Diabetes mellitus DM is a major disease that is becoming more prevalent, affecting more than million people worldwide. The number of people affected by DM is expected to rise to million by [ 1 ]. Demographic transition, combined with urbanization and industrialization, has resulted in drastic changes in lifestyles globally.

Consequently, lifestyle-related diseases like DM have emerged as major public health problems. Diabetes is characterized by a state of chronic hyperglycemia resulting from several environmental and genetic etiologies acting jointly [ 2 ]. Until a decade ago, diabetes was not considered a major public health problem in developing countries like Bangladesh, but the situation has now changed dramatically.

According to the International Diabetes Federation IDF report , Bangladesh now leads the world with 8. In Bangladesh, a higher prevalence of diabetes was found in urban 8.

Diabetes is a silent disease: many sufferers become aware that they have diabetes only when they develop one of its life-threatening complications [ 5 ]. Knowledge of diabetes mellitus can assist in early detection of the disease and reduce the incidence of complications.

Levels of knowledge about diabetes among the at-risk population and among those who suffer from the disease are unknown, but more knowledge is associated with better outcomes. There have been few studies on knowledge about diabetes among newly diagnosed diabetic patients in developing countries like Bangladesh, but studies such as these are crucial for the appropriate use of limited resources in poor socioeconomic and educational conditions.

The objective of this study was to test the relationship between knowledge and self-care practices among newly diagnosed type 2 diabetic subjects.

A cross-sectional study design was adopted, and newly diagnosed type 2 diabetic patients were selected conveniently in consideration of the inclusion and exclusion criteria from 19 healthcare centers.

Patients who had other medical complications or were unable to answer a short list of simple questions sociodemographic information such as name, address, disease complications, etc. were excluded from the study.

A method that has been used in various studies in different countries [ 7 — 9 ] was adapted for this study of knowledge and self-care practices in a Bangladeshi population. The knowledge and self-care practices of the subjects were assessed via an interviewer-administered questionnaire, and the interview was administered in an outpatient department OPD setting.

A medium-sized—three-part questionnaire was designed by the researcher. The first part of the questionnaire consisted of sociodemographic information, family history of diabetes, anthropometric measurements, and clinical and biochemical reports.

Part two consisted of 35 knowledge questions, and part three focused on steps taken to monitor glucose, control calorie and food intake, exercise, practice foot care, and take other actions indicative of patient lifestyle.

The Diabetes Knowledge Test DKT questionnaire, which was validated by the University of Michigan [ 10 ], was modified and used for data collection. This questionnaire was translated to Bangla by two separate translators who were native speakers of the target language Bangla ; two separate back-translations were done by translators who were native speakers of English.

Knowledge questions were also substantively modified according to the local guidelines of the Diabetic Association of Bangladesh [ 11 ].

The knowledge assessment questionnaire included questions about diabetes, blood testing, hyperglycemia, and general principles of disease care. A pre-test was conducted before the questionnaire was finalized.

During analysis, knowledge questions were divided into basic and technical sections; 13 items were included in the basic part, which consisted of fundamental knowledge of diabetes. Twenty-two technical knowledge questions involved such concepts as the target age for diabetes testing, the benefits of exercise, hyperglycemia, groupings of foods and their exchange list, ideal body weight, and ketoacidosis.

Each correct response was assigned a score of 1, and each incorrect response was assigned a score of 0. Thus, for 13 items for basic knowledge, the maximum attainable score was 13 and the minimum score was 0. For 22 technical knowledge items, the maximum attainable score was 22 and minimum was 0.

Similarly, for eight practice item such as glucose monitoring, exercise, foot care, smoking, consumption of betel nuts, groupings of foods and their exchange list, the maximum attainable score was 8 and minimum was 0. Frequencies were calculated for descriptive analysis. Chi-squared tests were performed on categorical data to find the relationships between variables.

Multivariate logistic regression was performed to identify the predictors of self-care practices. Socioeconomic classifications in this study were made according to the per capita Gross National Income GNI and according to World Bank WB calculations [ 13 ].

Informed written consent was obtained from all respondents after a full explanation of the nature, purpose, and procedures used for the study. Ethical approval was obtained from the ethics and research review committees of the Diabetic Association of Bangladesh.

