Diabetes symptoms and self-management behaviors in rural older adults

Abstract

Aims To evaluate the demographic and health correlates of reporting diabetes symptoms, and the relationship between diabetes symptoms and self-management behaviors in rural older adults. Methods Cross-sectional interviews were conducted with 489 African American, American Indian, and white female and male adults 60 years and older. Participants with diabetes were recruited from eight North Carolina counties. Participants completed the 34-item Diabetes Symptom Checklist (DSC). Associations of demographic and health characteristics with reported symptoms were evaluated. Multivariate linear regression models were used to examine the associations of DSC scores and diabetes self-management. Results Participants had low scores on the DSC. They largely practices appropriate diabetes self-management behaviors (self-foot checks, fruit and vegetable consumption, and self-monitoring blood glucose). Correlates of DSC included women having higher scores for hypoglycemia, psychological total, and fatigue dimensions. Neuropathic pain and vision dimensions were significantly associated with educational attainment. Most DSC dimensions were associated with ethnicity or economic status. Taking oral diabetes medicine was correlated with hyperglycemia; insulin use was associated with most DSC dimensions. HbA1c was not associated with any DSC dimension; diabetes duration >10 years was correlated with all dimensions except neuropathic pain and vision. Higher levels of psychological fatigue were significantly associated with fewer self-management behaviors. Discussion/Conclusions Demographic and health characteristics are associated with reported symptoms. Fatigue is a symptom negatively associated with diabetes self-management behavior in older adults. Health care providers are uniquely positioned to assess patient symptoms and potential relationships with successful diabetes management.

Relationship between sleep disturbance and self-care in adults with type 2 diabetes

“…Similarly, diabetes distress has been a strong predictor of self-care [11]. As a common and debilitating symptom, fatigue is associated with self-care [12]. Daytime sleepiness, one’s tendency to fall asleep under different situations [13], has also been related to self-care [9].…”

Effects of a Symptom Management Program for Patients With Type 2 Diabetes: Implications for Evidence‐Based Practice

“…Diabetes symptoms could alert T2DM patients about their poor glycemic control and push them to modify their self‐care behaviors or self‐management behaviors. This would finally allow T2DM patients to achieve better glycemic control (Kirk et al., ).…”

Real-Time Associations Between Glucose Levels and Fatigue in Type 2 Diabetes: Sex and Time Effects

“…Fatigue in adults with type 2 diabetes is common, potentially debilitating, and a serious impediment to self-care (Hernandez et al, 2019;Kirk et al, 2015;Laranjo et al, 2015). Studies have consistently cited fatigue as a major barrier to physical activity in these adults (Kirk et al, 2015;Laranjo et al, 2015;Thomas et al, 2004). Fatigue of this nature can best be defined as a subjective perception of a decreased capacity to perform physical and/or mental tasks.…”

“…Fatigue of this nature can best be defined as a subjective perception of a decreased capacity to perform physical and/or mental tasks. This construct of fatigue differs from muscle fatigability, which can be measured objectively through tests of strength or time to fatigue within a given bout of exercise (Egan et al, 2013;Kirk et al, 2015;McGuire et al, 2014;Miquelon & Castonguay, 2016).…”

“…Sex has been strongly associated with fatigue in patients with diabetes (Kirk et al, 2015;Nguyen et al, 2015;Valentine et al, 2009), with males generally reporting very low levels of fatigue. Women with type 2 diabetes consistently report significantly higher levels of fatigue than do men (Kirk et al, 2015;Nguyen et al, 2015).…”