Journal Article

Enablers and barriers to effective diabetes self-management: A multi-national investigation

Malabu, Usman H., Malau-Aduli, Aduli E. O., Malau-Aduli, Bunmi S., Adu, Mary D.

2019

Overview

The study aimed to identify the common gaps in skills and self-efficacy for diabetes self-management and explore other factors which serve as enablers of, and barriers to, achieving optimal diabetes self-management. The information gathered could provide health professionals with valuable insights to achieving better health outcomes with self-management education and support for diabetes patients. International online survey and telephone interviews were conducted on adults who have type 1 or type 2 diabetes. The survey inquired about their skills and self-efficacy in diabetes self-management, while the interviews assessed other enablers of, and barriers to, diabetes self-management. Surveys were analysed using descriptive and inferential statistics. Interviews were analysed using inductive thematic analysis. Survey participants (N = 217) had type 1 diabetes (38.2%) or type 2 diabetes (61.8%), with a mean age of 44.56 SD 11.51 and were from 4 continents (Europe, Australia, Asia, America). Identified gaps in diabetes self-management skills included the ability to: recognize and manage the impact of stress on diabetes, exercise planning to avoid hypoglycemia and interpreting blood glucose pattern levels. Self-efficacy for healthy coping with stress and adjusting medications or food intake to reach ideal blood glucose levels were minimal. Sixteen participants were interviewed. Common enablers of diabetes self-management included: (i) the will to prevent the development of diabetes complications and (ii) the use of technological devices. Issues regarding: (i) frustration due to dynamic and chronic nature of diabetes (ii) financial constraints (iii) unrealistic expectations and (iv) work and environment-related factors limited patients' effective self-management of diabetes. Educational reinforcement using technological devices such as mobile application has been highlighted as an enabler of diabetes self-management and it could be employed as an intervention to alleviate identified gaps in diabetes self-management. Furthermore, improved approaches that address financial burden, work and environment-related factors as well as diabetes distress are essential for enhancing diabetes self-management.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adolescent / Adult / Aged / Analysis / Analysis of Variance / Applications programs / Biology and Life Sciences / Blood / Blood glucose / Business education / Care and treatment / Communication / Complications / Cost of Illness / Decision making / Dentistry / Diabetes / Diabetes mellitus / Diabetes mellitus (insulin dependent) / Diabetes mellitus (non-insulin dependent) / Diabetes Mellitus - economics / Diabetes Mellitus - therapy / Diabetes therapy / Diabetics / Effectiveness / Electronic devices / Environmental management / Female / Food intake / Frustration / Glucose / Health aspects / Health care / Health surveys / Humans / Hypoglycemia / Information management / Low income groups / Male / Management / Medical personnel / Medical research / Medicine and Health Sciences / Methods / Middle Aged / Mobile computing / Objectives / Patient compliance / Polls & surveys / Public health / Quality of life / Self care (Health) / Self Efficacy / Self-Management / Skills / Social Sciences / Statistical analysis / Stress (Psychology) / Studies / Surveys / Type 2 diabetes / Young Adult