Mean age of the respondents was The knowledge distribution of the subjects regarding fundamental components of diabetes management is shown in Figure 1. The mean basic knowledge score of the respondents was 6 ±3. Regarding technical knowledge, mean score among respondents was 12±4.

Approximately one-third of respondents in each knowledge group partially followed the rules for measuring food before eating, a significant relationship. The rest of the respondents from each knowledge group either fully followed or partially followed the advice, a significant relationship.

Results of the multivariate logistic regression analysis are presented in Table 3. The mean practice score of the respondents was 3 ± 1. In model 1, total basic knowledge TBK and business profession were significant independent predictors of good practice.

Total technical knowledge TTK also tended as an independent predictor of good practice with an odds ratio of 1. In the second model high income group was negatively associated with average practice, with an odds ratio of 0.

TBK and TTK did not play any significant role in this model. The available scientific knowledge concerning diabetes mellitus is an important resource to guide and educate diabetes patients concerning self-care.

Self-care concepts that can benefit patients include adherence to diet, physical activity, blood glucose monitoring, and taking oral medication and insulin. Few studies regarding the relationship between knowledge and self-care practices among newly diagnosed diabetics are available in Bangladesh or elsewhere in the world.

Studies have mostly involved the general population and type 2 diabetes patients who have had the disease for a significant period of time [ 5 , 12 , 14 — 17 ]. This study was undertaken in order to assess the relationships between knowledge and self-care practices among newly diagnosed type 2 diabetics attending different healthcare centers in Bangladesh.

A study was conducted on members of the general public in Singapore to evaluate their level of knowledge about diabetes, and the results indicated that the respondents had an acceptable level of knowledge [ 5 ].

However, the relationship was significant. Similar results were found in technical knowledge groups, and the relationship was not significant.

These results revealed that the frequency of blood glucose monitoring increases gradually as the level of knowledge changes. The patients in this study showed higher rates of self-monitoring than those found in the study from Singapore [ 16 ].

Further findings indicated that a good number of the respondents in each basic knowledge group did exercise, and the rate of exercise rose with increasing levels of knowledge.

In the present study, many respondents in all three basic and technical knowledge groups did not take extra care of their feet regularly. Almost the same rates of smoking were found in the technical knowledge groups. Similar results were found in the three technical knowledge groups, and the relationship was significant both in basic and technical knowledge groups.

Diet plays an important role in the prevention and management of DM. Diabetes significantly changes the relationships between patients, their bodies, and the world around them, and restrictions on eating habits make them more aware of their limitations.

This is why the conflict between the desire to eat and the imperious need to refrain from indulging such desire is always present in the daily lives of people with diabetes. Similar and significant results were found in the technical knowledge groups. Notably, about one-third of respondents in all basic and technical knowledge groups partially practiced the measurement of food before eating, a significant result.

Respondents of the present study were fairly informed about diabetes management and we have found an association between basic knowledge and practice.

There is evidence that patient awareness is the most effective way to lessen the complications of diabetes [ 18 ]. Business, one of the categories of occupations, has also been identified as determinant of good practice. We assume that this might have been due to their better access to goods and services as well their independence in availing the health care.

Contrarily, rich people showed lower level of practice. The reason needs exploration. In this study, several explanations were possible for the fact that respondents had average knowledge of DM but inappropriate self-care practices.

First, the bulk of the respondents had family history of diabetes. It would be reasonable to assume that diabetic family members would share their knowledge with non-diabetics and newly diagnosed diabetics.

Second, as the respondents in this study were newly diagnosed, they had not attended any structured diabetes education programs. Ignorance, high confidence level and lack of time may also be the reasons behind the scenario. Various issues need to be addressed in order to close the gaps between knowledge and practice.

The results of this study encourage a positive outlook: all that is required is that a diabetes educator trained in diabetes management counsel patients during every visit and counseling may have an impact in improving the perception about disease, diet, and lifestyle changes and thereby on glycemic control and the complications of diabetes.

In this study, newly diagnosed type 2 diabetic subjects had similar levels of both basic and technical knowledge of DM. Repeated reinforcement of health education and strong motivation are bound to bring about positive changes in self-care practices with regard to diabetes control.

Wild S, Roglic G, Green A, Sicree R, King H: Global prevalence of diabetes: estimates for the year and projections for Diabetes Care.

