Diabetes self-management strategies -
Among non-completers, 20 withdrew because of the COVID pandemic and 10 lacked results of study blood tests. The socio-demographics of the participants are shown in Table 1. They were all Vietnamese. The majority had an education background of secondary school or above Fully Relative to lifestyle behaviors, The average HbA1c was 7.
According to ADA criteria The prevalence of overweight and obesity, android obesity and dyslipidemia were and The DSM and its internal consistency are shown in Table 2.
The mean total DSM score based on the V-DSMI self-administered questionnaire was The score for mean self-integration was Table 3 shows a comparison of the mean total DSMI scores across groups of participants by socio-demographic characteristics.
Table 4 gives information on the mean DSMI total score in accordance with clinical characteristics. The independently predictive factors of the DSMI total score resulted from multivariate linear regression are shown in Table 5.
Diabetes self-management can help achieve good individualized glycemic control to reduce the risk of diabetes microvascular and macrovascular complications [ 36 , 37 ]. Therefore, the latest ADA guidelines for the care of diabetes include self-management behavior SMB as a central component in diabetes treatment [ 32 ].
In addition, any diabetes self-management interventions were based on the 5 domains of DSMI self-integration, self-regulation, interaction with health professionals, self-monitoring blood glucose, and adherence to recommended regimen [ 33 ].
Our study provides insights into the self-management behavior characteristics of patients with DM, the majority of whom have type 2 diabetes, who are receiving primary care in central Vietnam. Our purpose was to examine diabetes self-management and its related factors by using the V-DSMI, a validated diabetes self-management instrument.
This study showed that the mean total DSM score based on the V-DSMI self-administered questionnaire was In the cohort of Vietnamese patients with diabetes in this study In addition, sex, educational status, BMI, waist circumference, following a medical nutrition therapy plan, and sufficient physical activity were independently predictive factors of DSMI total score.
In a comparison of DSMI scores with other regions, our outcomes are in line with the results of a study conducted in China [ 38 ] which showed that the mean DSMI score was However, our DSMI scores are lower than those found by Azar and his colleagues in Iran [ 33 ].
Their study showed that the mean total DSM score based on the DSMI self-administered questionnaire was These differences in DSMI scores may be explained by differences in the sample sizes, healthcare systems diabetes educational programs , healthcare settings, socio-demographic variables educational level , and time of their study.
That the current study was conducted during the COVID pandemic period could potentially account for lower DSMI scores.
Previous studies have reported a negative effect of COVID lockdown on diabetes self-management with blood glucose levels fluctuating more during the COVID lockdown being attributed to poor diet patterns, increased anxiety, and reduced physical activity levels [ 39 — 42 ].
This finding may be attributed to a higher educational level translating into better knowledge, attitudes and practices related to prevention and control of DM.
Higher educational levels were also associated with better adherence to diabetes medications, medical nutrition therapy, and better interactions with doctors [ 43 , 44 ].
Similarly, patients with higher educational levels are more likley to engage in DSM education programs and practices. Our study showed that participants following recommendations for medical nutrition therapy and physical activity had significantly higher DSMI scores than others. Additionally, medication adherence, medical nutrition therapy and regular physical activity are the focus of the DSM education programs which provide the knowledge and skills to help optimize glucose levels and prevent diabetes complications.
Notably, this study showed that the rate of good glycemic control was While this result is in line with other studies in Vietnam and other countries [ 45 — 47 ].
Although there are now many diabetes medications available to treat people with DM, there is still a need for use of these medications to be optimized. Clearly, engaging in DSM including adherence to DM medications helps people living with diabetes to achieve glycemic control reinforces their confidence in diabetes self-management [ 48 ].
In this study, other demographic and clinical factors were not significantly related to the total DSMI score. The multivariate linear regression model results lead to the conclusion that DSMI total score can be predicted through sex, educational status, BMI, waist circumference, medical nutrition therapy, and sufficient physical activity.
Sex plays an important role in adherence to self-management. As was the case in this study, female patients have been shown to more frequently engage in DSM, be more focused on self-care, and to search diabetes information more than males in a previous study [ 49 ].
Abdominal obesity has been shown to be a barrier to DM in self-management as those with bigger waist circumference were found to have more limitations in physical activities resulting in a obstacle to diabetes self-management [ 50 ].
