An assessment of attitudes, behaviors, and outcomes of patients with type 2 diabetes.
OBJECTIVE
Patient self-care behaviors, including taking medication, following a meal plan, exercising regularly, and testing blood glucose, influence diabetes control. The purpose of this research was to identify (1) which barriers to diabetes management are associated with problem behaviors and (2) which patient behaviors and barriers are associated with diabetes control.


METHODS
This was a cross-sectional study of linked medical record and self-reported information from patients with type 2 diabetes. A randomly selected sample of 800 clinic patients was mailed an investigator-developed survey. The study sample consisted of 253 (55%) individuals who had measured glycosylated hemoglobin (HbA1c) within 3 months of the survey date.


RESULTS
The barriers to each diabetes self-care behavior differed. Cost was the most common barrier to the 4 self-care behaviors. In a multivariable regression model, the belief that type 2 diabetes is a serious problem and depression were strongly associated with higher HbA1c levels. Lower HbA1c levels were significantly associated with being married and greater self-reported adherence-satisfaction with taking medication and testing blood glucose.


CONCLUSIONS
This study expanded earlier research by focusing on 4 specific self-care behaviors, their barriers, and their association with HbA1c. Barriers that were significantly associated with HbA1c were specific to the behavior and varied across behaviors.
Department of Family Medicine, University of Iowa, Iowa, USA. jeanette-daly@uiowa.edu
Jeanette M
JM
Daly
Arthur J
AJ
Hartz
Yinghui
Y
Xu
Barcey T
BT
Levy
Paul A
PA
James
Mary L
ML
Merchant
Robert E
RE
Garrett
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015190:Blood Glucose Self-Monitoring / Q000191:economics; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D003927:Diet, Diabetic; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000191:economics / Q000379:methods; D010349:Patient Compliance; D011159:Population Surveillance; D012648:Self Care / Q000379:methods; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents