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Introduction: To describe the self-care challenges, diabetes technology awareness, current use, and satisfaction among adults with type 1 diabetes and parents of children with type 1 diabetes in Singapore. Methods: An anonymous online survey was administered between November 2020 and October 2021. Data are presented as mean (standard deviation) or count (percentages). Comparisons between groups were done using the independent samples T-test. Results: 251 people (176 adults, 75 parents) participated. The most challenging self-care burdens were carbohydrate counting (24.4%) among adults and insulin dose calculations (28%) among parents. Nocturnal awakenings for diabetes care of their child were a common event (25.3%). Despite high awareness about continuous glucose monitoring devices (77.8% adults, 78.7% parents) the use (24.9% adults, 55% children) remained low. Both adults and parents of children with type 1 diabetes found continuous glucose monitoring to be liberating and less restrictive. Despite overall low insulin pump use (23.9% adults, 29.3% children); satisfaction scores were higher among insulin pump users than insulin pen users (P = 0.02). Conclusion: Carbohydrate counting and insulin dose calculations were the most challenging self-care tasks among people with type 1 diabetes in Singapore. Diabetes technology use was relatively low in Singapore. Continuous glucose monitoring and Insulin pump users found them to be beneficial.

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AIMS: Psychological interventions have had modest effects on HbA1c in adults with Type 1 diabetes (T1D). We evaluated a novel behaviour therapy (BT) group program aiming to improve diabetes self-care and reduce HbA1c and distress. Core features were the application of a functional-analytic model, behavioural self-management training, and personally selected T1D self-care behaviours as treatment targets. METHODS: Participants with T1D, 2-consecutive HbA1c ≥ 8.5 %(69 mmol/mol) and/or diabetes-related emotional/behavioural difficulties who had received specialist multidisciplinary input for ≥2 years completed 6-sessions of BT over 9-weeks. Outcomes were assessed at baseline, on completing 5-consecutive weekly sessions (post-) and at session 6, 1-month after (follow-up). RESULTS: Of 66 participants mean age 37.9 years, mean age at T1D diagnosis 22.0 years, and median T1D duration 14 years, 54 completed BT. HbA1c improved from baseline to follow-up (9.7 ± 1.9 %-8.8 ± 1.3 %, p < 0.001), as did diabetes distress (DD: total score 49.2 ± 7.8 baseline, 38.9 ± 14.7 post- and 32.8 ± 11.7 follow-up, p < 0.001). All DD subscales of emotional burden, and physician, regimen, and interpersonal distress, improved (p < 0.001). Consistent results were observed for patients on multiple daily injections and continuous subcutaneous insulin infusion therapy. CONCLUSIONS: BT based on a functional-analytic and behavioural self-management model holds promise as an effective means of improving HbA1c and reducing DD in adults with T1D.

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AIMS: This study explored the association between social determinants of health (SDOH) and diabetes care behaviors among individuals with health insurance. METHODS: Data from 57,206 US residents, representing a population of over 25.58 million adults with health insurance and diagnosed diabetes, were included in this cross-sectional analysis of data from the 2017 Behavioral Risk Factor Surveillance System. Logistic regression models were constructed to evaluate the likelihood of various diabetes care behaviors given the presence of several SDOH (e.g., food insecurity, poverty, housing insecurity, rurality). RESULTS: Most respondents exercised, ate vegetables, saw a provider for diabetes-related care in the last year, and reported checking their feet and testing their blood sugar daily. Not feeling safe (odds ratio (OR) 1.77, 95 % confidence interval (CI) 1.04, 3.01) was related to never checking blood sugar. Experiencing frequent stress was associated with a lower likelihood of exercise (OR .77, 95% CI 0.60, 0.999) and lower likelihood of checking blood sugar at least once a day (OR 0.73, 95% CI 0.54, 0.99). Food insecurity was associated with lower likelihood of vegetable consumption (OR 0.63, 95 % CI 0.47, 0.85) but a higher likelihood of checking blood sugar (OR 1.80, 95 % CI 1.26, 2.57). Low-income respondents were less likely to exercise (OR 0.72, 95 % CI 0.64, 0.80) or eat vegetables (OR 0.83, 95 % CI 0.75, 0.93) but more likely to check their feet (OR 1.19, 95 % CI 1.04, 1.35) and blood sugar at least once per day (OR 1.15, 95% CI 1.01, 1.31). Those who rent their home were also more likely to check their blood sugar (OR 1.22, 95% CI 1.07, 1.37) but less likely to have eaten vegetables in the last week (OR 0.87, 95% CI 0.78, 0.97). Respondents living in rural areas were more likely to have visited a provider in the last year (OR 1.21 95% CI 1.00, 1.47). CONCLUSIONS: SDOH can adversely affect diabetes self-care behaviors, providers should assist vulnerable patients by connecting them with community resources and providing individualized care.