Patients with DM with high BMI are generally well aware of the need to strictly follow physical activity and medical nutrition therapy regimens as well as healthy medication adherence behaviors [ 51 ].
However, there are some limitations in this study. First, a cross-sectional study at a single hospital with convenience sampling may not be generalizable to the whole picture of DSM among Vietnamese patients with DM.
The sample size was We were unable to use the shortened version of the DSMI which includes 20 items because it is currently unavailable in Vietnamese. The short version may be preferable for wider scale future administration, however, use of the full DSMI did allow us to obtain interesting insights into DSM in the present study.
Fourth, other related variables which might affect DSM status in people with diabetes, including prior participation in DSM education known to be essential to successfully acquiring DSM skills and knowledge, psychological illness including diabetes distress, depression, etc , medical insurance status, isolation status due to the COVID pandemic, and medical treatment costs were not collected in this study.
These limitations highlight the need for future research on DSM and the need for diabetes self-management education and support in adults living with DM in Vietnam.
The results of this cross-sectional study of the state of DSM among patients with diabetes at a single hospital in central Vietnam demonstrates that the status of diabetes self-management may be classified as average at this time, as reflected in the mean DSMI score of Female sex, higher educational status, higher BMI and waist circumference, following a medical nutrition therapy plan and regular sufficient physical activity were independently predictive factors of DSMI total score.
These findings demonstrate a need for improvement in diabetes self-management in the central region of Vietnam. There is clearly a need for further research into strategies to provide diabetes self-management education and support, particularly among those who are male, have a lower educational status and are not following medical nutrition therapy and regular physical activity regimens.
The authors would like to thank the patients who agreed to participate in this cohort study. Our sincere gratitude is expressed to Tiet-Hanh Dao-Tran and her colleagues for the Vietnamese version DSMI. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field.
Article Authors Metrics Comments Media Coverage Reader Comments Figures. Abstract Objective Diabetes self-management DSM enables maintenance of optimal individualized glycemic control for patients with diabetes through comprehensive lifestyle, medication adherence, and self-monitoring glucose level.
Methods A cross-sectional study was conducted at a single hospital in the central Vietnam. Results The mean total DSM score based on DSMI self-administered questionnaire scores was Conclusion This study emphasizes that the DSM situation is seen to be average among DM patients with mean DSMI score Funding: The authors received no specific funding for this work.
Introduction Globally, diabetes mellitus DM is recognized as one of the four major non-communicable diseases besides cardiovascular disease, cancer, and chronic respiratory diseases. Methods Study design and sampling From March to May , we conducted a cross-sectional study among outpatients at the Center of Endocrinology and Diabetes, Da Nang Family Hospital, Da Nang, Vietnam.
Ethical approval This study was conducted in accordance with the Declaration of Helsinki. Data measurements Socio-demographic information.
Clinical features. The Diabetes Self-Management Instrument DSMI. Data analysis To perform all data analysis, SPSS software version Results A total of participants consented to join the study among whom Download: PPT.
Table 1. Socio-demographic characteristics of DM participants. Table 2. Diabetes self-management scores and internal consistency. Table 3. The mean total DSMI scores across groups by socio-demographic characteristics.
Table 4. Clinical characteristics and the mean total DSMI scores by clinical characteristics. Table 5. Factors independently predictive of total DSMI score via multiple linear regression analysis. Discussion Diabetes self-management can help achieve good individualized glycemic control to reduce the risk of diabetes microvascular and macrovascular complications [ 36 , 37 ].
Conclusion The results of this cross-sectional study of the state of DSM among patients with diabetes at a single hospital in central Vietnam demonstrates that the status of diabetes self-management may be classified as average at this time, as reflected in the mean DSMI score of Supporting information.
S1 Data. s XLSX. Acknowledgments The authors would like to thank the patients who agreed to participate in this cohort study. References 1. Saeedi P. Hamid Akash M. J Pak Med Assoc, Rehman K. and Akash M.
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search close. PREV Sep 15, NEXT. A 3 , 8 — 10 Patients with prediabetes should be encouraged to engage in minutes per week of moderate-intensity physical activity e. A 3 , 8 — 10 Receptive patients with type 2 diabetes mellitus should be provided a structured intensive lifestyle intervention program e.
