A study on diabetes-related self-care plan and its determinants among diabetes patients in a Warangal region, Telangana, India

Syed, Wajid; Menaka, M.; Parimalakrishnan, S.; Yamasani, Vamshi Vishnu

doi:10.1590/s2175-97902022e21266

Acessibilidade / Reportar erro

Brasil

Brazilian Journal of Pharmaceutical Sciences

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Article • Braz. J. Pharm. Sci. 58 • 2022 • https://doi.org/10.1590/s2175-97902022e21266 copy

A study on diabetes-related self-care plan and its determinants among diabetes patients in a Warangal region, Telangana, India

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The prevalence of epidemiological diseases, including diabetes, has continued to increase because of the adaption of Western culture and the lack of self-care activities among patients with diabetes. Therefore, in this cross-sectional study, we aimed to assess self-care plans and determinants among diabetes outpatients in Warangal. We conducted a prospective observational study among diabetes outpatient clinic in Warangal, India over 6 months from October 2019 to March 2020. We used the expanded Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. A P value of less than < 0.05 was considered statistically significant. Respondents (mean age, 52.3 (standard deviation (SD), 11.01) years) had an overall SDSCA score of 49.18 ± 3.57 (SD). Mean scores for the diet, physical activity, foot care, medication adherence, and blood sugar testing scales were 12.79 (SD, 1.61), 10.24 (SD, 1.77), 15.67 (SD, 1.5), 5.66 (SD, 1.17), and 4.80 (SD, 0.68), respectively. Patients’ age, education, disease duration and hemoglobin A1C (HbA1C) levels of <7.5% (P < 0.001)) had significantly higher mean scores for blood sugar testing, diet, physical activity, and adherence (P < 0.001). The employment status is associated with all the domains of Summary of Diabetes Self-Care Activities (P < 0.001). Taken together, our results revealed that patients with diabetes in Warangal had poor self-care planning, highlighting the need for strengthening initiatives that generate awareness regarding diabetes and improving related self-care practices.

Keywords:
Diabetes; Self-care; Diet control; Physical activity; Foot care; Medication adherence

Characteristics	Frequency (n)	Percentage (%)
Sex
Male	259	64.4
Female	143	35.6
Marital status
Married	336	83.6
Single	9	2.2
Divorced/separated /widowed	57	14.2
Education level
Illiterate	107	26.6
Literate (basic education and above)	295	73.4
Employment status
Employed	198	49.3
Unemployed	24	6.0
Retired	75	18.7
Self-employed	53	13.2
Housewife	52	12.9
Smoking status
Yes	148	36.8
No	254	63.2
Alcohol status
Yes	254	63.2
No	148	36.8
Diseases duration
<5 years	186	46.3
6-10 years	171	42.5
>10 years	45	11.2
*Insurance status*
Yes	119	29.6
No	283	70.4

Questionnaires	Days in the past week								Mean (SD)
Questionnaires	0	1	2	3	4	5	6	7	Mean (SD)
Diet plan
How many days did you follow the eating plan?	0	0	0	0	47 (11.7)	185 (46)	135 (33.6)	35 (8.7)	5.39 ± 0.80
How many days did you eat ≥5 servings of fruits and vegetables?	0	0	4 (1.4)	4 (1.4)	99 (24.6)	230 (57.2)	57 (14.2)	8 (2.0)	4.88 ± 0.76
How many days did you consume fatty foods?	2 (0.5)	25 (6.2)	184 (45.8)	155 (38.6)	29 (7.2)	6 (1.5)	-	1 (2.0)	2.51 ± 0.83
Physical activity and exercise
How many days did you participate in physical activity (30 min)?	1 (0.2)	3 (0.7)	1 (0.2)	9 (2.2)	58 (14.4)	177 (44)	116 (28.9)	37 (9.2)	5.23 ± 1.02
Specific exercise session?	1 (0.2)	1 (0.2)	4 (1.0)	11 (2.7)	78 (19.4)	200 (49.8)	87 (21.6)	20 (5.0)	5.01 ± 0.95
Foot care
Checked your feet	3 (0.7)	1 (0.2)	12 (3.0)	65 (16.2)	201 (50)	111 (27.6)	9 (2.2)	0	4.06 ± 0.88
Inspecting the inside of your shoes	3 (0.7)	0	5 (1.2)	38 (9.5)	189 (47)	153 (38.1)	13 (3.2)	1 (0.2)	4.30 ± 0.84
Foot washing	0	0	0	24 (6.0)	126 (31.3)	223 (55.5)	23 (5.7)	6 (1.5)	4.65 ± 0.74
Foot soaking	1 (0.2)	4 (1.0)	168 (41.8)	207 (51.5)	14 (3.5)	3 (0.7)	-	5 (1.2)	2.65 ± 0.79
Blood sugar testing
Blood sugar testing recommended by a healthcare provider	0	1 (0.2)	3 (0.7)	5 (1.2)	97 (24.1)	256 (63.7)	38 (9.5)	2 (0.5)	4.80 ± 0.68
Medication
Took the prescribed medication?	1 (0.2)	0	0	7 (1.7)	66 (16.4)	107 (26.6)	89 (22.1)	132 (32.8)	5.66 ± 1.17