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Background A significant portion of the Pakistani population is affected by diabetes, which has emerged as a global healthcare concern. Objective This study aimed to assess the correlation between glycemic control in diabetes patients and their engagement in diabetes self-care activities (DSCA). Methodology Cross-sectional research was conducted at Hayatabad Medical Complex in Peshawar between June 2019 and May 2020. A total of 280 carefully selected patients with type 2 diabetes mellitus (T2DM) were included. Data collection involved an interviewer-administered questionnaire encompassing sociodemographic information, diabetes-related data, and the summary of the Diabetes Self-Care Activities (SDSCA) scale. Descriptive statistics and Pearson's chi-square test were employed for data analysis. Results The study observed that the majority of participants (40.36%) were females, and the age range of the participants was between 42 and 53 years (68.22%). According to the study, 55.00% of participants had a normal body mass index (BMI), and 71.08% of participants had diabetes in their family. Regarding glycemic control, 55.71% of individuals exhibited good control based on fasting blood sugar (FBS) levels while 74.64% showed poor control according to hemoglobin A1C (HbA1c) values. HbA1c was substantially linked with a general diet (healthy eating plan), physical activities, and adherence to medication ((odds ratios (OR): 3.12), (95% confidence interval (CI): 1.02 - 8.78), (P value: 0.031)); ((OR: 2.19, 95%), (CI:1.18 - 3.79), (P value: 0.003)); ((OR: 2.85), (95% CI: 1.22 - 6.59), P value: 0.021)). Conclusion The findings indicated that health professionals need to create health education programs on DSCA in order to increase DSCA adherence in people with T2DM while maintaining glycemic control.

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Diabetes self-management or self-care activity related to diet, physical activity, and glucose monitoring, among other things, is recognized as important to effectively managing this condition. The aim of this study was to create an assessment tool for evaluating knowledge and self-management behavior in Type 2 Diabetes Mellitus (T2DM) for patients and their providers. The study utilized an online survey with a cross-sectional design of adults diagnosed with Type 2 diabetes. The survey consisted of 8 sections and a total of 56 questions, which were designed to measure the participants' current knowledge and behavior regarding diabetes self-management. The total sample size was 306 participants, and the results revealed a significant association between performance on diabetes knowledge questions and self-management behavior (ß = 0.46; 95% CI: 0.34, 0.58; p < 0.001). Furthermore, education had a significant impact on diabetes self-management behavior (ß = 0.59; 95% CI: 0.14, 1.03; p = 0.01). Overall, the data indicated that participants who performed well on knowledge-based questions exhibited higher scores in desired diabetes management behaviors. Increasing awareness of this work in the diabetic community could facilitate the clinical encounters between diabetic patients and their healthcare providers, with an emphasis on each individual's needs being taken into consideration.

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Objective: To investigate the current status of diabetes self-care behavior and the association between depression, self-efficacy and self-care in a sample of Chinese elderly type 2 diabetes mellitus (T2DM) patients. Methods: A cross-sectional study with a convenient sample including 240 elderly T2DM patients collected the data of demographic characteristics, diabetes self-care behavior, self-efficacy and depression status. The difference of self-care behavior in different sample characteristics was compared by independent t-test. The Personal correlation analysis was employed to examine the correlation of study variables. The method of bootstrap was used to analyze mediating role of depression. Results: Only 22.5% of patients reported better diabetes self-care behavior and depression partly mediated the association between self-efficacy and self-care behavior. The significant coefficient of path a (B = -0.052, p < 0.001) and path b (B = -0.423, p < 0.05) indicated negative associations of self-efficacy on depression, and depression on self-care behavior. The indirect effect (Path a × b) between self-efficacy and self-care behavior through depression was significant (B = 0.022, p < 0.05), the 95% bias-corrected bootstrap confidence interval was 0.004 to 0.006. Meanwhile, the mediating role of depression was not found significant among the participants reported 60-74 years old (B = 0.104, p < 0.001). But depression completely mediated this association among the participants reported 75-89 years old (B = 0.034, p > 0.05). Conclusion: The level of diabetes self-care behavior among the elderly T2DM patients in Dahu community of Anqing city was hardly optimistic. The self-efficacy focused intervention could be encouraged for community and clinicians to improve diabetes self-care behavior. Moreover, the prevalence of depression and T2DM is increasing in younger population. More work is needed to confirm these findings, especially conducting cohort studies on different populations.

