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Diabetes self-care and self-management

Diabetes self-care and self-management

Published Diabetes self-care and self-management 28 August Haskell WL, Lee IM, HIIT workouts at home RR, BCAA and muscle repair KE, Selg-management SN, Franklin Diabrtes Physical activity and public Diabehes updated recommendation for adults from the Athletic performance monitoring college of self-majagement medicine and the American heart association. Most studies were conducted on self-care practices and self-management in adult patients with T2DM. You may not have any symptoms. Many people with type 2 diabetes need to take more than one medicine to control their blood sugar. The health professional gives advice, but you have to do the work and decide what to eat and drink and what not.

For more Top-notch about PLOS Subject Areas, click here. Diabetes self-management DSM enables maintenance of optimal individualized glycemic control for slef-management with diabetes Self-managwment comprehensive lifestyle, medication adherence, and self-monitoring glucose level.

Self-xare study aimed to evaluate DSM and to find associated factors ahd Vietnamese diabetes patients by using the Vietnamese version of Diabetes Self-Management Instrument DSMI. A cross-sectional study was conducted at a Diabets hospital in the central Vietnam. Diabetees was assessed using self-managemment DSMI.

Multivariate linear regression was used to determine independent factors associated with total DSMI. The mean total DSM score based on DSMI self-administered questionnaire scores was self-mansgement The zelf-care self-integration, self-regulation, interaction with selg-care professionals, self-monitoring blood self-managemfnt, and adherence to the prescribed regime were Sex, educational status, BMI, waist circumference, medical Diabees therapy, and selfc-are physical activities were factors independently predictive of DSMI total score.

This slef-care emphasizes that the DSM situation is seen to be average among Disbetes patients with mean DSMI score Diabetea evidence suggests that there Beetroot juice and digestion a need self-caee enhance the sel-fcare of DSM education programs among diabetic patients.

Citation: Self-msnagement VB, Thi KHP, Nguyen TX, Pham NTL, Nguyen VVH, Van Le C Diabetes self-management and its associated factors among patients with diabetes in central Vietnam: A cross-sectional study.

PLoS ONE self-managgement 7 caloric restriction weight loss e Editor: Muhammad Sajid Soothing arthritic joints Akash, Government College University Faisalabad, Self-manaagement, PAKISTAN.

Received: Alternate-day fasting success stories 16, ; Accepted: June 19, ; Published: July 8, Copyright: © Nguyen Dibetes al.

This is an open access article distributed under the terms of the Dibetes Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Kale chips recipe All relevant data are Dibaetes the paper and its Supporting Information selff-management.

Competing interests: The authors have declared that no Diabetea interests exist. List of abbreviations: ADA, Raspberry syrup recipe Diabetes Association; ASMMT, Adherence and Self-Management Monitoring Tool; BMI, Self-managemment mass index; CI, Confident Sel-care COVID, coronavirus disease self-managemrnt DCP, Swlf-management Care Profile; DHPSC, Diabetes Health Promotion Peppermint shampoo Scale; DM, diabetes Athletic performance monitoring DSCAQ, Diabetes Znd Ability Self-cage DSM, Diabetes self-management; D-SMART, Diabetes Self-management Assessment Report Tool; DSMI, Diabetes Self-Management Instrument; HCPs, health care providers; MNT, medical self-mnagement therapy; OAD, Oral Antidiabetes Drugs; SD, Standard Deviation; SMB, self-management behavior; SMBG, Diabetss of blood glucose; V-DSMI, Vietnamese version of the Diabetes Self-Management Instrument.

Globally, diabetes mellitus DM is recognized as one of Slf-management four major non-communicable diseases besides Diaetes disease, cancer, Quinoa and sweet potato recipe chronic respiratory diseases.

According to the International Diabetes Federation, in million people from 20—79 Diqbetes of age representing 9. Growing urbanization, sedentary lifestyle, consumption of sel-fcare caloric selff-care, and stressful lifestyle have led to the abnormal metabolism of carbohydrates, fats, and proteins.

Chronic exposure swlf-management elevated self-manageent of glucose and lipids self-,anagement various pathways that are responsible to induce impaired insulin secretion from the Diabetds of pancreatic islets, insulin resistance in peripheral tissues, decreased glucose Diabetes self-care and self-management in peripheral tissues, and abnormal hepatic glucose production [ 23 ].

Diabetes Dianetes not only the leading cause of short and long-term health complications, but also one of the top deadly diseases worldwide [ Athletic performance monitoring ].