Questionnaires	Satisfactory n (%)	Unsatisfactory n (%)
Diet planning
How many days over the last 7 days did you follow your eating plan?	355 (88.3)	47 (11.7)
How many days over the last 7 days did you eat ≥5 more servings of fruits and vegetables?	295 (73.4)	107 (26.6)
How many days over the last 7 days did you eat high-fat foods, such as red meat or full-fat dairy products?	7 (1.7)	395 (98.3)
Physical activity and exercise
How many days over the last 7 days did you participate in at least 30 minutes of physical activity?	330 (82.1)	72 (17.9)
How many days over the last 7 days did you participate in a specific exercise session?	307 (76.4)	95 (23.6)
Foot care
How many days over the last 7 days did you check your feet?	120 (29.9)	282 (70.1)
How many days over the last 7 days did you inspect the inside of your shoes?	167 (41.5)	235 (58.8)
How many days over the last 7 days did you wash your feet?	252 (62.7)	150 (37.3)
How many days over the last 7 days did you soak your feet?	8 (2.0)	394 (98)
Blood sugar testing
How many days over the last 7 days did you test your blood sugar for the number of times recommended by your healthcare provider?	296 (73.6)	106 (26.4)
Medication
How many days over the last 7 days did you take your prescribed diabetes medication?	221 (55)	181 (45)

Data set (SDSCA)	Value Mean(SD)
Diet score	12.7 ± 1.61
Physical activity	10.24 ± 1.77
Blood sugar testing	4.80 ± 0.68
Foot care	15.67 ± 1.5
Adherence to medication	5.66 ± 1.17
Total score	49.18 ± 3.57