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BACKGROUND: Type 2 diabetes mellitus (T2DM) disproportionally impacts Latin Americans (Latinos) in the U.S. compared to non-Latino Whites, as reflected by an increased risk for disease complications and higher mortality rates. Guided by an Integrative Model of Culture, Psychological Processes, and Health Behavior, the purpose of the present study was to examine the role of cultural beliefs and diabetes distress as determinants of self-care behaviors and HbA1c among Latino patients with T2DM. METHODS: Participants included 109 Latino patients with T2DM recruited from a diabetes treatment center located in a region of Southern California with high diabetes mortality rates. Structural equation modeling was employed to examine the extent to which cultural beliefs about diabetes-related social exclusion and diabetes distress impact self-care behaviors and self-reported HbA1c. RESULTS: Consistent with the study hypotheses, cultural beliefs about diabetes-related social exclusion predicted diabetes distress, which in turn predicted poor diabetes self-care. CONCLUSIONS: Findings suggest an important need for intervention efforts that address both cultural and psychological factors in order to improve diabetes self-care behaviors and associated disease outcomes among Latino patients with T2DM. Future research could benefit from investigating protective aspects of culture that could help counter the negative implications of cultural beliefs about social exclusion and diabetes distress associated with poor self-care.

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BACKGROUND: African American (AA) women with type 2 diabetes (T2D) carry disproportionate diabetes-related morbidity and mortality burdens. Diabetes medical nutrition therapy (MNT) improves glycemic, blood pressure, and cholesterol control, all critical in preventing and reducing diabetes complications. Yet, MNT does not address low motivation for dietary intake management, which is frequently reported among AA women with T2D living in the Southeastern US. METHODS: A randomized controlled trial will be used to test the central hypothesis that diabetes MNT plus culturally-tailored motivational interviewing (MI) (diabetes MNT plus MI) is more effective than diabetes MNT alone (diabetes MNT). Two hundred ninety-one Southeastern AA women who are at risk for development and/or progression of T2D complications will be randomized to diabetes MNT plus MI or diabetes MNT. Both groups will include: 1) a 3-month active intervention period, consisting of group-based, nutritionist-facilitated MNT sessions; 2) a 3-month maintenance intervention period, including one group-based, nutritionist-facilitated maintenance support session; and 3) a 6-month inactive period. Culturally-adapted MI exercises will be integrated into the diabetes MNT plus MI group only. Primary (HbA1c) and secondary (systolic blood pressure, LDL cholesterol) outcomes will be assessed at baseline and 3, 6, and 12 months following the active intervention period. DISCUSSION: The results from this study, called the SISTER (Sisters Inspiring Sisters to Engage in Relevant Diabetes Self-Care) Diabetes Study, are vital to the adoption and uptake of rigorously-tested MNT interventions that address motivation among AA women with T2D as a way to reduce their risk and/or progression of diabetes-related complications.