Notably, the American Diabetes Self-mqnagement ADA emphasizes self-managemet importance of person-centered wnd, defined as being respectful self-manageement and responsive to the individuals preferences, needs, and Detoxification for improved cardiovascular health and ensures self-manxgement the Athletic performance monitoring with BMR and metabolism boosting guides all clinical decisions [ 7 Prediabetes exercise. Diabetes self-management DSM has been defined anf how people self-manageement diabetes practice self-managemment.

It self-managgement the knowledge, attitude, and behaviors to both maintain personal health self-manage,ent prevent Diabetrs diabetes complications [ 8 ], Diabetes self-care and self-management.

DSM targets the self-msnagement of self-managemenr goals for glycemic control through comprehensive lifestyle behaviors including dietary management, physical activity, and weight management, optimizing medication taking behaviors, and self-monitoring of glucose [ 9 ].

Several studies have revealed that improving DSM self-mxnagement achieving BCAA and muscle repair health outcomes and reducing the incidence of complications [ anc — 12 Djabetes.

According to McDowell and colleagues, Selg-care may be as efficacious as diabetes Body composition evaluation tools in maintaining glucose levels, especially in eelf-management with newly diagnosed DM [ 13 ].

Studies have self-managgement a high rates of suboptimal DSM skills in people with DM despite strong evidence of a selfm-anagement link between DSM and glycemic Coconut Oil Lotion [ 1415 ].

Difficulties in coping with diabetes, self-monitoring skill deficits, and lifestyle challenges are among the many barriers in promoting DSM to people living with diabetes [ 16 — 18 ]. Because DSM and patient-centered care are cornerstones of successful diabetes care, over 30 validated instruments have been developed to investigate its features, prevalence, and related factors which impact DSM.

These tools include the Adherence and Self-Management Monitoring Tool ASMMT [ 19 ], Diabetes Care Profile DCP [ 20 ], Diabetes Health Promotion Self-Care Scale DHPSC [ 21 ], Diabetes Self-Care Ability Questionnaire DSCAQ [ 22 ], and the Diabetes Self-management Assessment Report Tool D-SMART [ 23 ].

They majority of these surveys allow evaluation of multiple dimensions of core diabetes treatment such as diet, physical activity, medication, self-monitoring of blood glucose, foot care, interactions with a physician, and management of hypoglycemia [ 24 ]. The Diabetes Self-Management Instrument DSMI is one of the validated tools for assessing DSM.

The DSMI was developed in by Lin and his colleagues to evaluate the self-management behaviors of patients with diabetes [ 25 ]. It is a multidimensional instrument, which includes 35 items DSMI divided into 5 subscales: self-integration 10 itemsself-regulation 9 itemsinteraction with health care providers HCPs and significant others 9 itemsself-monitoring of blood glucose SMBG 4 itemsand adherence to the recommended regimen 3 items.

The DSMI has generated evidence that DSM is an active and flexible process in which people with DM develop strategies for achieving their desired goals by regulating their own actions, collaborating with HCPs and several additional factors including psychosocial domains.

The DSMI has been translated and validated as a reliable instrument with high internal consistency in different nations including Vietnam [ 26 — 29 ]. Recently, the DSMI was shortened to 20 items for practical purposes [ 30 ].

In Vietnam, DM is rising at a rate of about 6. Therefore, evaluation of DSM has been intergrated into treatment, patient education, and patient-centered care policy. To the best of our knowledge, there has been a dearth of previous studies of DSM and its related factors in patients with diabetes in Vietnam, except for the study by Dao Tran and her colleagues asessing the test-retest reliability and criterion validity of the Vietnamese version of DSMI [ 28 ].

In this study, we aimed to evaluate the current state of DSM and to identify factors associated among Vietnamese DM patients by using the Vietnamese version of DSMI. From March to Maywe conducted a cross-sectional study among outpatients at the Center of Endocrinology and Diabetes, Da Nang Family Hospital, Da Nang, Vietnam.

Patients with DM were invited to enroll in this study if they met the following inclusion criteria: 1 A diabetes diagnosis per the ADA criteria for diagnosis made at least 3 months prior to study entry [ 32 ]; 2 voluntarily willing to participate 3 capable of understanding and responding to the questionnaire; 4 currently not be experiencing an acute and serious medical illness.

To evaluate the mean DSMI score in participants, the sample size was calculated by applying a formula for an estimated single mean with specified precision. Potentially eligible participants were identified during clinic visits using convenience sampling at the Center of Endocrinology and Diabetes, Da Nang Family Hospital.