Article PubMed Google Scholar. Park K: Epidemiology of chronic noncommunicable diseases and conditions. Google Scholar. IDF Diabetes ATLAS. Edited by: Unwin N, Whiting D, Guariguata L, Ghyoot G, Gan D. Hussain A, Rahim MA, Azad Khan AK, Ali SMK, Vaaler S: Type 2 diabetes in rural and urban population: diverse prevalence and associated risk factors in Bangladesh.

Diabetes UK Diabetic Medicine. Article CAS Google Scholar. Wee HL, Ho HK, Li SC: Public Awareness of Diabetes Mellitus in Singapore. Singapore Med J. CAS PubMed Google Scholar. Kirkwood BR, Sterne JAC: Medical Statistics. Mehrotra R, Bajaj S, Kumar D: Influence of education and occupation on knowledge about diabetes control.

And bugs there will inevitably be. Acknowledging this reality from the start can help prevent the disappointment—and even discouragement—that many patients and providers feel when a plan does not work perfectly.

He needs to be ready. He needs to be ready to remind himself that this is par for the course and not an indication of failure; ready to try another approach to his goal, such as asking coworkers to put away their candy; and ready to call for help before discouragement sets in. People who see diabetes management or any major life challenge as a series of experiments in living well generally succeed in living well.

They experiment to make diabetes care easier or more effective, and they use the results of each experiment to plan further refinements and solve new problems as they arise.

Thomas Edison, who had type 2 diabetes, personified this attitude. A reporter came to his lab and questioned Mr. Edison about his years of then-fruitless effort to develop the incandescent light bulb.

How can you stand to fail 2, times? I am 2, steps closer to the solution! The power of a motivated experimenter and problem solver should not be underestimated. Many of us were not trained in psychology or counseling. You may not feel confident using the techniques I mention.

You may even have tried some and found that they did not work. See the list of suggested readings at the end of this article for resources that can help, and consider taking a workshop in motivational interviewing or communications skills, if that appeals to you.

Diabetes is a family disease. That is true genetically, of course, but also emotionally. Diabetes affects everyone who lives with, loves, and cares for someone who has diabetes. And the way all those people relate to the person with diabetes affects how that person manages it.

Family members may be involved in many different ways, from offering wonderful support to attempting to over-control to ignoring diabetes altogether.

Helping people with diabetes get what they need from family and friends can go a long way toward facilitating diabetes self-care. Involving family members in your consultations with patients can be helpful.

You can also ask your patients questions to help them get more practical help and emotional support. I have found these to be useful:. Support groups—real and virtual—can also provide practical and emotional support. Recommend any local groups or Websites you consider worthwhile. Feeling emotionally exhausted is the hallmark of diabetes overwhelmus.

Sometimes, that emotional exhaustion is so severe that a person may be clinically depressed. While major depression is two to four times more common in people with diabetes than it is in the general population, it is underdiagnosed and undertreated in people with diabetes.

This situation should not continue. Valid, easy-to-use, and easy-to score depression screening questionnaires are available and can often be obtained free from companies selling antidepressant medications.

These questionnaires take less than 10 minutes to complete and about 2 minutes to score. People who score high on a depression screening questionnaire should be referred for diagnosis and treatment.

Recent studies show that both counseling cognitive behavioral therapy and antidepressant medication are effective in resolving depression and improving glycemic control in people with diabetes. So please screen patients for depression and treat or refer those who are depressed.

Relieving depression often resolves diabetes overwhelmus and triggers a positive cascade of feelings, behaviors, and metabolic outcomes. Some other psychological problems, such as anxiety disorder, are also more common in people with diabetes. Other problems, such as eating disorders, while perhaps no more common at least in their full-syndrome manifestations are especially dangerous for people who have diabetes.

The list of suggested readings at the end of this article contains sources of additional information on these disorders and their treatment. Identification and treatment of psychological disorders is facilitated when care is provided by a multidisciplinary team, because several professionals see the patient.

Having a mental health professional on the team is especially helpful, because the whole team is made more aware of emotional issues. Even with subclinical, garden-variety diabetes overwhelmus , nurturing emotional coping skills—especially feelings of hope and humor—is essential. I ask patients about the main sources of hope and faith in their lives, when they feel most hopeful about diabetes, and what they can do to draw more effectively on their feelings of faith and hope.

Faith in a higher power, in medical science and technology, or in oneself can all help people cope more easily and effectively with the daily demands of diabetes. When our patients have both in good measure, their lives are good. I am always interested in what makes people laugh, what they find funny.

