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    Posted March 27, 2014 by

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    Diabetes self-management behavior linked to prolonged life expectancy

    Self-management of diabetes also lowers cardiovascular mortality

    Research supports diabetes self-management behavior particularly in the short term however, little is known about the impact of diabetes self-management behavior (SMB) on long-term outcomes.

    Scientists of the Institute of Health Economics and Health Care Management (IGM) and of the Institute of Epidemiology II (EPI II) at Helmholtz Zentrum München (HMGU), together with colleagues of the German Diabetes Center (DDZ) in Düsseldorf, examined the association among patient-reported self-management behavior (SMB) intermediate clinical outcomes, and mortality in patients with type 2 diabetes.

    Researchers led by Professor Rolf Holle and Michael Laxy collected data from 340 patients with type 2 diabetes of the KORA-A study (1997/1998) who were recruited from two previous population-based surveys (161 patients) and a myocardial infarction registry (179 patients) in southern Germany.

    A high level of SMB was defined as being compliant with at least four of six different self-care dimensions, comprising physical exercise, foot care, blood glucose self-monitoring, weight monitoring, having a diet plan, and keeping a diabetes diary.

    During a mean follow-up of 11.6 years, 189 patients died.

    The analysis showed that SMB was a preventive factor for all-cause (hazard ratio 0.61 [95% CI 0.40–0.91]) and cardiovascular mortality (0.65 [95% CI 0.41–1.03]).

    In their conclusion the researchers write “Although measuring SMB is difficult and the used operationalization might be limited, our results give some indication that a high level of SMB is associated with prolonged life expectancy in patients with type 2 diabetes and highlight the potential impact of the patients’ active contribution on the long-term trajectory of the disease. We assume that the used proxy for SMB is associated with unmeasured, but important, dimensions of health behavior.”

    According to Professor Hollie "The results show that in addition to physician delivered treatment according to medical guidelines, the patient's behavior is also of great significance for the course of the disease and for the success of the treatment process.”

    "Patient-centered services, such as diabetes education, self-management training and information services therefore make a valuable contribution to good patient care and should continue to be expanded,” said Hollie.

    Diabetes affects nearly 10% of the population in Germany and the United States.

    This analysis appears in Diabetes Care.
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