Development of participatory self-management in behavior modification on glycemic control in uncontrolled type 2 diabetes patients, Sisaket province

Abstract

This research investigated factors associated with uncontrolled blood levels of type 2 diabetes (type 2 DM) and developed a model for self-management in behavior modification on glycemic control among uncontrolled type 2 DM patients. The research consisted of three phases: phase 1, an analytical case-control study; phase 2, the action research aimed to develop a participatory self-management model to modify glycemic control behavior based on the PDCA model; and phase 3, a quasi-experimental study aimed to assess the effect of the developed model from phase 2. Data were analyzed using multivariable logistic regression, content analysis, and independent t-test statistics.

The results indicated three predicted factors of glycemic control in uncontrolled type 2 DM patients including received oral and injectable treatment (Adjusted odds ratio (AOR) = 0.11, 95% Confidence interval (95% CI= 0.02-0.53, P=0.0004), a good level of social support (AOR = 0.13, 95% CI=0.05-0.40, P<0.0001), and a good level of the glycemic control behavior (AOR = 0.28, 95% CI = 0.10-0.78, p= 0.0151). The diabetes management model in Sisaket Province (DNCMSF Model) contains a data center, networking, mentor, monitoring, social support, and patient follow-up. In phase 3, the HbA1C level of the experimental group was 2.18% lower than the comparison group (Mean difference = 2.18, 95% CI = 1.18-3.17). Moreover, the mean scores for the glycemic control behavior, knowledge, perceived risk exposure, and perceived severity in the experimental group were higher than in the comparison group significantly.