Association of diabetes related self-care activities with glycemic control of patients with type 2 diabetes in Pakistan

Abstract

Allah Bukhsh,1,2 Tahir Mehmood Khan,1,2 Muhammad Sarfraz Nawaz,3 Hafiz Sajjad Ahmed,4 Kok Gan Chan,5,6 Learn-Han Lee,1,2,7–10 Bey-Hing Goh1,2,7–10 1School of Pharmacy, Monash University, Jalan Lagoon Selatan 45700, Selangor, Malaysia; 2Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, 54000, Lahore, Pakistan; 3Department of Pharmacy, Quaid-i-Azam University Islamabad, Pakistan; 4Capital Hospital Islamabad, Pakistan; 5International Genome Centre, Jiangsu University, Zhenjiang, China; 6Division of Genetics and Molecular Biology, Faculty of Science, Institute of Biological Sciences, University of Malaya, Kuala Lumpur, Malaysia; 7Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia; 8Novel Bacteria and Drug Discovery Research Group, Microbiome and Bioresource Research Strength, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia; 9Biofunctional Molecule Exploratory Research Group, School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia; 10Center of Health Outcomes Research and Therapeutic, Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Mueang Phayao, Thailand Objective: Association of various self-care activities on glycemic control of people with diabetes (PWD) in Pakistan is yet to be explored. The current study aimed to evaluate the association of various diabetes-related self-care activities with glycated hemoglobin (HbA1c) levels and to examine the predictive relationship of patients’ demographic variables with their self-care activities.Patients and methods: A cross-sectional study was conducted on adult PWD (N=218) who were diagnosed with type 2 diabetes mellitus of at least 1 year duration. Self-care activities were examined by using the Urdu version of Diabetes Self-management Questionnaire. Linear regression analysis was conducted to examine the significant predictors for diabetes-related self-care activities and glycemic control.Results: Mean age of the patients was 50.77±13.3 years. Poor glycemic control (HbA1c ≥7%) was observed in majority of the patients (83%). Linear regression analysis revealed that glucose management (β=-0.44; 95% CI -0.438, -0.209; P<0.001) was the strongest predictor for low levels of patients’ HbA1c, followed by dietary control (β=-0.19; 95% CI -0.248, -0.018; P=0.24) and physical activity (β=-0.17; 95% CI -0.165, -0.023; P=0.010), respectively. Linear regression analysis showed that use of oral hypoglycemic agents only (β=-0.218; 95% CI -0.956, -0.200; P=0.003) and higher education level (β=0.204; 95% CI 0.138, 0.777; P=0.005) were significant predictors for higher scores of patients’ self-care activities.Conclusion: The findings support that PWD having better self-reported self-care activities achieve better glycemic control. Patients’ self-care activities should be monitored on a regular basis, especially for those who are at risk of poor glycemic control. Keywords: self-care, self-management, glycemic control, glycated hemoglobin

Keywords

• Self-care
• self-management
• glycemic control
• glycated hemoglobin
• HbA1c.