Self Care Activities, Diabetic Distress and other Factors which Affected the Glycaemic Control in a Tertiary Care Teaching Hospital in South India

Abstract

Background: Interventions which were made to promote a better self-management have produced improvements in the glycaemic control in patients with Diabetes mellitus. An improved glycaemic control is known to prevent the long term complications.Method: This study was conducted at the Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, which is a rural tertiary health care centre. 546 patients were included in our study and they were assessed for the glycaemic control (HbA1c), diabetes distress (DDs), and self care activities.Results: Of the total 546 patients, 49% had a poor glycaemic control, as was indicated by HbA1c levels of >7%. The factors which are significantly associated with a poor glycaemic control are age (p=0.03 ), sex (p= 0.0415), literacy (p=0.0422), duration of the disease (p=0.0006), diabetic distress (p=0.0001) and self care activities like diet ( p=0.0001), medication (p=0.0001) and exercise (p=0.0001), whereas there was no significant effect of the BM I (p=0.094) on the glycaemic control. Conclusion:This study revealed the factors that could predict the glycaemic control in the diabetic patients who attended our tertiary care teaching hospital. The barriers that prevent these patients from meeting their goals must be explored, to improve their health outcomes.

Evaluation of factors related to glycaemic control among South Korean patients with type 2 diabetes

“…We also found that medication adherence exhibited the highest adherence value (6.3 d), followed by dieting (4.9 d), exercising (3.4 d), and blood glucose self-monitoring (2.8 d). These results agree with other studies' findings (Kang & Gu, 2012;Lee & Park, 2014;Osborn, Mayberry, & Kim, 2016;Sasi et al, 2013), which showed that type 2 diabetes patients exhibited the greatest values for medication adherence and relatively low adherence values for dieting, exercising, and blood glucose self-monitoring. The high value for medication adherence may be related to the relatively simple requirement to take a specific medication dose at the scheduled time; however, dieting, exercising, and blood glucose self-monitoring require more extensive habitual changes that are relatively difficult to perform (Lee & Park, 2014).…”

“…The high value for medication adherence may be related to the relatively simple requirement to take a specific medication dose at the scheduled time; however, dieting, exercising, and blood glucose self-monitoring require more extensive habitual changes that are relatively difficult to perform (Lee & Park, 2014). Furthermore, we only found that medication adherence was significantly associated with glycaemic control, whereas previous studies have found significant differences in glycaemic control according to exercise and diet (Kang & Gu, 2012); medication and exercise (Osborn et al, 2016); and medication, exercise, and diet (Sasi et al, 2013). These study-specific differences are presumably related to the use of different tools to measure self-care behaviours.…”

“…Several studies have found that diabetes-related distress is significantly associated with glycaemic control among type 2 diabetes patients (Aikens, 2012;Fisher, Glasgow, & Strycker, 2010;Fisher et al, 2012;Fisher, Mullan, et al, 2010;Kang & Gu, 2012;Sasi et al, 2013;Strandberg et al, 2014); we found that greater diabetes-related distress was associated with poor glycaemic control. Diabetes-related distress encompasses patient's emotional reactions and responses to their diabetes (Strandberg et al, 2014), and it is related to their experiences with diabetes and its treatment and management (Fisher et al, 2012).…”

Predictor effect of Locus Of Control (LOC) on self-care activities and metabolic control in individuals with type 2 diabetes

“…Jordon’s study (2010) Jordon found a weak correlation with age. In the study of Sasi Sekhar et al (2013), gender made a significant difference. Weak glycemic control was more prevalent among women.…”

“…The average A1c values of the group aged 36–49 years were significantly lower than the other groups. In the study of Sasi Sekhar et al (2013), a relation was found between age and A1c. Jordon’s study (2010) Jordon found a weak correlation with age.…”