title: Successful self-management among non-insulin-treated adults with Type 2 diabetes: a self-regulation perspective.
abstract: OBJECTIVE
  To clarify the role of self-monitoring of blood glucose (SMBG) in the self-management of Type 2 diabetes from the patient's perspective, using in-depth interviews with non-insulin-treated adults to investigate how they learned to manage their diabetes effectively and whether SMBG played a significant role in this process.
  
  
  METHODS
  Individual interviews were conducted with 14 non-insulin-treated adults with Type 2 diabetes who had significantly improved their glycaemic control [64% women; 50% black; 21% Hispanic; mean age 60 years; mean HbA(1c) concentration 43 mmol/mol (6.1%)]. Interviews were transcribed and analysed by a coding team, applying the concept of illness coherence from the Common Sense Model of Self-Regulation.
  
  
  RESULTS
  The majority of participants relied on SMBG to evaluate their self-management efforts. Key themes included: adopting an experimental approach; experiencing 'a-ha' moments; provider-assisted problem-solving; using SMBG and other feedback to evaluate when their efforts were working; and normalizing diabetes-specific behaviour changes as being healthy for everyone.
  
  
  CONCLUSIONS
  Our qualitative data are consistent with the argument that SMBG, if implemented appropriately with enough education and provider access, can be a powerful tool for non-insulin-treated adults with Type 2 diabetes to monitor their self-management. Establishing sufficient conditions for illness coherence to develop while individuals are learning to use SMBG could increase their sense of personal control in managing a complex and demanding illness.
authors.affiliation: Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Tanenbaum
authors.affiliation: Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ.
authors.forename: H
authors.initials: H
authors.lastname: Leventhal
authors.affiliation: Center for Innovation to Implementation, VA Palo Alto Healthcare System, Menlo Park, CA, USA.|Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: J Y
authors.initials: JY
authors.lastname: Breland
authors.affiliation: Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ.
authors.forename: J
authors.initials: J
authors.lastname: Yu
authors.affiliation: Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Walker
authors.affiliation: Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.|Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Gonzalez
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D003927:Diet, Diabetic; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009515:New Jersey; D009519:New York City; D010349:Patient Compliance; D010353:Patient Education as Topic; D012189:Retrospective Studies; D012648:Self Care; D060685:Sense of Coherence
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human