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

Abstract

Introduction: Little is reported about how much time patients spend on self-management, a corner-stone 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 self-care 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.