urban residents. Different studies have shown that having a good or acceptable level of diabetes-related knowledge has been associated with good self-care practice [ 13 , 22 , 24 ].
On the contrary, our finding showed that there was no significant association between them. This multicenter study was conducted in six hospitals of the region and would have a better representation of the study participants and generalizability of the result. The use of multivariable logistic regression analysis would have benefit in controlling the confounding effect of variables.
However, this study also has some limitations, since this was a cross-sectional study, the causal effect relationship between variables could not be established. Secondly, as the study asks the self-care activities of patients for the past seven days and there might be a recall bias among respondents.
Another limitation of this study is that as the data were collected using an interviewer-administered method the responses are prone to social desirability biases. In conclusion, the level of diabetes self-care practice among T2DM patients in the Tigray region was found to be poor.
Urban residency, age group between 49—63 years, having family or social support, not having a formal education, and having personal glucometer at home were predictors of good self-care practices. This suggested that clinicians and nurses might have to consider giving emphasis on caring and giving follow-up services to DM patients coming from rural areas.
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Article Authors Metrics Comments Media Coverage Reader Comments Figures. Abstract Background The prevalence of type 2 diabetes is increasing steadily at an alarming rate. Methods An institution-based, cross-sectional study was conducted in six selected hospitals of Tigray region from January to February Results A total of patients with type 2 diabetes were included in this study.
Conclusion The diabetes self-care practice in the region was found to be poor. Funding: The authors received no specific funding for this work. Introduction Diabetes Mellitus DM is one of the fastest-growing global health emergencies of the 21 st century [ 1 , 2 ]. Data analysis The data were cleaned, coded, entered into Epidata.
Download: PPT. Table 1. Clinical characteristics of the respondents The mean SD duration of DM was 6 ± 4. Table 2. Table 3. Factors associated with diabetes self-care practice On binary logistic regression analysis variables like age, educational status, family support, place of residency, BMI, duration of diabetes, and having personal glucometer at home were statistically associated with diabetes self-care practices.
Uncontrolled hyperglycaemia can lead to macro- and microvascular fro. Adolescents with T2DM diaebtes similar complications Natural fat blocker in adults, including cardiovascular disease, Diqbetes, myocardial infarction, Self-care practices for better diabetes outcomes insufficiency, and diwbetes renal failure. Although regular medical follow-up Selfcare essential to avoid long-term complications, patients with diabetes mellitus need to perform holistic self-care activities such as opting for a healthy diet, physical activity, self-monitoring, and proper medication. To the best of our knowledge, only a limited number of studies have focused on self-care activities and self-management, including self-care practices, supportive networks, and self-care education programs in adolescent with T2DM. Some of the studies focused on the appreciation of self-care in adolescents with T2DM.
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