Then I encourage people to get more of whatever that might be. There is no such thing as too much laughter. Sometimes, there are even things about diabetes to laugh about.

I collect good diabetes stories, and the funny ones are my favorites. So I will close this article with one you might enjoy. I like it because it shows that humor can and often does arise in the most unlikely circumstances. A woman who has diabetes awoke in the middle of the night shaking, sweating, and confused, her blood glucose level very low.

She realized that she could not stand up and get downstairs for the juice and crackers she needed, so she woke her husband. He staggered out of bed and proceeded groggily down to the kitchen. As the minutes passed, the woman lay in bed shaking and waiting.

Finally, after 10 minutes, she was just about to try crawling down the stairs in search of her food and her husband, when he came staggering back up the stairs empty-handed. I ate it myself. Sign In or Create an Account.

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Lifestyle and Behavior April 01 Facilitating Self-Care in People With Diabetes Richard R. Rubin, PhD, CDE Richard R. Rubin, PhD, CDE. This Site. Google Scholar. Diabetes Spectr ;14 2 — Get Permissions.

toolbar search Search Dropdown Menu. toolbar search search input Search input auto suggest. Anderson BJ, Rubin RR Eds. Alexandria, Va. Anderson R, Funnell M: The Art of Empowerment: Stories and Strategies for Diabetes Educators.

Feste C: Meditations on Diabetes: Strengthening Your Spirit in Every Season.

Feb 14, accessed Feb 14, Anita Ramesh. Stroop Effect. Apr 21, accessed Apr 21, Follow MedIndia. Self-Care Practices in Diabetes Management Diabetes Mellitus Self-Care Practices Support System FAQs Glossary.

Written by Dr. Sreeja Dutta, M. Medically Reviewed by Hannah Joy, M. Facebook Twitter Pinterest Linkedin. What is Diabetes Mellitus? There are three main types of diabetes: Type 1 diabetes - The body does not make insulin and needs to take the sugar glucose from the foods we eat and turn it into energy for our body.

Type 2 diabetes - The body does not make or use insulin well. We need to take pills or insulin to help control your diabetes. It is the most common type of diabetes. Gestational diabetes - Some women get this kind of diabetes when they are pregnant.

Though it goes away after pregnancy, they have a greater chance of getting diabetes later in life. Published on Aug 14, Last Updated on Aug 14, i Sources Cite this Article. Medindia adheres to strict ethical publishing standards to provide accurate, relevant, and current health content.

We source our material from reputable places such as peer-reviewed journals, academic institutions, research bodies, medical associations, and occasionally, non-profit organizations. We welcome and value audience feedback as a part of our commitment to health literacy and informed decision-making.

Please use one of the following formats to cite this article in your essay, paper or report: APA Dr. MLA Dr. Chicago Dr. Harvard Dr. html Ask an Expert: How does Stroop Effect apply to real life situations? Please use one of the following formats to cite this article in your essay, paper or report: APA Anita Ramesh.

MLA Anita Ramesh. Chicago Anita Ramesh. Peer Review reports. Diabetes mellitus DM is a major disease that is becoming more prevalent, affecting more than million people worldwide.

The number of people affected by DM is expected to rise to million by [ 1 ]. Demographic transition, combined with urbanization and industrialization, has resulted in drastic changes in lifestyles globally.

Consequently, lifestyle-related diseases like DM have emerged as major public health problems. Diabetes is characterized by a state of chronic hyperglycemia resulting from several environmental and genetic etiologies acting jointly [ 2 ]. Until a decade ago, diabetes was not considered a major public health problem in developing countries like Bangladesh, but the situation has now changed dramatically.

According to the International Diabetes Federation IDF report , Bangladesh now leads the world with 8. In Bangladesh, a higher prevalence of diabetes was found in urban 8. Diabetes is a silent disease: many sufferers become aware that they have diabetes only when they develop one of its life-threatening complications [ 5 ].

Knowledge of diabetes mellitus can assist in early detection of the disease and reduce the incidence of complications. Levels of knowledge about diabetes among the at-risk population and among those who suffer from the disease are unknown, but more knowledge is associated with better outcomes.

There have been few studies on knowledge about diabetes among newly diagnosed diabetic patients in developing countries like Bangladesh, but studies such as these are crucial for the appropriate use of limited resources in poor socioeconomic and educational conditions.