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Objective: Egyptian studies in assessing the relationship between diabetes self-care, social support, and glycemic control in primary healthcare (PHC) are limited. Therefore, this study aimed to assess this relationship, and to evaluate the associated factors of diabetes self-care, social support, and glycemic control in Egyptian PHC patients with type 2 diabetes (T2DM). Methods: A cross-sectional study was conducted on 320 T2DM patients at four PHC settings in Port Said city, affiliated with the General Authority of Healthcare. A semi-structured questionnaire was used to collect data, including demographic characteristics, socioeconomic status scale, disease profile, the Arabic versions of the Summary of Diabetes Self-Care Activities, and the received social support scales. Data were collected from January 2020 to June 2020. Results: Diabetes self-care activities, and self-monitoring of blood glucose had a very weak negative correlations with glycated hemoglobin (HbA1c) levels (rho = - 0.125, p = 0.025, rho = - 0.112, p = 0.044, respectively). Receiving social support on following a meal correlated positively and very weakly with HbA1c levels (rho = 0.145, p = 0.010). Hardly positive correlation was found between receiving emotional support on feelings about diabetes, and following a specific diet (rho = 0.169, p = 0.002). Diabetes self-care activities were positively associated with higher education levels, and elevated BMI. Received social support was negatively associated with having coronary artery disease, and marital status e.g. divorced and widow. Increased age, and female gender were the predictors of good glycemic control. Conclusion: Diabetes self-care activities were linked with reduced HBA1c levels. Further studies are needed to evaluate the buffering effect of social support on glycemic outcomes in PHC patients with T2DM.

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Introduction: The projected increase in the prevalence of diabetes mellitus globally is expected to hit the low and middle income countries the hardest. The majority of the day to day disease management activities needed to achieve glycaemic control and improve the quality of life among patients with diabetes mellitus falls on the patient and/or their families. Determining the self-management practices by patients with diabetes mellitus can help develop interventions that can enhance these practices and help prevent complications. Objective: The current study aimed to explore the self-management practices of patients with type II diabetes mellitus in low and middle-income countries to prevent complications. Design: A scoping review was conducted using the Joanna Briggs Institute approach to conducting scoping reviews. The context of the review was low and middle income countries with the core concept being self-management practices for prevention of complications. Methods: Articles in Scopus databases and on the EBSCOHost platform were searched, as were their reference lists. If abstracts met inclusion criteria, full articles were downloaded and data extracted. The review included original research studies, published in the English language. The research studies included in the review were conducted between the year 2000 to 2022 among patients diagnosed with type II diabetes mellitus. Results: This search yielded 823 articles; after deduplication, twelve studies were included in the final list. Four categories of self-management practices for preventing complications of type II diabetes mellitus were identified. The categories are i) acquisition of diabetes-related knowledge, ii) essential skills to manage diabetes mellitus, iii) lifestyle modification, and iv) availability of psychological support and follow-up. Conclusions: Most diabetes care is dependent on patients' self-management levels. The studies reviewed in this article show that patients are capable of adequate self-management when practices are tailored to their needs. Registration: The scoping review protocol was registered in the Fig Share platform on 17th January 2022 under the digital object identifier https://doi.org/10.38140/ufs.17206751.

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Background: Globally, prevalence of diabetes is 10.5%, and in 2019, approximately 463 million adults were living with diabetes by 2045; this will increase to 700 million (10.9%). India is a diabetic capital of world, prevalence of diabetes in India is 8.3%. Aim: This study aimed to assess self-care practices (SCPs) among type 2 diabetes mellitus (T2DM) patients, its predictors, and effect of SCP on glycemic control. Materials and Methods: A cross-sectional hospital-based study was conducted among 300 known T2DM patients in the age group of 18-60 years attending noncommunicable diseases clinic at Secondary and Tertiary Care Hospitals of Lucknow, Uttar Pradesh, selected using two-stage purposive sampling method. Data were collected using a predesigned and pretested semi-structured questionnaire. Data were collected from consenting respondents on the sociodemographic profile (about their residence, gender, marital status, type of family, educational status, family income, employment status, etc.). SCP was assessed using Summary of Diabetes Self-Care Activities. Data were analyzed using SPSS. Results: Among 300 patients with a mean age 50 ± 8.9 years, the prevalence of good SCPs was 37%. Out of 189 T2DM patients with poor SCPs, 66.4% had uncontrolled blood sugar level (285.4 ± 67 mg/dL). Out of 73 T2DM patients with poor SCPs, 65.7% had uncontrolled glycated hemoglobin level (8.4% ± 2%), and this was statistically significant. Conclusion: The practice of self-care was found to be suboptimal among patients with T2DM in the study.

