Motivation for change, cornerstone of diabetes self-management in patients with type 2 diabetes

Abstract

Background: Personal motivation for change plays a fundamental role in creation of sustainable changes regarding diabetes self-management. The aim of this study is to assess the motivation as well as the relation between the level of patients motivation in relation to disease characteristics, metabolic control, beha-vioral determinants and the barriers patients encounter in diabetes self-management. Methods: The data for this cross-sectional study were obtained by combining anthropometric measurements (body mass index-BMI), biochemical parameters (glycosylated hemoglobin-HbA1c) and by interviewing respondents using certain sub-scale of a structured Personal Diabetes Questionnaire (PDQ). Results: The sample consisted of 117 respondents with T2DM. The majority (61.06%) was not motivated to make self-management changes. Non-motivated respondents were older than 65 years of age (X2 = 8,046; p = 0.005) and had: a lower level of education (X2 = 35.320; p = 0.000), diabetes for more than 10 years, poor glyco-regulation (90,14%) and were overweight / obese (81,7%). Motivated respondent were more physically active (X2 = 6.439; p = 0.000), more adherent to anti-hyperglucemic therapy (OHAs) (X2 = 9.673; p = 0,002), and more adherent to dietary regime. Average barrier scores: in the following healthy diet [t =-7.960; p = 0.000], in therapeutic adherence [t =-4.318; p = 0.000] and physical activity [t =-6.439; p = 0.000] were also statistically significantly different with the high impact in relation to respondents' motivation. Conclusions: Assessment of the motivation for changes in diabetes self-management should become an integral part of monitoring patients with T2DM in Primary Health Care (PHC). In this way, individual advisory strategies could be developed, because motivated and not motivated persons have different needs for counseling. Key messages: Motivated and not motivated persons with T2DM have different needs for counseling. Assessment of the motivation for changes in diabetes self-management should become an integral part of monitoring patients with T2DM.