Successful self-management among non-insulin-treated adults with Type 2 diabetes: a self-regulation perspective

Diabet Med. 2015 Nov;32(11):1504-12. doi: 10.1111/dme.12745. Epub 2015 Apr 11.

Abstract

Aims: To clarify the role of self-monitoring of blood glucose (SMBG) in the self-management of Type 2 diabetes from the patient's perspective, using in-depth interviews with non-insulin-treated adults to investigate how they learned to manage their diabetes effectively and whether SMBG played a significant role in this process.

Methods: Individual interviews were conducted with 14 non-insulin-treated adults with Type 2 diabetes who had significantly improved their glycaemic control [64% women; 50% black; 21% Hispanic; mean age 60 years; mean HbA(1c) concentration 43 mmol/mol (6.1%)]. Interviews were transcribed and analysed by a coding team, applying the concept of illness coherence from the Common Sense Model of Self-Regulation.

Results: The majority of participants relied on SMBG to evaluate their self-management efforts. Key themes included: adopting an experimental approach; experiencing 'a-ha' moments; provider-assisted problem-solving; using SMBG and other feedback to evaluate when their efforts were working; and normalizing diabetes-specific behaviour changes as being healthy for everyone.

Conclusions: Our qualitative data are consistent with the argument that SMBG, if implemented appropriately with enough education and provider access, can be a powerful tool for non-insulin-treated adults with Type 2 diabetes to monitor their self-management. Establishing sufficient conditions for illness coherence to develop while individuals are learning to use SMBG could increase their sense of personal control in managing a complex and demanding illness.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Blood Glucose / analysis
  • Blood Glucose Self-Monitoring
  • Combined Modality Therapy
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diet therapy
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / therapy*
  • Diet, Diabetic
  • Exercise
  • Female
  • Glycated Hemoglobin / analysis
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Hyperglycemia / prevention & control*
  • Hypoglycemic Agents / therapeutic use
  • Life Style*
  • Male
  • Middle Aged
  • New Jersey
  • New York City
  • Patient Compliance*
  • Patient Education as Topic
  • Retrospective Studies
  • Self Care*
  • Sense of Coherence*

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • hemoglobin A1c protein, human