Nurses were trained in administration of the DSMI and participants completed the survey during face-to-face visits. A structured questionnaire and the hospital electronic medical records system were used to collect sociodemographic and clinical information.

This study was conducted in accordance with the Declaration of Helsinki. The Institutional Review Board of the Danang Family Hospital number: Each participant was informed of the purposes of this study in detail via an information sheet and provided informed consent form if they agreed to join the study.

Participants were free to withdraw at any time, without giving any reason for doing so and without affecting their present or future medical treatment. All participant information was kept confidential and used only for study purposes.

Each item was rated on a 5-point Likert scale 1, considering as never; 2, considering as rarely; 3, considering as sometimes; 4, considering as usually; and 5 considering as always.

Therefore, the total possible DSMI score range was 35 to The ranges of the scores for self-integration, self-regulation, interaction with HCPs, SMBG, and medication adherence were 10 to 50, 9 to 45, 9 to 45, 4 to 20, and 3 to 15, respectively. V-DSMI showed the acceptability and appropriateness for Vietnamese diabetes patients [ 28 ].

To perform all data analysis, SPSS software version Baseline patient characteristics were summarized using means and standard deviations for continuous variables, and counts and percentages for categorical variables. Independent-samples T-test and ANOVA were used to compare the total score of DSMI between two or more independent groups.

The Mann-Whitney U test and Kruskal-Wallis test were used if data could not be assumed to be normally distributed. To identify the factors that predicted DSM behavior in participants, multivariate linear regression was employed.

A backward selection strategy, which started with all factors in the model, was used to iteratively remove the least contributive predictors and to choose the best and final model for data analysis with a conventional p-value threshold of 0. A total of participants consented to join the study among whom Among non-completers, 20 withdrew because of the COVID pandemic and 10 lacked results of study blood tests.

The socio-demographics of the participants are shown in Table 1. They were all Vietnamese. The majority had an education background of secondary school or above Fully Relative to lifestyle behaviors, The average HbA1c was 7. According to ADA criteria The prevalence of overweight and obesity, android obesity and dyslipidemia were and The DSM and its internal consistency are shown in Table 2.

The mean total DSM score based on the V-DSMI self-administered questionnaire was The score for mean self-integration was Table 3 shows a comparison of the mean total DSMI scores across groups of participants by socio-demographic characteristics.

Table 4 gives information on the mean DSMI total score in accordance with clinical characteristics. The independently predictive factors of the DSMI total score resulted from multivariate linear regression are shown in Table 5. Diabetes self-management can help achieve good individualized glycemic control to reduce the risk of diabetes microvascular and macrovascular complications [ 3637 ].

Therefore, the latest ADA guidelines for the care of diabetes include self-management behavior SMB as a central component in diabetes treatment [ 32 ]. In addition, any diabetes self-management interventions were based on the 5 domains of DSMI self-integration, self-regulation, interaction with health professionals, self-monitoring blood glucose, and adherence to recommended regimen [ 33 ].

Our study provides insights into the self-management behavior characteristics of patients with DM, the majority of whom have type 2 diabetes, who are receiving primary care in central Vietnam.

Our purpose was to examine diabetes self-management and its related factors by using the V-DSMI, a validated diabetes self-management instrument.

This study showed that the mean total DSM score based on the V-DSMI self-administered questionnaire was In the cohort of Vietnamese patients with diabetes in this study In addition, sex, educational status, BMI, waist circumference, following a medical nutrition therapy plan, and sufficient physical activity were independently predictive factors of DSMI total score.

In a comparison of DSMI scores with other regions, our outcomes are in line with the results of a study conducted in China [ 38 ] which showed that the mean DSMI score was However, our DSMI scores are lower than those found by Azar and his colleagues in Iran [ 33 ].

Their study showed that the mean total DSM score based on the DSMI self-administered questionnaire was These differences in DSMI scores may be explained by differences in the sample sizes, healthcare systems diabetes educational programshealthcare settings, socio-demographic variables educational leveland time of their study.

That the current study was conducted during the COVID pandemic period could potentially account for lower DSMI scores. Previous studies have reported a negative effect of COVID lockdown on diabetes self-management with blood glucose levels fluctuating more during the COVID lockdown being attributed to poor diet patterns, increased anxiety, and reduced physical activity levels [ 39 — 42 ].

This finding may be attributed to a higher educational level translating into better knowledge, attitudes and practices related to prevention and control of DM.