Characteristics	Diet Mean(SD)	Physical activity Mean(SD)	Blood sugar testing Mean(SD)	Foot care Mean(SD)	Adherence to medication Mean(SD)
Sex
Male	12.87 (1.64)	10.27(1.90)	4.79 (0.70)	15.6(1.55)	5.64 (1.20)
Female	12.65 (1.55)	10.19(1.51)	4.83 (0.66)	15.63(1.55)	5.71 (1.12)
P value	0.211	0.479	0.746	0.975	0.652
Age (years)
<32	13.50 (1.95)	9.80 (2.93)	4.50 (0.70)	16.20 (2.09)	5.50 (1.17)
32-42	13.00 (1.51)	10.94 (1.53)	4.81 (0.77)	15.00 (1.47)	6.00 (1.08)
43-52	12.82 (1.64)	10.28 (1.88)	4.82 (0.74)	15.85 (1.57)	5.79 (1.19)
52-60	12.50 (1.39)	10.05 (1.56)	4.77 (0.66)	15.79 (1.46)	5.46 (1.19)
>60	12.88 (1.80)	10.04 (1.75)	4.83 (0.57)	15.61 (1.50)	5.52 (1.14)
*P value*	0.126	0.004	0.668	0.014	0.018
Education
Illiterate	13.44(1.48)	10.78 (1.68)	4.91 (0.58)	15.54 (1.54)	6.252 (0.95)
Literate	12.55(1.60)	10.05 (1.77)	4.76 (0.72)	15.72 (1.55)	5.454 (1.18)
*P value*	0.000	0.000	0.081	0.281	0.000
Employment
Employed	12.76 (1.61)	10.12 (1.87)	4.85 (0.61)	15.66 (1.58)	5.72 (1.11)
Unemployed	12.70 (1.89)	10.62 (1.86)	4.50 (0.88)	15.08 (1.93)	5.50 (1.21)
Retired	12.25 (1.47)	9.48 (1.37)	4.65 (0.68)	16.14 (1.35)	4.94 (1.03)
Self-employed	13.39 (1.65)	11.05 (1.63)	4.81 (0.85)	15.64 (1.66)	5.94 (1.33)
Housewife	13.11 (1.40)	10.82 (1.46)	4.98 (0.61)	15.34 (1.23)	6.26 (0.93)
*P value*	0.000	0.000	0.000	0.013	0.000
Disease duration			4.85 (0.74)	15.75 (1.57)	5.79 (1.12)
<5 years	12.87 (1.52)	10.41(1.57)	4.81 (0.59)	15.54 (1.52)	5.81 (1.12)
6-10 years	12.94 (1.68)	10.37(1.54)	4.55 (0.75)	15.82 (1.55)	4.57 (1.05)
>10 years	11.86 (1.45)	9.08 (1.32)
*P value*	0.000	0.000	0.021	0.381	0.000
HbA1C levels
<7.5%	12.95(1.68)	10.44 (1.77)	4.86 (0.66)	15.54(1.62)	5.94(1.05)
>7.5%	12.64 (1.54)	10.06(1.76)	4.74 (0.71)	15.79(1.47)	5.40(1.22)
*P value*	0.076	0.014	0.071	0.069	0.000
Body mass index
Underweight (<18.5)	13.44 (1.54)	11.13 (1.52)	4.88 (0.66)	14.97 (1.72)	5.86 (1.18)
Normal weight (18.51-24.9)	12.68 (1.56)	10.17 (1.75)	4.81 (0.66)	15.73 (1.52)	5.65(1.12)
Overweight (25.00-29.99)	12.74 (1.65)	10.08 (1.83)	4.77 (0.74)	15.84 (1.47)	5.63 (1.26)
Obese (>30.00)	14.33 (3.21)	9.66 (2.08)	4.00 (0.00)	14.33 (1.52)	5.00 (1.73)
*P value*	0.028	0.002	0.076	0.013	0.511
Smoking status
Yes	12.75 (1.70)	10.04 (1.81)	4.77 (0.75)	15.79 (1.62)	5.45 (1.29)
No	12.81 (1.57)	10.36 (1.74)	4.82 (0.64)	15.6 (1.50)	5.79 (1.09)
*P value*	0.827	0.123	0.725	0.274	0.013
Alcohol status
Yes	12.80 (1.64)	10.25 (1.81)	4.77 (0.69)	15.70 (1.53)	5.55 (1.19)
No	12.77 (1.56)	10.22 (1.72)	4.85 (0.67)	15.61 (1.58)	5.86 (1.13)
*P value*	0.953	0.995	0.352	0.725	0.010
Treatment type
Insulin injection	15.33 (3.78)	11.66(3.21)	5.66 (1.15)	14.66 (0.57)	5.33(1.15)
Oral medication	12.71(1.61)	10.07 (1.87)	4.76(0.69)	15.67(1.67)	5.63 (1.18)
Injection and tablet	12.74 (1.75)	10.33(1.62)	4.77 (0.83)	15.47 (1.29)	5.55 (1.31)
Diet, exercise, and oral medication	12.90 (1.46)	10.47 (1.63)	4.87(0.53)	15.82 (1.48)	5.79 (1.07)
*P value*	0.456	0.418	0.291	0.308	0.856
Marital status
Married	12.79 (1.59)	10.24 (1.83)	4.81 (0.69)	15.68 (1.52)	5.67 (1.20)
Single	12.77 (2.38)	11.11 (1.61)	4.44 (1.23)	14.77 (2.16)	6.00 (0.86)
Divorced/separated	12.68 (1.57)	10.10 (1.59)	4.78 (0.57)	15.89 (1.62)	5.36 (1.12)
Widowed	13.05 (1.71)	10.21 (1.13)	4.89 (0.45)	15.42 (1.57)	5.94 (0.91)
*P value*	0.813	0.378	0.823	0.407	0.213

Universidade de São Paulo, Faculdade de Ciências Farmacêuticas Av. Prof. Lineu Prestes, n. 580, 05508-000 S. Paulo/SP Brasil, Tel.: (55 11) 3091-3824 - São Paulo - SP - Brazil
E-mail: bjps@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] *Correspondence: V. V. Yamasani. Department of Pharmacy. Aurobindo College of Pharmacy. Warangal, AP, India. E-mail: pharmvishnu77@gmail.com; Wajidalisyed06@gmail.com.