Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus

Objective: The objective was to evaluate the relationships between diabetes management self-efficacy and diabetes self-management behaviors and glycemic control. Methods: A cross-sectional design was used. A convenience sample of 223 subjects with type 2 diabetes, >= 25 years old, who sought care at the National Diabetes Center in Amman, Jordan, was enrolled. A structured interview and medical records provided the data. The instruments included a sociodemographic and clinical questionnaire, a diabetes management self-efficacy scale, and a diabetes self-management behaviors scale. Glycosylated hemoglobin was used as an index for glycemic control. The analyses are presented as proportions, means (+/- S.D.), odds ratios, and 95% confidence intervals obtained from logistic regressions. Results: Diet self-efficacy and diet self-management behaviors predicted better glycemic control, whereas insulin use was a statistically significant predictor for poor glycemic control. In addition, subjects with higher self-efficacy reported better self-management behaviors in diet, exercise, blood sugar testing, and taking medication. The findings showed that more than half of the subjects did not have their diabetes under control and that only 42% had attended diabetes education programs. Conclusions: The majority of subjects did not have their diabetes controlled; their self-efficacy was low, and they had suboptimal self-management behaviors. Therefore, strategies to enhance and promote self-efficacy and self-management behaviors for patients are essential components of diabetes education programs. Furthermore, behavioral counseling and skill-building interventions are critical for the patients to become confident and be able to manage their diabetes. (C) 2012 Elsevier Inc. All rights reserved.