The objective of this study was to test the relationship between knowledge and self-care practices among newly diagnosed type 2 diabetic subjects. A cross-sectional study design was adopted, and newly diagnosed type 2 diabetic patients were selected conveniently in consideration of the inclusion and exclusion criteria from 19 healthcare centers.

Patients who had other medical complications or were unable to answer a short list of simple questions sociodemographic information such as name, address, disease complications, etc.

were excluded from the study. A method that has been used in various studies in different countries [ 7 — 9 ] was adapted for this study of knowledge and self-care practices in a Bangladeshi population.

The knowledge and self-care practices of the subjects were assessed via an interviewer-administered questionnaire, and the interview was administered in an outpatient department OPD setting.

A medium-sized—three-part questionnaire was designed by the researcher. The first part of the questionnaire consisted of sociodemographic information, family history of diabetes, anthropometric measurements, and clinical and biochemical reports.

Part two consisted of 35 knowledge questions, and part three focused on steps taken to monitor glucose, control calorie and food intake, exercise, practice foot care, and take other actions indicative of patient lifestyle.

The Diabetes Knowledge Test DKT questionnaire, which was validated by the University of Michigan [ 10 ], was modified and used for data collection. This questionnaire was translated to Bangla by two separate translators who were native speakers of the target language Bangla ; two separate back-translations were done by translators who were native speakers of English.

Knowledge questions were also substantively modified according to the local guidelines of the Diabetic Association of Bangladesh [ 11 ]. The knowledge assessment questionnaire included questions about diabetes, blood testing, hyperglycemia, and general principles of disease care. A pre-test was conducted before the questionnaire was finalized.

During analysis, knowledge questions were divided into basic and technical sections; 13 items were included in the basic part, which consisted of fundamental knowledge of diabetes.

Twenty-two technical knowledge questions involved such concepts as the target age for diabetes testing, the benefits of exercise, hyperglycemia, groupings of foods and their exchange list, ideal body weight, and ketoacidosis.

Each correct response was assigned a score of 1, and each incorrect response was assigned a score of 0. Thus, for 13 items for basic knowledge, the maximum attainable score was 13 and the minimum score was 0.

For 22 technical knowledge items, the maximum attainable score was 22 and minimum was 0. Similarly, for eight practice item such as glucose monitoring, exercise, foot care, smoking, consumption of betel nuts, groupings of foods and their exchange list, the maximum attainable score was 8 and minimum was 0.

Frequencies were calculated for descriptive analysis. Chi-squared tests were performed on categorical data to find the relationships between variables.

Multivariate logistic regression was performed to identify the predictors of self-care practices. Socioeconomic classifications in this study were made according to the per capita Gross National Income GNI and according to World Bank WB calculations [ 13 ].

Informed written consent was obtained from all respondents after a full explanation of the nature, purpose, and procedures used for the study. Ethical approval was obtained from the ethics and research review committees of the Diabetic Association of Bangladesh.

Mean age of the respondents was The knowledge distribution of the subjects regarding fundamental components of diabetes management is shown in Figure 1. The mean basic knowledge score of the respondents was 6 ±3.

Regarding technical knowledge, mean score among respondents was 12±4. Approximately one-third of respondents in each knowledge group partially followed the rules for measuring food before eating, a significant relationship. The rest of the respondents from each knowledge group either fully followed or partially followed the advice, a significant relationship.

Results of the multivariate logistic regression analysis are presented in Table 3. The mean practice score of the respondents was 3 ± 1. In model 1, total basic knowledge TBK and business profession were significant independent predictors of good practice. Total technical knowledge TTK also tended as an independent predictor of good practice with an odds ratio of 1.

In the second model high income group was negatively associated with average practice, with an odds ratio of 0. TBK and TTK did not play any significant role in this model. The available scientific knowledge concerning diabetes mellitus is an important resource to guide and educate diabetes patients concerning self-care.

Self-care concepts that can benefit patients include adherence to diet, physical activity, blood glucose monitoring, and taking oral medication and insulin.

Few studies regarding the relationship between knowledge and self-care practices among newly diagnosed diabetics are available in Bangladesh or elsewhere in the world. Studies have mostly involved the general population and type 2 diabetes patients who have had the disease for a significant period of time [ 5 , 12 , 14 — 17 ].