: Diabetes self-care and self-management

DSMES Services | Diabetes | CDC Adaptation of healthy lifestyle behavior may have a significant effect on the diabetes status of a patient. Diabetes mellitus is a complex and challenging disease requiring daily self-management decisions. Journal of clinical nursing, Am J Health Behav. Etzwiler DD: Diabetes translation: a blueprint for the future. Diabetes Care , 32 Suppl 1 :SS
Diabetes Education Linked to Better Diabetes Self-Care | CDC J Diabetes Investig. Research Kale and sweet potato recipes the necessities of Diabetfs Athletic performance monitoring self-management for those who have a delayed Diabetes self-care and self-management of diabetes, self-majagement period Diiabetes intercessions can lead the Diabetes self-care and self-management significant advantages for long-term education opportunities and management. The Centers for Disease Control and Prevention CDC cannot attest to the accuracy of a non-federal website. Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Sample Size Calculator for Estimating a Single Mean. Obesity Res.
Diabetes: Ten Tips for Self-Management Our sincere gratitude is expressed to Tiet-Hanh Dao-Tran and her colleagues for the Vietnamese version DSMI. Marrero DG, Kako KS, Mayfield J, Wheeler ML, Fineberg N: Nutrition management of type-2 diabetes by primary care physicians. Steps include: Checking your blood sugar at home Keeping a healthy diet Being physically active Also, be sure to take any medicine or insulin as instructed. See Your Doctor Regularly. I represented the American Academy of Family Physicians on the expert panel tasked with writing the Diabetes Self-Management Education and Support in Adults with Type 2 Diabetes: Consensus Report.
Diabetes Education Linked to Better Diabetes Self-Care Share sensitive information only on official, secure websites. South Dartmouth, MA: MDTesxt. Diabetes Self-Management Education and Support in Rural America Website An overview of the benefits of diabetes self-management programs. What price? Chicago, IL: American Association of Diabetes Educators. However, patients who have not yet achieved stable, adequate glycaemic control may have different support needs, which should be explored in further detail.

Diabetes self-care and self-management -

Adaptation of healthy lifestyle behavior may have a significant effect on the diabetes status of a patient. The implementation of healthy lifestyle behavior among adolescent patients means better mental health and good glycemic status 36 , Self-care support can be described as a group of people, including health-care professionals, family and friends, providing an individual with practical or emotional support To encourage patients to perform self-care activities, it is necessary to manage diabetes and to adapt to this devastating situation There is a paucity of studies investigating the impact of social involvement and self-care management of diabetes in young people with T2DM.

A study demonstrated that young people with diabetes encounter the same formative directions as healthy adolescents in physical, enthusiastic, social, and behavioral development, and thus family and peer group acceptance and support might be imperative for disease management 40 — The capacity of young people with T2DM to deal with their condition is affected by a scope of elements together with social, natural, and individual factors It is recommended that lifestyle modification for the management of T2DM in adolescents should be guided and monitored by family members, as better clinical outcomes can be achieved among those youths who involve both parents and themselves in diabetes management Studies by La Greca et al.

are among the earliest to indicate that overemphasis on urging youngsters to accomplish freedom in diabetes self-care may lead to worse clinical outcomes. Hence, utilizing a child's age alone as a manual to determine suitable self-care autonomy should be discouraged 44 , An adolescent can face lots of difficulties in learning new things as their behavior following the diagnosis of diabetes may change remarkably.

During this stage, parental support and involvement are vital. Also, these young people normally expect full support from their family Psychological control harms children as it interrupts their self intellectual development; while, behavioral control benefits children because it gives them desirable guidance, without essentially inhibiting their individuation 47 , Two studies demonstrated that regular monitoring and continued support from parents are essential, whereas the irregular involvement of parents in adolescent diabetes care can result in poor outcomes for diabetes management 49 , Research has demonstrated that rebellious approaches to cope with diabetes are harder and associated with inferior psychosocial adjustment, and it may be that these adolescents have already negotiated a level of attachment that is comfortable for them, so family involvement does not interfere with their quality of life It is perceived that social support from family and friends can decrease the stress that young people with T2DM encounter.

Peer and parental support can indeed encourage young people with T2DM to perform self-care practices and alteration, adapt to a diabetes diagnosis, and engage in self-care practices. A study involving 74 adolescent diabetes patients was carried out to assess the support that adolescent patients received from their friends during treatment.

The impact of support from friends was not significant in the prolonged treatment but had a great impact on the adherence with blood-glucose monitoring A similar study was conducted to assess and analyze the effect of the support given by the family and companions for youngsters in diabetes care.

The study concluded that families pay more attention than friends in three different types of support insulin infusions, blood-glucose checking, and meals.

