Clinical outcomes associated to self-care behaviours of type 2 diabetes patients: a cross-sectional study

Background. Self-care is vital for diabetes patients to prevent complications and to maintain quality of life. Although several studies were conducted to explore outcomes associated to self-care in type 2 diabetes patients (T2DM), results were often conflicting and available evidence need to be strengthened. Aim. The aims of this study were: to describe self-care of T2DM patients; to evaluate clinical outcomes associated to self-care in T2DM patients. Methods. A cross-sectional study was conducted on a sample of 302 randomly selected T2DM patients. Clinical and socio-demographic data were collected by medical records. The Summary of Diabetes Self-care Activities was used to measure self-care about diet, blood testing, exercise and foot care (score range for each dimension = 1-7; higher score = better self-care). The EQ-5D was used to measure perceived quality of life (score range 0-100; higher score = better quality of life). Multiple regression models were performed to estimate associations between self-care and body mass index (BMI), glycated haemoglobin (HbA1c), presence of diabetes complications and quality of life. Results. Self-care was lower about exercise (median = 2.0; interquartile range Q1-Q3 = 0,5 – 3.5) and foot care (median = 3.5; interquartile range Q1-Q3 = 0,5 – 6.0) than about diet (median = 5.2; interquartile range Q1-Q3 = 4.2 - 6.0) and blood testing (median = 2.0; interquartile range Q1-Q3= 2.0 – 7.0). Diet was associated to HbA1c (p = 0,025). Exercise was significantly associated to BMI (p = 0.0071), HbA1c (p = 0.0017), presence of diabetes complications (p = 0.031), and quality of life (p < 0.0001). Blood testing was associated to HbA1c (p = 0.034), presence of complications (p < 0.0001) and quality of life (p = 0.032). Foot care was significantly associated to quality of life (p = 0.013). Conclusion. Self-care influences several clinical outcomes of T2DM patients. Although exercise is the most important determinant of positive outcomes, it is poor in T2DM patients. Any intervention aimed to improve exercise is strongly recommended. Further research is needed to explore barriers to exercise in T2DM patients.