title: Severe obesity and diabetes self-care attitudes, behaviours and burden: implications for weight management from a matched case-controlled study. Results from Diabetes MILES--Australia.
abstract: OBJECTIVE
  To investigate whether diabetes self-care attitudes, behaviours and perceived burden, particularly related to weight management, diet and physical activity, differ between adults with Type 2 diabetes who are severely obese and matched non-severely obese control subjects.
  
  
  METHODS
  The 1795 respondents to the Diabetes MILES--Australia national survey had Type 2 diabetes and reported height and weight data, enabling BMI calculation: 530 (30%) were severely obese (BMI ≥ 35 kg/m(2); median BMI = 41.6 kg/m(2)) and these were matched with 530 control subjects (BMI < 35 kg/m(2); median BMI = 28.2 kg/m(2)). Diabetes self-care behaviours, attitudes and burden were measured with the Diabetes Self-Care Inventory-Revised. Within-group and between-group trends were examined.
  
  
  RESULTS
  The group with BMI ≥ 35 kg/m(2) was less likely to achieve healthy diet and exercise targets, placed less importance on diet and exercise recommendations, and found the burden of diet and exercise recommendations to be greater than the group with BMI < 35 kg/m(2). The group with BMI ≥ 35 kg/m(2) was more likely to be actively trying to lose weight, but found weight control a greater burden. These issues accentuated with increasing obesity and were greatest in those with BMI > 45 kg/m(2). There were no between-group differences in other aspects of diabetes self-care: self-monitoring of blood glucose, use of medications and smoking. Moderate-to-severe symptoms of depression were independently associated with reduced likelihood of healthy diet and physical activity, and with greater burden associated with diet, physical activity and weight management.
  
  
  CONCLUSIONS
  Severely obese people with diabetes demonstrated self-care attitudes, behaviours and burdens that infer barriers to weight loss. However, other important diabetes self-care behaviours are supported equally by severely obese and non-severely obese individuals.
authors: Clinical Obesity Research, Baker IDI Heart and Diabetes Institute, Melbourne, Vic., Australia; School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.
authors: J B
authors: JB
authors: Dixon
authors: J L
authors: JL
authors: Browne
authors: K G
authors: KG
authors: Mosely
authors: T L
authors: TL
authors: Rice
authors: K M
authors: KM
authors: Jones
authors: F
authors: F
authors: Pouwer
authors: J
authors: J
authors: Speight
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001315:Australia / Q000453:epidemiology; D001519:Behavior; D016022:Case-Control Studies; D017281:Cost of Illness; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D010465:Perception; D012648:Self Care; D061217:Weight Reduction Programs / Q000706:statistics & numerical data