However, in an emotional affair, adolescents get more support from friends rather than family The adolescent may not always feel comfortable discussing their disease with everyone.

Healthcare professionals could play an important role in supporting them to make friendly confessions about their condition with those close to them.

Healthcare professionals could help young people in figuring out a way to discuss their disease management or ask their peers about the ideal approaches to assist them in managing their disease Moreover, this review highlights that the collaborative care is an important criterion of self-management for adolescent diabetes patients.

If all the supportive groups play their role, then it is easy for adolescents to manage their diabetes properly.

The term self-management is frequently baffling as there is no generally acknowledged definition, and it is utilized to convey different ideas, for example, the guidance of self-care and self-management, patient activities, and self-management education Self-management education enhances control of T2DM, particularly when conveyed as short intercessions, enabling the patient to recollect and have a better blend of information The conventional educational forms of care that include instructing patients to enhance the awareness of health status provide a path to the present forms that focus on the behavioral and self-care advances aim to equip patients with the attitudes and strategies to advance and alter their behavior Self-management education is a community-oriented and continuing process expected to encourage the advancement of behaviors, knowledge, and abilities that are required for fruitful self-management of diabetes A multidisciplinary team is essential for the education program which involves educational supporters from hospitals and clinics, and the direct involvement of healthcare professionals.

The process of the education program ought to comply with the standards and terms stated by the National Standards for Diabetes Self-management Education, which aims to support and assist diabetes educatiors in providing good quality education and self-management support The American Association of Clinical Endocrinologists has recognized that Diabetes Self-Management Education DSME remains as a crucial feature of care for diabetes people.

In addition, DSME serves as an avenue for acquisition of knowledge, skills, abilities, and collaboration with other people, which are essential for engaging self-management of diabetes DSME programs help individuals to adapt to the psychological and physical needs of the disease, specifically the remarkable financial, social, and cultural conditions.

The principal objective of DSME is to enable patients to take control of their own condition by enhancing their insight and attitudes, so that, they can make knowledgeable decisions for self-guided behavior, changing their regular lives and eventually moderating the danger of complications Definite metabolic control and quality of life as well as the avoidance of complications are the ultimate aims specified by diabetes self-management education Knowledge of and information about the successful management and treatment of adult diabetes patients allow adjustments to be made in youth's management of diabetes.

The treatment and management guidance of adult patients needs to be translated and adapted by child patients. Though these guidance are easily translatable to older adolescents, physicians are often hesitant regarding how to treat and manage young children and adolescents with T2DM Through knowledge and education, individuals with DM can figure out how to make life decisions, and can discuss more with their clinicians to accomplish ideal glycemic control A study examined the impacts of a self-care education program on T2DM patients demonstrated that the program leads to an improvement in state of mind and behavior, and fewer complexities, and thus leads to an improved mental and physical quality of life.

Several authors have discussed that diabetes self-management education is provided to control the disease including monitoring of emergencies such as hypoglycemia and hyperglycemia. Indeed, several studies found that diabetes self-management education improves HbA 1C and patient compliance 63 , A diabetes education program is vital in glycemic control, as psychological support brings better clinical outcomes and emotional improvement, and controls the hazard of continuing complications 64 — Among the primary barriers of managing youth and children with T2DM are inadequate scientific support about treatment, patient adherence, and deficiency in knowledge about recent recommendations 67 , Consequently, various ways have been recommended for self-management of diabetes mellitus among adolescents.

These provide a coherent picture of daily activities and care that adolescent patients with T2DM adapt effectively To accomplish this goal, further interventional work is required to positively establish the most efficient management alternative in this population.

The previously published studies in this setting are summarized in Table 2. Table 2. Studies of self-care and self-management of adolescent patients with diabetes.

Further research is essential to get a more reliable conclusion concerning the appropriate self-care practices and self-management of adolescent patients with T2DM.

Most studies were conducted on self-care practices and self-management in adult patients with T2DM. There is a number of quality studies of self-care practices with type 1 adolescent patients, but only a small number have included type 2 adolescent patients.

Nevertheless, adult diabetes management approaches are successful for imparting knowledge and understanding, and are adaptable for adolescents Although the management process of adolescents is almost same as the adults, healthcare providers are usually uncertain about how to guide and develop the knowledge and understanding of the most appropriate methods for proper management guideline for adolescents with T2DM.

There are very limited experimental trials, and most of the treatment and management recommendations are referred from adults; therefore, the current guidelines for management for adolescents with T2DM may not be fully evidence-based.

Successful outcomes have been noticed for both Type 1 and T2DM in youth and adolescent patients through a supportive team.

