Contributing factors to effective self-management in type 2 diabetes mellitus
Abstract
Background: Self-management plays a pivotal role in the management of Type 2 Diabetes Mellitus (T2DM). Active patient participation is crucial for achieving optimal glycemic control, preventing complications, and enhancing overall quality of life in the context of long-term, sustainable disease management.
Objectives: This study aims to analyze the factors influencing self-management in patients with T2DM, to provide a foundation for developing more effective interventions that support patients in independently managing their condition.
Methods: This study employed a literature review method by analyzing articles published within the last five years from the PubMed, ScienceDirect, and ProQuest databases. The search keywords used were “Self-management, Type 2 Diabetes Mellitus, and Factors influencing.†Out of 1,168 identified articles, 22 articles were selected based on relevant inclusion criteria, with a primary focus on self-management and its influencing factors in T2DM patients.
Results: Self-management in patients with T2DM is influenced by both internal and external factors as well as individual skills. Key contributing factors include family support, cultural values, self-efficacy, emotional regulation, and time management. These elements interact dynamically, demonstrating that patients’ ability to manage diabetes is not determined by a single factor but rather by an integration of psychological readiness, supportive environments, and contextual influences. The findings highlight the importance of designing interventions that are holistic, culturally sensitive, and adaptable to patients’ daily realities. A holistic intervention approach, grounded in the bio-psycho-social and cultural model, is needed to enhance the effectiveness of self-management.
Conclusions: Self-management is a crucial component in the management of T2DM. Ineffective implementation may lead to poor disease control and an increased risk of complications. Therefore, understanding the factors influencing self-management is essential for supporting sustainable and independent diabetes care.References
1. De Luca V, Bozzetto L, Giglio C, Tramontano G, De Simone G, Luciano A, et al. Clinical outcomes of a digitally supported approach for self-management of type 2 diabetes mellitus. Frontiers in Public Health. 2023;11:1219661. https://doi.org/10.3389/fpubh.2023.1219661
2. Hurst CP, Rakkapao N, Hay K. Impact of diabetes self-management, diabetes management self-efficacy and diabetes knowledge on glycemic control in people with Type 2 Diabetes (T2D): A multicenter study in Thailand. PLoS One. 2020;15(12):e0244692. https://doi.org/10.1371/journal.pone.0244692
3. Chen M, Liu M, Pu Y, Wu J, Zhang M, Tang H, et al. The effect of health quotient and time management skills on self-management behavior and glycemic control among individuals with type 2 diabetes mellitus. Frontiers in Public Health. 2024;12:1295531. https://doi.org/10.3389/fpubh.2024.1295531
4. Ratnawati R, Jumari J, Pratama EF, Syahrir A, Usman RD, Hadi I. The Effect of Motivational Interviewing and Family Support on Self-Management in Type 2 Diabetes Mellitus Patients. Evidence Based Care Journal. 2024;14(3):35–43. https://doi.org/10.22038/ebcj.2024.75964.2932
5. Yang N, Masingboon K, Samartkit N. Factors influencing diabetes self- management among adults with type 2 diabetes mellitus in China. Belitung nursing journal. 2022;8(5):389–95. https://doi.org/10.33546/bnj.2199
6. Almutairi N, Hosseinzadeh H, Gopaldasani V. The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self- management behaviors: A systematic review of RCTs. Primary Care Diabetes. Elsevier Ltd; 2020 ;14(1): p. 12–20. https://doi.org/10.1016/j.pcd.2019.08.009
