Participation in structured diabetes mellitus self-management education program and association with lifestyle behavior: results from a population-based study

Abstract

ObjectiveWhether participation in structured diabetes self-management education programs (DSME) for participants with diabetes mellitus is associated with a healthy lifestyle in routine care apart from randomized-controlled studies remains unclear and is this studies’ research question.Research design and methodsWe identified 1300 persons with diabetes mellitus drawn from the cross-sectional population-based analysis German Health Update 2014/2015 (GEDA 2014/2015), which integrated the modules of the European Health Interview Survey (EHIS) wave 2. Of those, 816 were ever-DSME participants and 484 never-participants. We conducted multivariable weighted logistic regression analyses for lifestyle differences comparing ever-DSME and never-DSME participants. Lifestyle was defined by physical activity (PA), current smoking, fruit/vegetable consumption and body mass index (BMI). Age, sex, socioeconomic status, living together, limitation due to health problems for at least for 6 months, self-efficacy and attention to one’s health were included as confounders in the regression models.ResultsEver-DSME participants engaged significantly more often in cycling at least 1 day per week (OR 1.62, 95% CI: 1.15–2.30) and performed significantly more often aerobic endurance training of 150 min per week (including walking: OR 1.42, 95% CI: 1.03–1.94, without walking: OR 1.48, 95% CI: 1.08–2.03) compared with never-DSME participants. Ever-DSME participants were significantly more often ex-smoker compared with never-DSME participants (OR 1.39, 95% CI: 1.03–1.88). DSME attendance was not significantly associated with current smoking, BMI and fruit or vegetable consumption.ConclusionDSME participation is associated with a moderately healthier lifestyle particularly for PA even in routine healthcare. Study results emphasize the importance of a broadly dissemination of DSME access for nationwide diabetes healthcare. Future studies should adjust for DSME participation when investigating lifestyle in persons with diabetes.

Effectiveness of Diabetes Self-Management Education (Dsme) in Type 2 Diabetes Mellitus (T2Dm) Patients: Systematic Literature Review

“…Several interventions are also able to influence lifestyle changes such as increasing the duration of exercises (cycling, walking, aerobics), reducing smoking habits, and increasing the consumption of fruits and vegetables. 18 Lifestyle changes caused by DSME interventions are expected to improve the clinical and health status of T2DM patients. One study proved this showing DSME’s effectiveness in controlling fasting blood glucose, random blood glucose, total cholesterol, and triglycerides.…”

Patterns and associated factors of diabetes self-management: Results of a latent class analysis in a German population-based study

“…International literature underlines the effectiveness of DSME for effective diabetes SMB [ 10 , 19 ] and concurs that participation in DSME is positively associated with glycaemic control [ 3 ]. In accordance, participation in DSME emerges as the strongest factor of an adherent SMB pattern within our analysis.…”

“…Among sociodemographic factors of SMB, age [ 12 , 23 ], sex [ 17 ], socioeconomic status [ 15 , 18 ], employment [ 15 ], and partnership status [ 16 ] have been reported in the literature. Among disease-related variables, time since diagnosis [ 15 ], DSME-participation [ 10 , 19 ], limitation due illness [ 24 ] and attendance toward health [ 15 , 21 ] emerged as factors of SMB. We adopted these variables as exogenous covariates within our analyses.…”

“…In contrast, financial constraints and a low socioeconomic status can impede patients’ adherence to prescribed behavior [ 18 ]. Most importantly, diabetes self-management education (DSME) is relevant in the implementation of diabetes self-management [ 10 ] and was shown to be associated with a healthier lifestyle in routine healthcare [ 19 ].…”

Are depressive symptoms associated with quality of care in diabetes? Findings from a nationwide population-based study

“…Several factors were chosen as potential confounders of the association between depressive symptoms and care indicators based on previous findings indicating associations of these factors with depression 33 34 and care indicators. [35][36][37] Educational level was assessed according to the Comparative Analysis of Social Mobility in Industrial Nations, encompassing general as well as vocational training, and classified into low, medium or high. 38 Social support was assessed using the Oslo-3 Scale 39 and categorized as low, moderate and high social support.…”