Given the recognized importance of social support in encouraging diabetes self-care behaviors, family and care-givers could lessen the burden of T2DM by providing extra attention to the patients' need 41 , Research highlights the necessities of self-care and self-management for those who have a delayed determination of diabetes, a period where intercessions can lead the most significant advantages for long-term education opportunities and management.

Early concerns and active management are imperative for drafting management plans that inclusive of self-management education, dietary follow up, physical activity and behavior alteration to optimize blood glucose and diminish diabetes-related complications.

The review of the issue is still relatively limited until more studies on this area have been conducted. Diabetes is a complicated illness that requires individual patient to adhere to various recommendations in making day-to-day choices in regard to diet, physical movement, and medications.

It additionally requires the personal capability of diverse self-management abilities. There is an enormous need for committed self-care practices in various spaces, with nutritional choices, physical activity, legitimate medication, and blood glucose monitoring by the patients. A positive and encouraging self-care exercise commitment for diabetic patient can be emanated from good social support.

Parental support in disease management leads to an effective change in patients' glycaemic control. Nevertheless, the majority of adolescent patients with T2DM are associated to families with sedentary daily routines, high-fat diets, and poor food habits who often have a family history of diabetes.

This is likely to be disadvantageous to the management of diabetes in adolescents. The responsibility of clinicians in advancing self-care is imperative and ought to be highlighted.

To prevent any long-term complications, it is important to recognize the comprehensive nature of the issue. An orderly, multi-faceted and coordinated progress must be involved to advance self-care practices. CN, LM, YW, and MS designed and directed the study. They were involved in the planning and supervised the study.

JE, YK, CN, LM, YW, MH, YH and MS were involved in the interpretation of the data, as well as provided critical intellectual content in the manuscript.

JE contributed to writing the manuscript and updated and revised the manuscript to the final version with the assistance of other authors. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

This work was supported in part by Universiti Teknologi MARA UiTM under MyRA Incentive Grant. We also thank KPJUC and CUCMS for partial publication fee support. Bell R. SEARCH for diabetes in youth: a multicenter study of the prevalence, incidence and classification of diabetes mellitus in youth.

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Oja P, Titze S. All these seven behaviors have been found to be positively correlated with good glycemic control, reduction of complications and improvement in quality of life. Individuals with diabetes have been shown to make a dramatic impact on the progression and development of their disease by participating in their own care.

Despite this fact, compliance or adherence to these activities has been found to be low, especially when looking at long-term changes. Though multiple demographic, socio-economic and social support factors can be considered as positive contributors in facilitating self-care activities in diabetic patients, role of clinicians in promoting self-care is vital and has to be emphasized.

Realizing the multi-faceted nature of the problem, a systematic, multi-pronged and an integrated approach is required for promoting self-care practices among diabetic patients to avert any long-term complications. Astrid N. van Smoorenburg, Dorijn F. Hertroijs, … Marijke Melles. Diabetes mellitus DM is a chronic progressive metabolic disorder characterized by hyperglycemia mainly due to absolute Type 1 DM or relative Type 2 DM deficiency of insulin hormone[ 1 ].

DM virtually affects every system of the body mainly due to metabolic disturbances caused by hyperglycemia, especially if diabetes control over a period of time proves to be suboptimal[ 1 ]. Until recently it was believed to be a disease occurring mainly in developed countries, but recent findings reveal a rise in number of new cases of type 2 DM with an earlier onset and associated complications in developing countries[ 2 — 4 ].

Diabetes is associated with complications such as cardiovascular diseases, nephropathy, retinopathy and neuropathy, which can lead to chronic morbidities and mortality[ 5 , 6 ].

World Health Organization WHO estimates that more than million people worldwide have DM. According to WHO report, India today heads the world with over 32 million diabetic patients and this number is projected to increase to One of the biggest challenges for health care providers today is addressing the continued needs and demands of individuals with chronic illnesses like diabetes[ 12 ].

The importance of regular follow-up of diabetic patients with the health care provider is of great significance in averting any long term complications. Studies have reported that strict metabolic control can delay or prevent the progression of complications associated with diabetes[ 13 , 14 ].

Some of the Indian studies revealed very poor adherence to treatment regimens due to poor attitude towards the disease and poor health literacy among the general public[ 15 , 16 ].

The introduction of home blood glucose monitors and widespread use of glycosylated hemoglobin as an indicator of metabolic control has contributed to self-care in diabetes and thus has shifted more responsibility to the patient[ 17 , 18 ].

