Clinical and socio-demographic determinants of inadequate self-care in adults with type 1 diabetes mellitus: the leading role of self-care confidence

AimsTo describe self-care maintenance, monitoring, and management behaviors in adults with type 1 diabetes (T1DM), and to identify clinical and socio-demographic determinants of inadequate self-care.MethodsA cross-sectional study was conducted in two diabetes outpatient clinics in Italy. Clinical and socio-demographic characteristics were collected from the medical records of 181 consecutively enrolled T1DM patients. The Self-Care of Diabetes Inventory was used to measure self-care maintenance, self-care monitoring, self-care management and self-care confidence. A standardized 0-100 score was used for each self-care dimension. A score<70 was considered inadequate self-care. Three multiple logistic regression models were run to find determinants of inadequate self-care maintenance, monitoring, and management.ResultsThe majority of patients had adequate self-care maintenance (74%; n=134), self-care monitoring (68.5%; n=124) and self-care confidence (87.3%; n=158), while self-care management was adequate for only a minority (34.8%; n=63). The odds of inadequate self-care maintenance increased by 4.5 times when self-care confidence was inadequate (OR adjusted4.589; 95% CI1.611-13.071; p=0.004). The odds of inadequate self-care monitoring increased four times when patients had inadequate self-care confidence (OR adjusted4.116; 95% CI1.457-11.628; p=0.008). Inadequate self-care confidence increased the odds of performing inadequate self-care management more than five times (OR adjusted5.313; 95% CI1.143-24.686; p=0.033).ConclusionsSelf-care management is commonly inadequate in adults with T1DM. Self-care confidence is the most important determinant of self-care behaviors in this population. Educational interventions are recommended to improve self-care confidence in adults with T1DM.