Factors associated with the self-management practices of Type 2 diabetes among the middle-aged population of rural area of Pakistan

Abstract Background: This study is aimed at identifying the factors associated with the self-management practices of type 2 diabetes among the middle-aged population of rural area of Pakistan. Methods: The sample of 200 participants was purposively recruited from the medical clinics of rural area of Pakistan. The study questionnaire consisted of three main sections: socio-demographics, the Urdu-version of Summary of Diabetes Self-care Activities (U-SDSCA), and the extended version of U-SDSCA. In addition, glycosylated hemoglobin (HbA1c) level results were obtained from the medical clinics. The study explored the factors associated with the self-management practices of type 2 diabetes among the middle-aged population of Pakistan. Results: The current study has demonstrated that self-management activities level among the patients of type 2 diabetes in the rural area of Pakistan was not achieved in majority of patients, and that glycemic control was unsatisfactory. The bi-variate analysis showed the differences in all the sub-scales but some of these differences are not statistically significant (p > 0.05). The exception was statistically significant exercise sub-scale (Diff.= .404; p= .047) at p<0.05. The participants with lower income tested blood glucose less often as compared to those with higher income (Diff= -.598; p = .003). The longer duration of diabetes associated significantly with poor glycemic control (Diff.= -.438; p = .032). The difference between the controlled blood glucose levels (≤ 7%) and uncontrolled (> 7%) was statistically significant (Diff= .88; p = .015). The multivariate regression analysis revealed that the participants’ characteristics accounted for 21% of the variability in the total self-management score (R²=0.211). In addition, women were more inclined to undertake appropriate diabetes self-management activities (β= .302; p = .001). Conclusion: This study has identified the factors associated with the self-management activities among the patients with type 2 diabetes in rural area of Pakistan. In order to overcome the influence of these factors, healthcare professionals should pay special attention to the patients of rural area of Pakistan to ensure that the population is aware of diabetes and its complications, emphasizing lifestyle modification with importance of adherence to treatment which would be most beneficial to their self-management activities