This study was undertaken in order to assess the relationships between knowledge and self-care practices among newly diagnosed type 2 diabetics attending different healthcare centers in Bangladesh.

A study was conducted on members of the general public in Singapore to evaluate their level of knowledge about diabetes, and the results indicated that the respondents had an acceptable level of knowledge [ 5 ]. However, the relationship was significant. Similar results were found in technical knowledge groups, and the relationship was not significant.

These results revealed that the frequency of blood glucose monitoring increases gradually as the level of knowledge changes. The patients in this study showed higher rates of self-monitoring than those found in the study from Singapore [ 16 ].

Further findings indicated that a good number of the respondents in each basic knowledge group did exercise, and the rate of exercise rose with increasing levels of knowledge.

In the present study, many respondents in all three basic and technical knowledge groups did not take extra care of their feet regularly. Almost the same rates of smoking were found in the technical knowledge groups.

Similar results were found in the three technical knowledge groups, and the relationship was significant both in basic and technical knowledge groups. Diet plays an important role in the prevention and management of DM. A thematic analysis approach was used to process the data.

Overall self-care practices were not adequate. Most patients reported irregular self-monitoring of blood sugar. Dietary and physical exercise recommendations were inadequately practiced by most of the participants.

Most patients better adhered to medication prescriptions. Diabetes patients largely depend on prescribed medications to control their blood sugar level. The importance of proper self-care practices for effective management of diabetes is not adequately emphasized in diabetes care centers and patients lack sufficient knowledge for proper self-care.

Citation: Tewahido D, Berhane Y Self-Care Practices among Diabetes Patients in Addis Ababa: A Qualitative Study. PLoS ONE 12 1 : e Received: July 16, ; Accepted: December 12, ; Published: January 3, Copyright: © Tewahido, Berhane. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Interview transcripts cannot be made public without participant consent due to ethical reasons due to confidentiality issues, as required by the Addis Continental Institute of Public health Institutional Review Board.

Data will be made available upon request at the following contact: Dagmawit Tewahido, email: Dagmawit. tewahido gmail. com , tel. Competing interests: The authors have declared that no competing interests exist.

Globally over 14 million people die each year from non-communicable diseases such as diabetes mellitus between the ages of 30 and 70, of which 85 per cent are in developing countries [ 1 ].

Ethiopia is among the top five countries with the highest number of people affected by diabetes mellitus in Sub Saharan Africa [ 2 ]. As a result hospital admissions for diabetes management has been rising in recent years [ 3 , 4 ].

Effective management of diabetes requires strong and consistent cooperation of the patient [ 5 ]. Often the complications associated with diabetes management are highly attributable to the failure to comply with self-care recommendations [ 6 ]. Various strategies were adopted in different countries to help people with diabetes improve their self-care practices depending on the context [ 9 ].

Implementation of a comprehensive patient education program was reported to have enhanced diabetes self-care practices [ 10 ]. Improved social support for patients with diabetes has facilitated diabetes self-care and achieve improved glycemic control [ 11 ].

Task shifting is another approach successfully implemented to improve self-care in places where doctors have heavy work load; either nurses or other health professionals were specifically trained to provide proper information to the patient instead of the busy doctor [ 12 ].

Understanding patients self-care cultural and value systems is another important factor to designing a responsive program that can influence their diet and exercise choices, trend of blood glucose monitoring, and compliance with prescribed medication regimens [ 9 ].

While the burden of diabetes is increasing in Ethiopia, studies conducted to understand self-care practices are very limited. Thus the aim of this study was to describe the diabetes self-care practices and identify facilitators and barriers to the practice among type II diabetes patients attending follow-up in public hospitals.

The study was conducted in Addis Ababa, the capital city of Ethiopia. There were five public hospitals that ran a special diabetes follow up clinics at the time of the study where patients are appointed every four to six months to see their doctor and receive services in outpatient departments.

The clinics provide diabetes education on self-care practices and on proper self-injection techniques. We selected Menelik II and Zewditu memorial hospitals for this study. These two hospitals have been running a separate diabetes follow up clinics for more than three decades.

In Ethiopia all public hospitals provide consultation and anti-diabetes medications free of charge. The study participants were patients with type II diabetes that came to follow up clinics between November and February The inclusion criteria were having been diagnosed with type II diabetes for at least five years and being between the ages of 35 and 65 years.

