S.K.W. WONG1, ELYA1
National Healthcare Group Polyclinics1
Self-care management and glycaemic control are foundational components of diabetes care but remain poor in many patients. Our study aims to understand factors that are associated with poorer self-care behaviours (diet, exercise, medication adherence) and HbA1c to inform clinical practice and development of interventions.
A cross-sectional survey study was conducted in 409 patients with type 2 diabetes across 4 polyclinics, and included measures of social support, diabetes-related distress, generic mental health, self-efficacy, illness perceptions, diabetes knowledge, self-care behaviours (general and specific diet), exercise, medication adherence and HbA1c. Multiple linear regression was carried out to identify factors that were independently associated with self-care behaviours and HbA1c.
The average age of patients was 49.0 (±7.8) years. In multiple regression analysis, regimen-related distress was associated with higher hbA1c levels (b=0.52, CI=0.22-0.81), poorer specific (b=-0.39, CI=-0.71 to-0.07) and general dietary (b=-0.73, CI=-1.27 to-0.19) behaviors and lower medication adherence (b=-1.44, CI=-2.11. to-0.77). Worse perception of personal control was associated with higher HbA1c (b=0.12, CI=0.05-0.19), worse general diet (b=0.23, CI=-0.35 to-0.10) and exercise (b=-0.11, CI=-0.21 to-0.001). Poor emotional support was associated with poorer specific (b=0.02, CI=0.006-0.025) and general diet (b=0.02, CI=0.006-0.038), less spacing of carbohydrates (b=0.04, CI=0.021-0.053) and exercise (b=0.02, CI=0.004-0.030).
Though different factors were associated with self-care behaviors and HbA1c, some factors were associated with multiple self-care behaviors and HbA1c. Our findings suggest that diabetes-related distress, illness perceptions, and social support play important roles in diabetes care, and further studies should be conducted to evaluate the effectiveness of addressing these factors in clinical care.