7. Butayeva J, Ratan ZA, Downie S, Hosseinzadeh H. The impact of health literacy interventions on glycemic control and self-management outcomes among type 2 diabetes mellitus: A systematic review. Journal of Diabetes. John Wiley and Sons Inc; 2023 ;15(9): p. 724–35. https://doi.org/10.1111/1753-0407.13436
8. Qi X, Xu J, Chen G, Liu H, Liu J, Wang J, et al. Self-management behavior and fasting plasma glucose control in patients with type 2 diabetes mellitus over
60 years old: multiple effects of social support on quality of life. Health and quality of life outcomes. 2021;19(1):254. https://doi.org/10.1186/s12955-021-01881-y
9. Zare M, Tarighat-Esfanjani A, Rafraf M, Shaghaghi A, Asghari-Jafarabadi M, Shamshiri M. The barriers and facilitators of self-management among adults with type 2 diabetes mellitus: A trans theoretical model (ttm)-based mixed method study in Iran. Diabetes, Metabolic Syndrome and Obesity. 2020;13:2687–99. https://doi.org/10.2147/dmso.s230083
10. Suglo JN, Evans C. Factors influencing self-management in relation to type 2 diabetes in Africa: A qualitative systematic review. PLoS One. 2020;15(10):e0240938. https://doi.org/10.1371/journal.pone.0240938
11. Patel T, Umeh K, Poole H, Vaja I, Newson L. Cultural identity conflict informs engagement with self-management behaviours for south asian patients living with type-2 diabetes: A critical interpretative synthesis of qualitative research studies. International Journal of Environmental Research and Public Health. 2021;18(5):2641. https://doi.org/10.3390/ijerph18052641
12. Visagie E, Deacon E, Kok R. Exploring the thoughts, emotions, and behaviours related to the self-management practices of adults with type 2 diabetes. Health Psychology Open. 2024;11:20551029241278976. https://doi.org/10.1177/20551029241278976
13. Al Slamah T, Nicholl BI, Alslail FY, Harris L, Melville CA, Kinnear D. Cultural adaptation of self-management of type 2 diabetes in Saudi Arabia (qualitative study). PLoS One. 2020;15(7):e0232904. https://doi.org/10.1371/journal.pone.0232904
14. Almutairi N, Gopaldasani V, Hosseinzadeh H. Relationship Between Patient Activation and Type 2 Diabetes Mellitus Self-management and Clinical Outcomes in Saudi Arabian Primary Care Setting. American Journal of Health Promotion. 2024;38(6):767–77. https://doi.org/10.1177/08901171231224889
15. Klinovszky A, Buzás N, Sallay V, Lengyel C, Papp-Zipernovszky O. Behind the Curtain: Patients’ Perceptions, Treatment Expectations and Behavior in Type 2 Diabetes Mellitus Self-management. American Journal of Health Behavior. 2023;47(6):1080–97. https://doi.org/10.5993/AJHB.47.6.1
16. Habibi Soola A, Davari M, Rezakhani Moghaddam H. Determining the Predictors of Self-Management Behaviors in Patients With Type 2 Diabetes: An Application of Socio-Ecological Approach. Front Public Health. 2022;10:820238. https://doi.org/10.3389/fpubh.2022.820238
17. Peng X, Guo X, Li H, Wang D, Liu C, Du Y. A Qualitative Exploration of Self- Management Behaviors and Influencing Factors in Patients With Type 2 Diabetes. Frontiers in Endocrinology (Lausanne). 2022;13:771293. https://doi.org/10.3389/fendo.2022.771293
18. Lin PY, Lee TY, Liu CY, Lee YJ. The effect of self-efficacy in self-management on diabetedistress in young people with type 2 diabetes. In Healthcare (Switzerland). 2021;9(12):1736. https://doi.org/10.3390/healthcare9121736
19. He Q, Liu Y, Lin K, Zhao F, Guo H, Shen Y. Diabetes self-management and its related factors among Chinese young adults with type 2 diabetes mellitus. Nursing Open. 2023;10(9):6125–35. https://doi.org/10.1002/nop2.1834
20. Kumar L, Mohammadnezhad M. Perceptions of patients on factors affecting diabetes self-management among type 2 diabetes mellitus (T2DM) patients in Fiji: A qualitative study. Heliyon 2022;8(6):e09688. https://doi.org/10.1016/j.heliyon.2022.e09728