As the aim of the study was to describe the day to day self-care practices of patients with diabetes, newly diagnosed patients were not included in the study.

This was done to be able to see the different forms of self-care practices from different perspectives. The doctors and nurses working in the follow up clinics helped in identifying patients that fulfil the inclusion criteria of the study.

We tried to include patients believed to be interactive, open minded and those who were willing to participate in the study. Each person identified as potential respondent was then individually asked for consent after being informed about the purpose and the required procedures. The semi-structured interview guide used for data collection was developed by reviewing relevant literatures.

In addition, participants were encouraged to speak up their mind in case they had anything further to tell related to the topic. A pilot was conducted in another public hospital to assess the acceptability and ease of understanding the interview process.

Then interview guide was revisited to make the necessary changes and modifications before conducting the actual interviews included in the analysis. All interviews were conducted by the first author in a private space within the hospital compound.

The interviews were conducted in Amharic language, which is the national language of Ethiopia. All interviews were tape recorded with verbal consent obtained from the study participants. In addition relevant notes were taken during the interview to document key issues and observations.

Interviews took approximately 45—60 minutes. Interviews were conducted until the point of relative saturation with regard to the issues being discussed. All interviews were transcribed verbatim in Amharic and then translated into English for data analysis.

The translated content was coded manually and entered into a computer software open-code used for qualitative data sorting. Codes were given and grouped into categories that were predefined based on the objective of the study.

The field notes were included in the memos section of the software. Coding started by a thorough reading of each interview material, followed by line-by-line flagging of each of the interviews.

A coding procedure was established jointly by the co-authors. A thematic analysis approach was used to categorize the codes thorough several iterations.

The thematic areas were diet, physical exercise, medication adherence, self- monitoring of blood glucose and foot care. Ethical clearance for the study was obtained from Institutional Review Board of Addis Continental Institute of Public Health and permission to conduct the study was granted by the Addis Ababa city administration Health Bureau.

Interviews were conducted after participants provided verbal informed consent. The interviews were conducted in manners that assured privacy for the respondents. Access to raw data was restricted only to the study investigators.

A total of thirteen in-depth interviews were conducted with type II diabetes patients. All participants have had diabetes for at least five years. Seven of the participants were female. All respondents were between the age of 35and 65, and nine of them were married. With regard to their educational back ground, one has attended college, six had elementary to high school education, and three could not read and write.

Participants were from various religious and ethnic groups. None of the patients invited for the study refused to participate in the study. Participants generally reported that they do not regularly check their blood glucose level.

Even patients who had their own gluco-meter machine at home reported testing their blood sugar once every 4—6 six weeks. Those who do not own the glucometer machine at home reportedly go to either a nearby private clinic or laboratory only when they feel ill.

About a third of the study participants reported checking their blood sugar level only during their follow up visits to the hospital, which is every three to four months.

These findings indicate blood sugar monitoring is irregular and the high risks to develop long term diabetes complication due to poor glycemic control. And when it gets down , I lower it back to the previous dose. They tell you not to do that but I have been monitoring my sugar like that for all these years.

Another patient described her experience of self-monitoring of her blood sugar as frustrating. She felt that controlling her blood sugar was beyond their capability.

No matter what I do to control it , nothing prevents it from shooting up high. All I can do is take the prescribed medications. Most study participants recognized diet as an essential component of self-care practice for people with diabetes. Almost all respondents reported to have totally avoided taking table sugar and minimized intake of sweet drinks and food.

A diabetes friendly meal plans were not widely recognized by most patients. Only one participant had an idea of the approximate amount of proteins, carbohydrates and fats recommended for people with diabetes.

The following are illustrative quotes on dietary practices:.

Follow MedIndia. Self-Care Practices in Diabetes Management Diabetes Mellitus Self-Care Practices Support System FAQs Glossary. Written by Dr. Sreeja Dutta, M. Medically Reviewed by Hannah Joy, M. Facebook Twitter Pinterest Linkedin.

What is Diabetes Mellitus? There are three main types of diabetes: Type 1 diabetes - The body does not make insulin and needs to take the sugar glucose from the foods we eat and turn it into energy for our body.

Type 2 diabetes - The body does not make or use insulin well. We need to take pills or insulin to help control your diabetes. It is the most common type of diabetes. Gestational diabetes - Some women get this kind of diabetes when they are pregnant. Though it goes away after pregnancy, they have a greater chance of getting diabetes later in life.