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OBJECTIVES: Utilising coping strategies to reduce and manage the intensity of negative and distressing emotions caused by diabetes is essential. However, little is known about the use of coping strategies among people living with diabetes in Sub-Saharan African countries like Zambia. This study investigates coping strategies used by people with diabetes in Zambia and how these are associated with diabetes-specific emotional distress, depression and diabetes self-care. METHODS: Cross-sectional data from 157 people with diabetes aged between 12 and 68 years were collected. Of the 157, 59% were people with type 1 diabetes and 37% with type 2 diabetes. About 4% had missing information in their record but had either type 1 or type 2 diabetes. Coping styles were measured using the Brief Version of the Coping Orientation to Problems Experienced (Brief COPE), diabetes specific-distress using the Problem Areas in Diabetes, depression using the Major Depression Inventory and self-care using the Diabetes Self-Care scale. RESULTS: Data showed that adaptive coping strategies such as religious coping, acceptance among others, were the most frequently used coping strategies among Zambian individuals with diabetes. Maladaptive coping strategies e.g., self-blame and self-distraction were related to increased diabetes specific-distress and depression. Emotional support was related to better diabetes self-care, while self-blame was related to poor diabetes self-care. CONCLUSION: There is need to help individuals with diabetes identify adaptive strategies that work best for them in order to improve their quality of life.

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As increasing numbers of people with insulin-managed diabetes use automated insulin delivery (AID) systems or seek such technologies, healthcare providers are faced with a steep learning curve. Healthcare providers need to understand how to support these technologies to help inform shared decision making, discussing available options, implementing them in the clinical setting, and guiding users in special situations. At the same time, there is a growing diversity of commercial and open source automated insulin delivery systems that are evolving at a rapid pace. This practical guide seeks to provide a conversational framework for healthcare providers to first understand and then jointly assess AID system options with users and caregivers. Using this framework will help HCPs in learning how to evaluate potential new commercial or open source AID systems, while also providing a guide for conversations to help HCPs to assess the readiness and understanding of users for AID systems. The choice of an AID system is not as simple as whether the system is open source or commercially developed, and indeed there are multiple criteria to assess when choosing an AID system. Most importantly, the choices and preferences of the person living with diabetes should be at the center of any decision around the ideal automated insulin delivery system or any other diabetes technology. This framework highlights issues with AID use that may lead to burnout or perceived failures or may otherwise cause users to abandon the use of AID. It discusses the troubleshooting of basic AID system operation and discusses more advanced topics regarding how to maximize the time spent on AID systems, including how to optimize settings and behaviors for the best possible outcomes with AID technology for people with insulin-requiring diabetes. This practical approach article demonstrates how healthcare providers will benefit from assessing and better understanding all available AID system options to enable them to best support each individual.

Automated insulin delivery (AID) systems are a useful tool for people with insulin-requiring diabetes. AID systems include an insulin pump, continuous glucose monitor (CGM), and an algorithm embedded within the pump or a separate mobile device that can determine and automatically adjust insulin delivery in response to glucose levels. There are now a number of AID systems available, some which are made and distributed by commercial manufacturers and some that are available open source. Both open source and commercially developed automated insulin delivery systems have been proven to be safe and effective. Open source and commercially developed automated insulin delivery systems have also been proven to improve the quality of life of people with insulin-requiring diabetes. The choice of an AID system is not merely whether the system is open source or commercially developed. There are multiple criteria to assess when choosing an AID system: pump, CGM, smartphone connectivity and algorithm capabilities, flexibility of the system overall, and interoperability with connected platforms for real-time data access. Most importantly, the choices and preferences of the person living with diabetes should be at the center of any decision around the ideal automated insulin delivery system or any other diabetes technology. Healthcare providers will benefit from assessing and better understanding all available AID system options to enable them to best support each individual. This practical guide seeks to provide a conversational framework for healthcare providers to first understand and then jointly assess AID system options with users and caregivers.

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In order to determine the prevalence of adherence among diabetes patients treated at Queens Hospital Center's Diabetes Clinic and to determine barriers preventing adherence, 50 patients were asked a series of questions regarding their medication intake. The majority of patients reported that they understood the self-management steps that were necessary in order to control their diabetes. However, 30% of the interviewed patients with type 1 or type 2 diabetes reported that they missed a dose of their diabetes medication on at least one day in the last month. Forgetting and lifestyle inconveniences were the two most frequently reported reasons for non-adherence. Side effects and problems with the pharmacy or insurance were also significant reasons for non-adherence. Adherence can potentially be increased by combining new forms of treatment and increasing educational reinforcement.