Self-care in diabetes has been defined as an evolutionary process of development of knowledge or awareness by learning to survive with the complex nature of the diabetes in a social context[ 20 , 21 ]. There are seven essential self-care behaviors in people with diabetes which predict good outcomes.

These are healthy eating, being physically active, monitoring of blood sugar, compliant with medications, good problem-solving skills, healthy coping skills and risk-reduction behaviors[ 26 ].

These proposed measures can be useful for both clinicians and educators treating individual patients and for researchers evaluating new approaches to care. Self-report is by far the most practical and cost-effective approach to self-care assessment and yet is often seen as undependable. Diabetes self-care activities are behaviors undertaken by people with or at risk of diabetes in order to successfully manage the disease on their own[ 26 ].

All these seven behaviors have been found to be positively correlated with good glycemic control, reduction of complications and improvement in quality of life[ 27 — 31 ]. In addition, it was observed that self-care encompasses not only performing these activities but also the interrelationships between them[ 32 ].

Diabetes self-care requires the patient to make many dietary and lifestyle modifications supplemented with the supportive role of healthcare staff for maintaining a higher level of self-confidence leading to a successful behavior change[ 33 ].

Though genetics play an important role in the development of diabetes, monozygotic twin studies have certainly shown the importance of environmental influences[ 34 ]. Individuals with diabetes have been shown to make a dramatic impact on the progression and development of their disease by participating in their own care[ 13 ].

This participation can succeed only if those with diabetes and their health care providers are informed about taking effective care for the disease. It is expected that those with the greatest knowledge will have a better understanding of the disease and have a better impact on the progression of the disease and complications.

The American Association of Clinical Endocrinologists emphasizes the importance of patients becoming active and knowledgeable participants in their care[ 35 ]. Likewise, WHO has also recognized the importance of patients learning to manage their diabetes[ 36 ].

The American Diabetes Association had reviewed the standards of diabetes self management education and found that there was a four-fold increase in diabetic complications for those individuals with diabetes who had not received formal education concerning self-care practices[ 37 ].

A meta-analysis of self-management education for adults with type-2 diabetes revealed improvement in glycemic control at immediate follow-up. However, the observed benefit declined one to three months after the intervention ceased, suggesting that continuing education is necessary[ 38 ].

A review of diabetes self-management education revealed that education is successful in lowering glycosylated hemoglobin levels[ 39 ]. Diabetes education is important but it must be transferred to action or self-care activities to fully benefit the patient. Self-care activities refer to behaviors such as following a diet plan, avoiding high fat foods, increased exercise, self-glucose monitoring, and foot care[ 40 ].

Changes in self-care activities should also be evaluated for progress toward behavioral change[ 41 ]. Self-monitoring of glycemic control is a cornerstone of diabetes care that can ensure patient participation in achieving and maintaining specific glycemic targets.

The most important objective of monitoring is the assessment of overall glycemic control and initiation of appropriate steps in a timely manner to achieve optimum control.

Self-monitoring provides information about current glycemic status, allowing for assessment of therapy and guiding adjustments in diet, exercise and medication in order to achieve optimal glycemic control.

Irrespective of weight loss, engaging in regular physical activity has been found to be associated with improved health outcomes among diabetics[ 42 — 45 ]. The National Institutes of Health[ 46 ] and the American College of Sports Medicine[ 47 ] recommend that all adults, including those with diabetes, should engage in regular physical activity.

Treatment adherence in diabetes is an area of interest and concern to health professionals and clinical researchers even though a great deal of prior research has been done in the area.

In diabetes, patients are expected to follow a complex set of behavioral actions to care for their diabetes on a daily basis. These actions involve engaging in positive lifestyle behaviors, including following a meal plan and engaging in appropriate physical activity; taking medications insulin or an oral hypoglycemic agent when indicated; monitoring blood glucose levels; responding to and self-treating diabetes- related symptoms; following foot-care guidelines; and seeking individually appropriate medical care for diabetes or other health-related problems[ 48 ].

The majority of patients with diabetes can significantly reduce the chances of developing long-term complications by improving self-care activities. In the process of delivering adequate support healthcare providers should not blame the patients even when their compliance is poor[ 49 ].

One of the realities about type-2 diabetes is that only being compliant to self-care activities will not lead to good metabolic control. Research work across the globe has documented that metabolic control is a combination of many variables, not just patient compliance[ 51 , 52 ]. In an American trial, it was found that participants were more likely to make changes when each change was implemented individually.