C 3 , 11 , 12 Patients with type 2 diabetes should be encouraged to engage in minutes per week of moderate-to vigorous-intensity aerobic exercise over three or more days, with no more than two days between exercise bouts, as well as moderate to vigorous resistance training two or three days per week.
Impact of Timing. Assessing Patients' Readiness for Change. Patients may slide backward through these stages. Many patients attempt major lifestyle changes numerous times before succeeding. Assessing conviction and confidence. My job is not to talk you into something, but it is my job to make sure you understand the implications to your health.
Can we talk about some of these implications? Are you interested? Could you make this a part of your weekly routine if you start with briefer workouts just twice a week? How would that work? Clearly there are things you like about your current diet that make it hard to change.
Tell me about that. Let's imagine for a moment that you did make this change. How do you think you would feel a year from now? Succeeding for good means learning from previous attempts what works and what does not work for you.
Let's discuss what you have learned about what works and does not work for you. How long did you continue that effort? What helped you succeed for that long? What benefits did you notice? What do you think will work for you now?
Tell me about some of the other things you have successfully changed in the past. What might help with those obstacles now? to exercise for 90 minutes? For patients who are ready to change, the following approach is recommended. SET CLEAR OUTCOME GOALS AND BEHAVIOR TARGETS.
Sample lifestyle action plan. Weight Loss. Physical Activity. Maintaining Lifestyle Changes. REVISE THE ACTION PLAN. ENCOURAGE AND EMPOWER. HELP WITH THE STRUGGLE. Choose an option. Plan : Whenever my friend cancels, I'll do X instead. Try and see : If it worked out, great!
If not, brainstorm again for next time. I knew I couldn't do this. I give up. What triggered this slip? What can I learn from that? Continue Reading. More in AFP. More in Pubmed. Copyright © by the American Academy of Family Physicians. Copyright © American Academy of Family Physicians. All Rights Reserved.
Patients with prediabetes should be encouraged to engage in minutes per week of moderate-intensity physical activity e. Receptive patients with type 2 diabetes mellitus should be provided a structured intensive lifestyle intervention program e.
Patients with type 2 diabetes should be encouraged to engage in minutes per week of moderate-to vigorous-intensity aerobic exercise over three or more days, with no more than two days between exercise bouts, as well as moderate to vigorous resistance training two or three days per week.
Personalized coaching to tailor motivational enhancement and skill development to suit the participant, using a mix of group and individual sessions.
Long-term goals broken into small daily and weekly behavior goals with planned implementation tracking, and homework. USDA food pyramid note that USDA updated its consumer guidance to MyPlate in , reading food labels, principles of aerobic fitness frequency, intensity, time, type , and exercise safety.
Look AHEAD additionally encouraged the use of commercial replacement meals for breakfast and lunch during the first six months. Plan ahead, be assertive, develop stimulus control, and make healthy food choices. Incorporate lifestyle activities, such as taking stairs instead of elevators. Change environment to minimize triggers for unhealthy behavior and maximize triggers for healthy behavior.
Develop specific strategies for coping with parties, vacations, and holidays. Check for cues e. Follow steps: describe the problem-related chain of events, brainstorm options for resolving the problem, pick one, make a plan, try it. Identify common patterns of self-defeating thoughts and counter with positive statements.
Identify stress early and practice breathing or self-soothing techniques; exercise. Detailed teaching materials for a one-year program; updated from the original Diabetes Prevention Program intensive lifestyle intervention. The Centers for Disease Control and Prevention recognizes such programs, and to date, this program is offered by 1, community agencies across the United States.
Preparing for change e. Praise preparation; discuss options; assist in setting initial goals and behavior targets; set a start date.
Praise all efforts; encourage one or two small, realistic steps; begin to anticipate obstacles. Praise all efforts; encourage one or two small, realistic steps; help patient manage obstacles and slips. Ask about benefits noticed e.
Incorporating the change into routine and view of self e. If conviction is very low, ask permission to provide new information; vary the message each visit. Identify ambivalence to better understand the patient's perspective; avoid hard confrontation, which may make the patient defensive.
Discuss pros and cons; have the patient list the benefits and costs of no change vs. change; to engage the patient, begin with benefits of no change; summarize and let the patient draw conclusions. Facilitate the shift from viewing previous attempts as failures to partial successes from which the patient can learn.