21. Li S, Li Y, Zhang L, Bi Y, Zou Y, Liu L, et al. Impact of fear of hypoglycaemia on self-management in patients with type 2 diabetes mellitus: structural equation modelling. Acta diabetologica. 2022;59(5):641–50. https://doi.org/10.1007/s00592-021-01839-y
22. Banasiak K, Hux J, Lavergne C, Luk J, Sohal P, Paty B. Facilitating barriers: Contextual factors and self-management of type 2 diabetes in urban settings. Health & Place. 2020;61:102267. https://doi.org/10.1016/j.healthplace.2019.102267
23. Omodara DA, Gibson L, Bowpitt G. Exploring the impact of cultural beliefs in the self-management of type 2 diabetes among Black sub-Saharan Africans in the UK–a qualitative study informed by the PEN-3 cultural model. Ethnicity & health. 2022;27(6):1358–76. https://doi.org/10.1080/13557858.2021.1881764
24. Desse TA, Namara KM, Manias E. Patient-Perceived Challenges to Type 2 Diabetes Self-Management in Sub-Saharan Africa: A Qualitative Exploratory Study. The Science of Diabetes Self-Management and Care. 2024;50(6):456-
468. https://doi.org/10.1177/26350106241279809
25. Ansari RM, Harris MF, Hosseinzadeh H, Zwar N. Experiences of Diabetes Self- Management: A Focus Group Study among the Middle-Aged Population of Rural Pakistan with Type 2 Diabetes. Diabetology. 2022;3(1):17–29. https://doi.org/10.3390/diabetology3010002
2. Hurst CP, Rakkapao N, Hay K. Impact of diabetes self-management, diabetes management self-efficacy and diabetes knowledge on glycemic control in people with Type 2 Diabetes (T2D): A multicenter study in Thailand. PLoS One. 2020;15(12):e0244692. https://doi.org/10.1371/journal.pone.0244692
3. Chen M, Liu M, Pu Y, Wu J, Zhang M, Tang H, et al. The effect of health quotient and time management skills on self-management behavior and glycemic control among individuals with type 2 diabetes mellitus. Frontiers in Public Health. 2024;12:1295531. https://doi.org/10.3389/fpubh.2024.1295531
4. Ratnawati R, Jumari J, Pratama EF, Syahrir A, Usman RD, Hadi I. The Effect of Motivational Interviewing and Family Support on Self-Management in Type 2 Diabetes Mellitus Patients. Evidence Based Care Journal. 2024;14(3):35–43. https://doi.org/10.22038/ebcj.2024.75964.2932
5. Yang N, Masingboon K, Samartkit N. Factors influencing diabetes self- management among adults with type 2 diabetes mellitus in China. Belitung nursing journal. 2022;8(5):389–95. https://doi.org/10.33546/bnj.2199
6. Almutairi N, Hosseinzadeh H, Gopaldasani V. The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self- management behaviors: A systematic review of RCTs. Primary Care Diabetes. Elsevier Ltd; 2020 ;14(1): p. 12–20. https://doi.org/10.1016/j.pcd.2019.08.009
7. Butayeva J, Ratan ZA, Downie S, Hosseinzadeh H. The impact of health literacy interventions on glycemic control and self-management outcomes among type 2 diabetes mellitus: A systematic review. Journal of Diabetes. John Wiley and Sons Inc; 2023 ;15(9): p. 724–35. https://doi.org/10.1111/1753-0407.13436
8. Qi X, Xu J, Chen G, Liu H, Liu J, Wang J, et al. Self-management behavior and fasting plasma glucose control in patients with type 2 diabetes mellitus over
60 years old: multiple effects of social support on quality of life. Health and quality of life outcomes. 2021;19(1):254. https://doi.org/10.1186/s12955-021-01881-y
9. Zare M, Tarighat-Esfanjani A, Rafraf M, Shaghaghi A, Asghari-Jafarabadi M, Shamshiri M. The barriers and facilitators of self-management among adults with type 2 diabetes mellitus: A trans theoretical model (ttm)-based mixed method study in Iran. Diabetes, Metabolic Syndrome and Obesity. 2020;13:2687–99. https://doi.org/10.2147/dmso.s230083
10. Suglo JN, Evans C. Factors influencing self-management in relation to type 2 diabetes in Africa: A qualitative systematic review. PLoS One. 2020;15(10):e0240938. https://doi.org/10.1371/journal.pone.0240938