Published on Aug 14, Last Updated on Aug 14, i Sources Cite this Article. Medindia adheres to strict ethical publishing standards to provide accurate, relevant, and current health content.

We source our material from reputable places such as peer-reviewed journals, academic institutions, research bodies, medical associations, and occasionally, non-profit organizations. We welcome and value audience feedback as a part of our commitment to health literacy and informed decision-making.

Please use one of the following formats to cite this article in your essay, paper or report: APA Dr. MLA Dr. Chicago Dr. Harvard Dr. html Ask an Expert: How does Stroop Effect apply to real life situations?

Please use one of the following formats to cite this article in your essay, paper or report: APA Anita Ramesh. MLA Anita Ramesh. Chicago Anita Ramesh. Harvard Anita Ramesh. Recommended Reading. Diabetes Prevention. Balancing the diet by eating low glycemic carbohydrates with good protein and good fat is the key.

Diabetes is a metabolic disease caused by insulin deficiency that leads to high blood sugar levels and several associated complications if left untreated. ASK A DOCTOR ONLINE. 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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American Diabetes Association. Diabetes Care 32 Suppl. By tracking your blood sugar levels, physical activity, food intake, and emotional well-being, you provide your healthcare team with a comprehensive understanding of your diabetes management. This information gives them the ability to identify areas for improvement, make adjustments to your medication regimen, and provide personalized guidance on self-care practices.

Strive to build self-care practices and do them on a daily basis as they help you manage your condition more effectively and improve your quality of life.

It provides healthcare professionals with valuable information about your daily routines and habits, which reflects in developing personalized treatment plans and making more informed decisions about your therapy. Self-care practices also allow you to take control of your health and make positive changes to your lifestyle.

Overall, self-care is a critical component of diabetes management and a necessary part of achieving better outcomes for people with diabetes. Your email address will not be published. Save my name, email, and website in this browser for the next time I comment.

Post comment. Whitepaper: Diabetes and its Effects on Every System in the Body. Get ypour FREE copy now! Skip to content. The Role of Self-Care in Diabetes Management.

But what exactly is self-care in diabetes management, and why is it important? What is Self-Care? Diabetes Self-Management Education DSME First, you need to be trained on how to manage your type of diabetes best.

Some key topics covered in DSME programs include: Understanding the different types of diabetes and their effects on the body The importance of regular blood glucose monitoring and interpreting the results Developing a personalised meal plan based on individual needs and preferences The benefits of regular physical activity and how to incorporate it into daily routines Recognizing and managing the signs and symptoms of high and low blood sugar levels Identifying and managing stress and other emotional issues related to diabetes Proper use of medications and insulin therapy, if applicable These programs often include individualised assessments, goal setting, problem-solving, and ongoing support from qualified professionals.

Gaining a Better Overview of Blood Sugar Levels Over Time Managing blood sugar levels is a crucial aspect of diabetes self-care. Physical Self-Care Physical self-care is essential for maintaining good health and managing diabetes effectively.

Regular physical activity has numerous benefits for people with diabetes, including: Improved insulin sensitivity, which helps the body use insulin more effectively Lower blood sugar levels and better overall blood sugar control Increased energy and reduced fatigue Weight management, which reduces the risk of diabetes-related complications Lower blood pressure and cholesterol levels, reducing the risk of heart disease Experts recommend 3 at least minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity exercise per week, along with muscle-strengthening activities on two or more days per week.

Mental Self-Care Mental self-care involves taking care of your mental and emotional health. Some effective mental self-care strategies for people with diabetes include: Practicing mindfulness e. Yoga, Journaling, Breathing Methods, Meditation etc.

to increase awareness and reduce stress Seeking professional help, such as counselling or therapy, to address emotional challenges related to diabetes Engaging in hobbies and activities that bring you joy and relaxation Building a solid support network of your family, friends, and fellow people with diabetes Prioritizing sleep and maintaining a consistent sleep schedule to promote mental and emotional well-being These practices will help you manage the emotional and mental toll of living with the condition and improve your quality of life.

Enriched Information for Your Healthcare Team Your healthcare team plays a critical role in your diabetes management, but they can only help you as much as the information you provide them. Conclusion Strive to build self-care practices and do them on a daily basis as they help you manage your condition more effectively and improve your quality of life.

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