Anticipate difficulties; ask about what triggered previous slips and relapses, and what might make it difficult now; brainstorm ways to break a pattern of slips by anticipating triggers and planning solutions. Coach the patient to select small, easy steps based on previous experiences and preferences; if the patient sets a challenging initial goal that seems unrealistic, do not criticize it, but check confidence.
Learn Diabehes about the different tools used by Diabetes self-management strategies self-managementt diabetes. Intense workout routine healthy food is part of self-managemennt a wholesome life. However, having diabetes does't exclude Diabetes self-management strategies from Diabetes self-management strategies your favourite foods or going to your favourite restaurants. But you need to know that different foods affect your blood sugar differently. Activity has many health benefits in addition to losing weight. Physical activity lowers cholesterol, improves blood pressure, lowers stress and anxiety, and improves your mood. Being active can also keep your blood glucose levels in check and your diabetes under control.
Diabetes self-management strategies -
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Download references. Authors are thankful to the study participants, note taker, District Public Health Office, Rupandehi for their support and contributions. Thanks to my colleague Shiva Raj Mishra for his insightful comments.
Institute for Social and Environmental Research-Nepal, Pokhara, Nepal. Faculty of Science, Vrije University, Amsterdam, The Netherlands.
You can also search for this author in PubMed Google Scholar. MA conceptualised the research design, conducted the research, analysed data and wrote the first draft of the manuscript. TC and HRD contributed during the research design, research proposal and ethics application, adaptation of the data collection tool and analysis of the data.
TC and HRD contributed in revising the draft manuscript. All authors revised the manuscript and agreed on the findings and views expressed. The author s read and approved the final manuscript. Correspondence to Mandira Adhikari. Ethics committee approved both verbal and written consent.
Written and verbal consent was obtained from each participant before data collection. The consent form was signed by each participant. The notes and audio tapes are kept in secured password protected electronic device accessible only to the first author and the supervisors co-authors.
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Reprints and permissions. Adhikari, M. BMC Public Health 21 , Download citation. Received : 22 January Accepted : 17 June Published : 29 June Anyone you share the following link with will be able to read this content:. You can live better with Freedom , a Diabetes Self-Management Education and Support program that empowers you to take control of your diabetes.
By guiding you in the essentials of eating right, exercising, and monitoring your health, Freedom lets you take control of your type 1 or 2 diabetes—and your overall health and well-being. Freedom workshops are highly interactive and provide opportunities for clients to not only learn but to also share their experiences with others enrolled in the class.
As part of the classes, you will also receive follow-up calls and visits to ensure that you have the essential support needed to improve your current health and start living better.
The Freedom team will be working closely with your doctor as well, to discuss self-management strategies and help make sure those strategies are successful. The DSMES classes are taught in a group or individual setting by MSDH Registered Nurses, Registered Dieticians, Master's level social workers, and Pharmacists.
The seven specific self-care behaviors included in the curriculum are the basis of diabetes education and care:. Diabetes is complicated, and it takes practice to manage it in your everyday life. You may be wondering about eating balanced meals, engaging in safe physical activity, checking blood sugar, or giving yourself injectable medicines.
DSMES services help people live a healthy life with diabetes. DSMES will give you support to manage diabetes in a way that works for you and your lifestyle.
DSMES can help you improve your blood sugar levels so you can prevent or delay serious diabetes complications, such as heart disease, kidney disease, and vision loss.
This improvement can help you avoid emergency care, save money on health care costs, and improve your quality of life. People who participate in DSMES are more likely to have better overall health. Insurance coverage of DSMES varies, but many plans cover diabetes education.
Contact your insurance provider for more information about your benefits. Medicare Coverage and Resources [PDF — 1 MB]. Skip directly to site content Skip directly to search.
Living Diabetes self-management strategies diabetes? You self-managemrnt live better with Self-manageenta Diabetes Self-Management Education and Support program that empowers Hydration for staying hydrated to tsrategies control of your diabetes. Diabetes self-management strategies guiding you in the essentials of eating right, exercising, and monitoring Diabetes self-management strategies health, Freedom lets you take control of your type 1 or 2 diabetes—and your overall health and well-being. Freedom workshops are highly interactive and provide opportunities for clients to not only learn but to also share their experiences with others enrolled in the class. As part of the classes, you will also receive follow-up calls and visits to ensure that you have the essential support needed to improve your current health and start living better.
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