Factors influencing adherence to self-care practices among patients of type 2 diabetes mellitus from Saurashtra region of Gujarat: A conclusive research

BACKGROUND: It is commonly understood that diabetes self-care practice is critical in the management of the disease. However, the magnitude and determinants of self-care practices are not well evaluated at the community level. METHODS: A community based cross-sectional study was conducted among 178 type 2 DM patients. Self-care practices were evaluated for the last seven days and each item was scored from 0 (none of the days in a week) to 7 (all 7 days were followed). RESULTS: Adherence to medication (89.3%) and blood glucose monitoring (65.2%) were relatively higher than other domains. Factors associated with dietary adherence were secondary level education and above (OR = 22.1, 95% CI = 6.85 to 71.3), physician or endocrinologist treating doctors (OR = 3.36, 95% CI = 1.24 to 11.32), joint and three-generation family (OR = 3.32, 95% CI = 1.23 to 8.92) and upper and middle socioeconomic class (OR = 2.5, 95% CI = 1.1 to 6.2). Good glycemic control was significantly associated with dietary adherence (OR = 6.81, 95% CI = (2.71 to 17.16), medication adherence (OR = 4.59, 95% CI = 1.3 to 16.24) and regular exercise (OR = 3.65, 95% CI = 1.62 to 8.19). CONCLUSION: There is need to develop structured diabetes self-care education programs with involvement of private practitioners as a majority of the patients consult private practitioners for treatment. Health educators might have to place emphasis on self-care education to patients as well as caregivers belonging to low socioeconomic class and having lower education.