Diabetes self-care activities and perception and glycemic control in adult Puerto Rican residents with Type 2 Diabetes: The LLIPDS Study

Abstract

Background: Individuals with diabetes frequently have comorbid health conditions and suffer longer term complications. The control of blood glucose relies on diabetes management/self-care behaviors. Poor glycemic control, commonly encountered in underserved populations with type 2 diabetes (T2D) often results from inadequate diabetes self-care activities and/or perception. We aimed to assess the association between diabetes self-care activities/perception and glycemic control in adult Puerto Rican residents with T2D. Design and methods: We used a cross-sectional study design; our sample population was 260 individuals aged 40–65 years with T2D. We asked participants about their diabetes self-care over 8 weeks. High fasting blood glucose (≥130 mg/dL) and glycated hemoglobin (HbA1c; ≥7%) measures were defined. We estimated the strength of the following associations using logistic regression: each of three self-care activities and fasting glucose or HbA1c, adjusting for confounders. Results: Nearly 27% of the participants reported not checking their glucose levels, 7% did not take their medications as prescribed and 31% perceived their diabetes self-care as poor. Participants with less education perceived their diabetes self-care as poor more often than their counterparts (44% vs 25%; p = 0.003). Most participants had high glycemic levels (60%) or hbA1c levels (65%). Participants who perceived their diabetes self-care as poor had higher HbA1c levels than their counterparts (adj. odds ratio: 2.14, 95% CI (1.13, 4.08)). Conclusion: Poor diabetes self-care perception, possibly related to less education, likely explains poor glycemic control among adult Puerto Rican residents with T2D.

Associations between Diabetes Self-Management and Microvascular Complications Among Patients Living in Rural Areas, in Kenya

“…They include; healthy eating, being physically active, monitoring of blood sugar, compliance with medications, good problem-solving skills, healthy coping skills, and risk-reduction behaviors (13)(14)(15)(16). These measures can be useful for both clinicians and educators treating individual patients and for researchers evaluating new approaches to care (17). Self-report is an important practical and cost-effective approach for self-management assessment (18).…”

Periodontal Disease, Local and Systemic Inflammation in Puerto Ricans with Type 2 Diabetes Mellitus

“…Participants came from the Puerto Rico Center for Diabetes (PRCD) (50%), where the majority of T2DM individuals living in the San Juan municipality (the most populated area in PR) went for their routine health checkups; from the general population (45%), of which 7% came from the San Juan Overweight Adults Longitudinal Study (SOALS) project; and from COSSMA (5%), a private decentralized island-wide health care organization. The LLIPDS inclusion and exclusion criteria are described in detail elsewhere [25,26]. Some of the relevant criteria for this study were as follows: (1) age 40 to 65 years; (2) the presence of at least four natural teeth or no braces or orthodontic appliances; (3) no major CVD; and (4) no systemic complications, chronic inflammatory diseases, or infectious diseases within the previous 6 months.…”

“…The outcomes were assessed as described in previous LLIPDS publications [25,26]. The primary outcome was the percent of sites with PPD ≥ 4 mm [27], which was categorized into low, medium, or high tertiles.…”

“…In the interest of brevity, we refer the reader to the previous LLIPDS publications for a complete list of items we collected [25,26]. A few of the more relevant items were as follows: demographic data; lifestyle health habits, including smoking status (never, former, or current), alcohol consumption (abstainer, former, or current), and exercise information (yes/no); diabetes duration (years); and detailed information on current medication use.…”

The Education Effect of AADE7TM Model on Self-Care Activities in Type 2 Diabetes Mellitus Patients

“…pada 100 pasien selama enam bulan di Arab Saudi menemukan bahwa edukasi terstruktur berpengaruh terhadap kontrol glukosa yang lebih baik dan secara signifikan menurunkan risiko penyakit kardiovaskuler. Penelitian di Puerto Rico pada 260 orang penduduk dewasa dengan diabetes tipe 2 menemukan faktor penyebab kontrol glikemik yang buruk dimungkinkan oleh persepsi tentang perawatan diri serta terkait dengan pendidikan yang kurang(Llera-fábregas et al, 2022).…”