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Diabesity in Adults With Type 2 Diabetes Mellitus: A Cross-sectional Study Exploring Self-care and Its Determinants

Published:April 06, 2022DOI:https://doi.org/10.1016/j.jcjd.2022.03.009

      Abstract

      Objectives

      The purpose of this study was to describe self-care maintenance, self-care monitoring, self-care management and self-care self-efficacy in adults with type 2 diabetes (T2DM) and body mass index (BMI)<30 kg/m2 and adults with T2DM and BMI≥30 kg/m2 (“diabesity”), and to identify their clinical and sociodemographic determinants. Self-care is one of the main treatments for adults with T2DM. However, self-care has been poorly described in people with diabesity, and differences in clinical and sociodemographic determinants of self-care between patients with diabesity and patients with T2DM and BMI<30 kg/m2 have, to our knowledge, not been assessed.

      Methods

      A secondary analysis was performed of sociodemographic and clinical data using a multicentre, observational, cross-sectional design, wherein 540 adults diagnosed with T2DM were included in a consecutive and convenience sampling procedure.

      Results

      Self-care maintenance and management were significantly lower among patients with diabesity (p<0.001 and p=0.025, respectively). Among patients with diabesity, low income (relative risk [RR]=3.27, p=0.01) and presence of diabetic neuropathy (RR=4.16; p=0.03) were strongly associated with inadequate self-care maintenance; completion of high school (RR=0.45; p=0.01), availability of a family caregiver (RR=0.52; p=0.04) and the use of insulin as the main treatment (RR=2.09; p=0.01) decreased the likelihood of inadequate self-care monitoring.

      Conclusions

      The unfavourable behavioural profile of patients with diabesity could be further worsened by their lower level of confidence in performing adequate self-care.

      Résumé

      Objectifs

      L’objectif de la présente étude était de décrire le maintien des autosoins, la surveillance des autosoins, la prise en charge autonome des soins et l’auto-efficacité dans la réalisation des autosoins chez les adultes atteints du diabète sucré de type 2 (DST2) qui ont un indice de masse corporelle (IMC) < 30 kg/m2 et chez les adultes atteints du DST2 qui ont un IMC ≥30 kg/m2 (diabésité), et de relever leurs déterminants cliniques et sociodémographiques. Les autosoins sont l’un des principaux traitements chez les adultes atteints du DST2. Toutefois, les autosoins ont été mal décrits chez les personnes atteintes de diabésité, et les différences dans les déterminants cliniques et sociodémographiques des autosoins entre les patients atteints de diabésité et les patients atteints de DST2 qui ont un IMC < 30 kg/m2 n’ont pas, à notre connaissance, fait l’objet d’une évaluation.

      Méthodes

      Nous avons réalisé une analyse secondaire des données cliniques et sociodémographiques au moyen d’un devis transversal, observationnel et multicentrique dans lequel 540 adultes qui avaient un diagnostic de DST2 ont fait partie de l’échantillonnage consécutif et de commodité.

      Résultats

      Le maintien des autosoins et la prise en charge autonome des soins étaient significativement plus faibles chez les patients atteints de diabésité (p < 0,001 et p = 0,025, respectivement). Chez les patients atteints de diabésité, le faible revenu (risque relatif [RR] = 3,27, p = 0,01) et la présence de la neuropathie diabétique (RR = 4,16; p = 0,03) étaient fortement associés au maintien inadéquat des autosoins; l’obtention du diplôme d’études secondaires (RR = 0,45; p = 0,01), la disponibilité des aidants familiaux (RR = 0,52; p = 0,04) et l’utilisation de l’insuline comme traitement principal (RR = 2,09; p = 0,01) faisaient diminuer la probabilité d’une surveillance inadéquate des autosoins.

      Conclusions

      Le profil comportemental défavorable des patients atteints de diabésité pourrait davantage se dégrader en raison de leur plus faible niveau de confiance dans la réalisation d’autosoins adéquats.

      Mots clés

      Keywords

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