How much time do patients with diabetes spend on self-care?

Introduction: Little is reported about how much time patients spend on self- management, a cornerstone of diabetes care. Methods: We studied a cross- section of 1482 diabetic patients enrolled in 3 northeastern United States managed care plans. Patients were surveyed about how much time they spent on foot care, exercise, and food shopping/ preparation ( 7/ 00 to 9/ 01). Logistic regressions modeled which types of patients were likely to spend time, and linear regressions modeled characteristics associated with spending more/ less time. Results: Patients ( 57.9% >= 55 years; 51.6% women; 36.2% African American; 31.1% on insulin) spent 58 ( mean) minutes/ day on self- care ( interquartile range 19, 84). Many patients skipped individual selfcare elements: 37.9% reported no foot care, 37.7% no exercise, and 54.4% no time on food shopping/ preparation. One fourth of patients with severe foot neuropathy symptoms spent no time on foot care. Never self- testers were less likely than others to engage in foot care ( odds ratio ( OR) 0.4 ( 95% CI 0.3, 0.6), exercise ( OR 0.4 ( 95% CI 0.3, 0.6)), and food shopping/ preparation ( OR 0.7 ( 95% CI 0.5, 1.0)), and were likely to spend 30 minutes less total self- care time than frequent self- testers ( P < .01). Discussion: Most people spent considerable time engaged in self- care, but many skipped individual tasks, offering clinicians opportunities for collaborative decision making.