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Background: Diabetes mellitus places a considerable burden on the individual and the family with respect to lifestyle changes. There is a paucity of systematic studies in India examining the efficacy of self-management programs for diabetes. The study examined the impact of a brief self-management intervention (SMI) on primary outcome of HbA1c and secondary outcomes of quality of life (QOL), self-care, perceived barriers to self-care (BSC), perceptions regarding illness and mood in patients with type 2 diabetes mellitus. Methods and materials: Eighty patients with type 2 diabetes mellitus were randomly allocated to either a 4-session SMI or treatment as usual (TAU) and were assessed on HbA1c levels, QOL, self-care, BSC, illness perceptions, anxiety, and depression at baseline, postintervention , and at three-month postintervention follow-up. Results: Repeated measures analysis of variance indicated significant improvement in the SMI group from baseline to follow-up on HbA1c (P = 0.001), impact of diabetes on QOL (P = 0.006), self-care with respect to diet and exercise (Ps = 0.001), perceived barriers in adherence to diet, exercise, (P = 0.001), medication (P < 0.01), glucose testing (P = 0.04), general BSC (P = 0.001), total barriers (P = 0.001), illness perceptions-timeline or chronicity of illness (P = 0.002), personal control over illness, (P = 0.001), belief in effectiveness of treatment (P = 0.002), understanding of one’s illness (P = 0.001), and emotional representations regarding illness (P =0.001), depression, (P = 0.001), and anxiety (P = 0.001). In the SMI group, large effect sizes were obtained at the postintervention assessment and the three-month follow-up on most outcome measures. Conclusions: Brief psychological intervention is efficacious in patients with type 2 diabetes.

IntroductionType 2 Diabetes mellitus (T2DM) is a chronic disease that requires long-term medical care and lifestyle change. Many patients find it challenging to implement required behaviour changes and consequently, do not achieve glycaemic control. It is essential to research social cognitive factors that impact self care in T2DM.AimsTo study the impact of barriers and illness perceptions on self care in T2DMObjectivesTo explore barriers to self care and illness perception and examine their relationship with self care, metabolic control and quality of life in T2DM.MethodsA cross-sectional design was employed. The sample consisted of 60 patients with type 2 DM, meeting specified inclusion and exclusion criteria, recruited from the out-patient services of a hospital at Bangalore. The Barriers of self care questionnaire (Glasgow, 1994), The Revised Illness Perception Questionnaire (Morris et. al, 2002), The Summary of Diabetes Self Care Activities (Toobert & Glasgow, 1994) and The Diabetes Quality of Life Questionnaire Brief Clinical Inventory (Burroughs, Desikan, Waterman, Gilin & McGill, 2004) were administered. Metabolic control was assessed using glycosylated haemoglobin levels (HbA1c).ResultsFindings revealed that barriers to self care, negative perceptions of consequences of the illness and negative emotional representations were associated with poorer self care. Adherence was associated with better metabolic control and quality of life.ConclusionsBarriers to self care and maladaptive illness representations pose a challenge in achieving self-care goals. Understanding barriers is the first step in facilitating practitioners to identify their role in enabling patients to overcome them.