Abstract 13677: Self-Care and Health Outcomes of Diabetes Mellitus
Background: Diabetes mellitus (DM) is an important risk factor for cardiovascular disease. Studies show that self-care improves DM outcomes; however, all previous DM self-care studies evaluate treatment adherence (self-care maintenance) and little is known about patient decision-making processes (self-care management). Aim: To examine the influence of DM self-care maintenance and management on number of hospitalizations and hospitalization days.
Methods: A cohort design with secondary analysis of data from the Health and Retirement Study 2002–2004 (n=726; age 66.8±8.5, 48.5% female) was used. Data were analyzed with hierarchical logistic regression and generalized linear modeling with negative binomial loglink distribution after adjusting for sociodemographics, DM-related characteristics, comorbid conditions, and health perception.
Results: Self-care maintenance was a significant determinant of patients being hospitalized. Each one day increase in eating fruits and vegetables was associated with a 10% decrease in the likelihood of hospitalization (OR= 0.901, p=.042). Self-care maintenance and management were significant determinants of number of hospitalizations and number of days hospitalized. Checking blood sugar in response to high blood sugar symptoms (self-care management) was associated with an increase in hospitalizations (incidence rate ratio [IRR]=1.105, p=.037). Establishing a goal for HbA1c (self-care management) and eating ≥2 snacks or desserts per day (self-care maintenance) were associated with a decrease in hospitalizations (IRR=0.860, p=.001; IRR=0.914, p=.043, respectively). Checking blood sugar in response to symptoms of low blood sugar and establishing a goal for HbA1c (self-care management) were associated with a decrease in number of days hospitalized (IRR=0.728, p<.001; IRR=0.832, p=.033, respectively). Following doctors' advice about frequency of blood sugar testing (self-care maintenance) was associated with an increase in number of days hospitalized (IRR=1.170, p=.016).
Conclusion: DM self-care maintenance and management influence health outcomes differently. Tailoring DM patient education to enhance decision-making processes is as important as fostering treatment adherence.
- © 2010 by American Heart Association, Inc.