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INTRODUCTION: Peer support models for the management of diabetes self-care have been hailed as a promising solution to strengthen a formal health system to support diabetes patients. Diabetes self-care in patients can truncate the risk factors and reduce the complications. OBJECTIVE: To identify self-care level (adherence to the diet, exercise, treatment) and depression among known diabetes patients and to find the effect of the support group intervention on diabetes self-care. METHODS AND MATERIAL: A Sequential type Embedded Mixed-Method study (qual→QUAN(qual)→qual) was conducted in three phases in 168 known diabetes adults aged ≥ 30 years in a rural setting. After obtaining IEC clearance, the intervention was carried out over eight months, forming peer support groups in four villages. Each group comprises between six to 12 participants. Assessment of self-care, treatment adherence and depression with standardized scales. DATA ANALYSIS: A manual content analysis was performed on the qualitative data. The Wilcoxon rank test was used to compare the quantitative data before and after intervention and analyzed using SPSS (Version_24) software package. RESULTS: In this study, we found improved self-care practices and treatment adherence among study participants (p < 0.001). About 88.7% of participants said that the support group was useful and provided moral support for diabetes. CONCLUSION: We found an improvement in treatment adherence, self-care among diabetes patients' and marginal improvement in depression status through support group intervention. Also the peer support group was well accepted, and it provided the low-cost, feasible intervention respect to the chronic conditions like diabetes, by addressing their behavioral changes and support from community. By sustaining the support group, might able to achieve the efficient health care in high quality even at resource-poor settings. KEY MESSAGES: A Community-Based intervention for the diabetes self-care using peer support group among the diabetes patients will improve the self-care practices in the area with limited access to healthcare and financial resources, it provides a low-cost, flexible, culturally sensitive approach to support self-care management and reduce the further complications among It also imporve the problem-solving capacity and social support from families and peers patients.

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Diabetes self-care is explained as an illness-related coping behavior. Health literacy is an important predictor in self-care behaviors. However, little is known about their association with illness perception in Korean immigrants with diabetes. This study aimed to examine the relationships among health literacy, illness perception, and diabetes self-care in Korean-speaking immigrants with diabetes. This cross-sectional study was conducted in 2020. A convenience sample of 52 Korean adults with diabetes in Dallas-Fort Worth areas completed a survey. Data were analyzed using SPSS (version 25) with statistical significance at α < .05. The mean of health literacy was high (11.1, SD = 1.1, ranges 0-12). There were no statistically significant associations between health literacy, illness perception, and diabetes self-care. Language barriers are considered a literacy issue, but health literacy and limited English proficiency must be approached differently by health care providers.

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OBJECTIVE: Diabetes self-management education (DSME) is an essential component of lifestyle management needed for diabetes care. This pilot-study tested the effect of culturally-tailored education targeting diabetes selfcare on glycemia and cardiovascular risk factors of Lebanese with type 2 diabetes mellitus (T2DM) (n = 27; Age: 61 ± 10 yrs, 59% males, HbA1c: 8.98 ± 1.38%). RESULTS: Diabetes self-care (Diet, Self-Monitoring Blood Glucose and foot care) improved after 6 months, which was reflected in a significant drop in glycemic levels (HbA1c:-0.5%; FPG: - 38 mg/dl), and cholesterol/HDL ratio (4.45 ± 1.39 vs. 4.06 ± 1.29). Waist circumference decreased at 6 months compared to 3 months (p < 0.05). This is the first effective culturally-tailored intervention that improved self-care, glycemic control, body adiposity and lipid profile of Lebanese with T2DM. Larger scale implementation with representative sample is warranted.