11. Patel T, Umeh K, Poole H, Vaja I, Newson L. Cultural identity conflict informs engagement with self-management behaviours for south asian patients living with type-2 diabetes: A critical interpretative synthesis of qualitative research studies. International Journal of Environmental Research and Public Health. 2021;18(5):2641. https://doi.org/10.3390/ijerph18052641
12. Visagie E, Deacon E, Kok R. Exploring the thoughts, emotions, and behaviours related to the self-management practices of adults with type 2 diabetes. Health Psychology Open. 2024;11:20551029241278976. https://doi.org/10.1177/20551029241278976
13. Al Slamah T, Nicholl BI, Alslail FY, Harris L, Melville CA, Kinnear D. Cultural adaptation of self-management of type 2 diabetes in Saudi Arabia (qualitative study). PLoS One. 2020;15(7):e0232904. https://doi.org/10.1371/journal.pone.0232904
14. Almutairi N, Gopaldasani V, Hosseinzadeh H. Relationship Between Patient Activation and Type 2 Diabetes Mellitus Self-management and Clinical Outcomes in Saudi Arabian Primary Care Setting. American Journal of Health Promotion. 2024;38(6):767–77. https://doi.org/10.1177/08901171231224889
15. Klinovszky A, Buzás N, Sallay V, Lengyel C, Papp-Zipernovszky O. Behind the Curtain: Patients’ Perceptions, Treatment Expectations and Behavior in Type 2 Diabetes Mellitus Self-management. American Journal of Health Behavior. 2023;47(6):1080–97. https://doi.org/10.5993/AJHB.47.6.1
16. Habibi Soola A, Davari M, Rezakhani Moghaddam H. Determining the Predictors of Self-Management Behaviors in Patients With Type 2 Diabetes: An Application of Socio-Ecological Approach. Front Public Health. 2022;10:820238. https://doi.org/10.3389/fpubh.2022.820238
17. Peng X, Guo X, Li H, Wang D, Liu C, Du Y. A Qualitative Exploration of Self- Management Behaviors and Influencing Factors in Patients With Type 2 Diabetes. Frontiers in Endocrinology (Lausanne). 2022;13:771293. https://doi.org/10.3389/fendo.2022.771293
18. Lin PY, Lee TY, Liu CY, Lee YJ. The effect of self-efficacy in self-management on diabetedistress in young people with type 2 diabetes. In Healthcare (Switzerland). 2021;9(12):1736. https://doi.org/10.3390/healthcare9121736
19. He Q, Liu Y, Lin K, Zhao F, Guo H, Shen Y. Diabetes self-management and its related factors among Chinese young adults with type 2 diabetes mellitus. Nursing Open. 2023;10(9):6125–35. https://doi.org/10.1002/nop2.1834
20. Kumar L, Mohammadnezhad M. Perceptions of patients on factors affecting diabetes self-management among type 2 diabetes mellitus (T2DM) patients in Fiji: A qualitative study. Heliyon 2022;8(6):e09688. https://doi.org/10.1016/j.heliyon.2022.e09728
21. Li S, Li Y, Zhang L, Bi Y, Zou Y, Liu L, et al. Impact of fear of hypoglycaemia on self-management in patients with type 2 diabetes mellitus: structural equation modelling. Acta diabetologica. 2022;59(5):641–50. https://doi.org/10.1007/s00592-021-01839-y
22. Banasiak K, Hux J, Lavergne C, Luk J, Sohal P, Paty B. Facilitating barriers: Contextual factors and self-management of type 2 diabetes in urban settings. Health & Place. 2020;61:102267. https://doi.org/10.1016/j.healthplace.2019.102267
23. Omodara DA, Gibson L, Bowpitt G. Exploring the impact of cultural beliefs in the self-management of type 2 diabetes among Black sub-Saharan Africans in the UK–a qualitative study informed by the PEN-3 cultural model. Ethnicity & health. 2022;27(6):1358–76. https://doi.org/10.1080/13557858.2021.1881764
24. Desse TA, Namara KM, Manias E. Patient-Perceived Challenges to Type 2 Diabetes Self-Management in Sub-Saharan Africa: A Qualitative Exploratory Study. The Science of Diabetes Self-Management and Care. 2024;50(6):456-
468. https://doi.org/10.1177/26350106241279809
25. Ansari RM, Harris MF, Hosseinzadeh H, Zwar N. Experiences of Diabetes Self- Management: A Focus Group Study among the Middle-Aged Population of Rural Pakistan with Type 2 Diabetes. Diabetology. 2022;3(1):17–29. https://doi.org/10.3390/diabetology3010002
Authors
Copyright and license info is not available