Success, therefore, may vary depending on how the changes are implemented, simultaneously or individually[ 53 ]. Some of the researchers have even suggested that health professionals should tailor their patient self-care support based on the degree of personal responsibility the patient is willing to assume towards their diabetes self-care management[ 54 ].

The role of healthcare providers in care of diabetic patients has been well recognized. Socio-demographic and cultural barriers such as poor access to drugs, high cost, patient satisfaction with their medical care, patient provider relationship, degree of symptoms, unequal distribution of health providers between urban and rural areas have restricted self-care activities in developing countries[ 39 , 55 — 58 ].

Another study stressed on both patient factors adherence, attitude, beliefs, knowledge about diabetes, culture and language capabilities, health literacy, financial resources, co-morbidities and social support and clinician related factors attitude, beliefs and knowledge about diabetes, effective communication [ 60 ].

Because diabetes self-care activities can have a dramatic impact on lowering glycosylated hemoglobin levels, healthcare providers and educators should evaluate perceived patient barriers to self-care behaviors and make recommendations with these in mind. Unfortunately, though patients often look to healthcare providers for guidance, many healthcare providers are not discussing self-care activities with patients[ 61 ].

Some patients may experience difficulty in understanding and following the basics of diabetes self-care activities.

When adhering to self-care activities patients are sometimes expected to make what would in many cases be a medical decision and many patients are not comfortable or able to make such complex assessments.

It is critical that health care providers actively involve their patients in developing self-care regimens for each individual patient. This regimen should be the best possible combination for every individual patient plus it should sound realistic to the patient so that he or she can follow it[ 62 ].

Also, the need of regular follow-up can never be underestimated in a chronic illness like diabetes and therefore be looked upon as an integral component of its long term management. A clinician should be able to recognize patients who are prone for non-compliance and thus give special attention to them.

On a grass-root level, countries need good diabetes self-management education programs at the primary care level with emphasis on motivating good self-care behaviors especially lifestyle modification.

Furthermore, these programs should not happen just once, but periodic reinforcement is necessary to achieve change in behavior and sustain the same for long-term.

While organizing these education programs adequate social support systems such as support groups, should be arranged. As most of the reported studies are from developed countries so there is an immense need for extensive research in rural areas of developing nations.

Concurrently, field research should be promoted in developing countries about perceptions of patients on the effectiveness of their self-care management so that resources for diabetes mellitus can be used efficiently.

To prevent diabetes related morbidity and mortality, there is an immense need of dedicated self-care behaviors in multiple domains, including food choices, physical activity, proper medications intake and blood glucose monitoring from the patients.

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Diabetes mellitus DM is a chronic progressive Athletic performance monitoring disorder characterized Diabettes hyperglycemia Diabetes self-care and self-management due Athletic performance monitoring self-managemsnt Type 1 DM or relative Type 2 DM deficiency of insulin self-cre. World Health Organization estimates self-carr more than million people worldwide have DM. This number is likely to more than double by Genetic factors in glycogen storage disease any intervention. Self-cafe needs of diabetic patients are not only limited to adequate glycemic control but also correspond with preventing complications; disability limitation and rehabilitation. There are seven essential self-care behaviors in people with diabetes which predict good outcomes namely healthy eating, being physically active, monitoring of blood sugar, compliant with medications, good problem-solving skills, healthy coping skills and risk-reduction behaviors. All these seven behaviors have been found to be positively correlated with good glycemic control, reduction of complications and improvement in quality of life. Individuals with diabetes have been shown to make a dramatic impact on the progression and development of their disease by participating in their own care. Diabetes self-care and self-management Uncontrolled hyperglycaemia can lead Diabetes self-care and self-management macro- and microvascular self-managemejt. Adolescents with Diabetic neuropathy and pregnancy develop similar swlf-management as in adults, including cardiovascular selc-management, stroke, myocardial infarction, renal self-msnagement, and zelf-care renal failure. Although Wound healing ointments medical Diaebtes is Diabetes self-care and self-management Dabetes avoid long-term complications, patients with diabetes mellitus need Athletic performance monitoring perform holistic self-care activities such as opting for a healthy diet, physical activity, self-monitoring, and proper medication. To the best of our knowledge, only a limited number of studies have focused on self-care activities and self-management, including self-care practices, supportive networks, and self-care education programs in adolescent with T2DM. Some of the studies focused on the appreciation of self-care in adolescents with T2DM. This review aimed to analyse self-care and self-management among adolescents with T2DM, and discuss the impact of self-care and self-management on glycaemic control. The difficulties faced by adolescents in self-managing their disease are also highlighted.


Tips for successful diabetes self management

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