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BACKGROUND: The aim of this analysis was to examine the influence of housing insecurity on diabetes processes of care and self-care behaviors and determine if that relationship varied by employment status or race/ethnicity. METHODS: Using nationally representative data from the Behavioral Risk Factor Surveillance System (2014-2015), 16,091 individuals were analyzed for the cross-sectional study. Housing insecurity was defined as how often respondents reported being worried or stressed about having enough money to pay rent/mortgage. Following unadjusted logistic models testing interactions between housing insecurity and either employment or race/ethnicity on diabetes processes of care and self-care behaviors, stratified models were adjusted for demographics, socioeconomic status, health insurance status, and comorbidity count. RESULTS: 38.1% of adults with diabetes reported housing insecurity. Those reporting housing insecurity who were employed were less likely to have a physicians visit (0.58, 95%CI 0.37,0.92), A1c check (0.45, 95%CI 0.26,0.78), and eye exam (0.61, 95%CI 0.44,0.83), while unemployed individuals were less likely to have a flu vaccine (0.84, 95%CI 0.70,0.99). Housing insecure White adults were less likely to receive an eye exam (0.67, 95%CI 0.54,0.83), flu vaccine (0.84, 95%CI 0.71,0.99) or engage in physical activity (0.82, 95%CI 0.69,0.96), while housing insecure Non-Hispanic Black adults were less likely to have a physicians visit (0.56, 95%CI 0.32,0.99). CONCLUSIONS: Housing insecurity had an influence on diabetes processes of care and self-care behaviors, and this relationship varied by employment status and race/ethnicity. Diabetes interventions should incorporate discussion surrounding housing insecurity and consider differences in the impact by demographic factors on diabetes care.

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BACKGROUND: Type 2 diabetes mellitus (T2D) has become a global health challenge. Diabetic peripheral neuropathy (DPN) is one of the common comorbidities of T2D that may affect the ability to perform diabetes self-care. PURPOSE: To compare self-care practices between adult T2D patients with and without comorbid DPN and identify factors predicting self-care practices. METHODS: In this cross-sectional study, conducted at tertiary hospitals in Ethiopia, a total of 216 (108 with DNP and 108 without DNP) participants completed an interviewer-administered questionnaire including measures of diabetes self-care practices, self-evaluated peripheral neuropathy, self-efficacy, diabetes knowledge, and social support. RESULTS: Adult T2D patients with comorbid DPN had lower dietary (P< 0.001), exercise (P< 0.001), blood glucose testing (P = 0.001), and foot (P = 0.007) self-care practice than those without DPN. Social support is a significant predictor of dietary self-care in both groups while predicting foot self-care and blood glucose testing in those with comorbid DPN. Moreover, occupation, education, and having a glucometer are significant predictors of diabetes self-care practice in both groups. CONCLUSION: This study found that adult T2D patients with comorbid DPN have poorer diabetes self-care practice than those without comorbid DPN. Interventions should focus on addressing social support and access to a glucometer in order to improve diabetes self-care practices in adult T2D patients with comorbid DPN.

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Diabetes mellitus is a major public health issue that considerably impacts mortality, morbidity, and healthcare costs worldwide. The COVID-19 pandemic has created havoc in diabetes management, too, like other spectrums of life. A descriptive, cross-sectional study was adopted to determine the effect of Social Support, Self-Care Behaviour and Self-Efficacy in Type 2 Diabetes Mellitus (T2D) during this COVID-19 pandemic. Two hundred T2D patients who satisfied the inclusion criteria were chosen using a convenient sampling procedure. The tool consists of four sections, including socio-demographic characteristics, Multidimensional Scale of Perceived Social Support (MSPSS), revised Summary of Diabetes Self-Care Activities (SDSCA) Scale and modified Diabetes Management Self-Efficacy Scale (DMS). Descriptive and inferential statistics were used to analyze the obtained data. The mean and SD of diabetic management self-efficacy is 5.74 (1.95) and 4.37 (1.4), respectively, for patients with HbA1c < 6.5% and HbA1c ≥ 6.5%. The self-care activities of the patients who had good glycemic control were 4.31 (2.06) compared to 3.50 (1.73) who did not. The social support received by the patients was 6.13 (2.13) vs. 5.31 (1.67) among patients with glycemic control vs. no control. The results show that social support (p = 0.04), self-efficacy (p =0.01) and self-care activities (p = 0.001) were significantly related to the level of glycemic control of the T2D patients. A significant relationship was also identified between gender (p = 0.036), age (p = 0.001) and education status (p = 0.000) with HbA1c control of the participants. This study demonstrates a significant relationship between social support, self-care behaviours, self-efficacy and glycemic management in T2D patients. During this COVID-19 pandemic, interventions to enhance the self-care activities like exercise and social support to boost their self-efficacy; for better diabetes management, reducing diabetes complications or prolonging their onset are the need of the hour.