Correlation between Glycemic Control and Diabetes Self-Care in Patients with Type 1 Diabetes on Insulin Regimens (Basalbolus vs. Biphasic premixed)

Self-care is probably decisive factor to control blood glucose level to establish euglycemia in diabetes. 3.7 million deaths in 2016 were due to diabetes and hyperglycemia.

To assess correlation between diabetes self-care reflected by Diabetes Self-Management Questionnaire (DSMQ) scores and glycemic control by Hemoglobin A1c (HbA1c) in patients with type 1 diabetes and to stratify them according to the prescribed insulin regimen (basal-bolus vs. twice-daily premixed regimen) for further comparison.

100 patients with type 1 diabetes were cross-sectionally assessed using DSMQ in interview sessions at Kerbala Educational Children Hospital-Endocrinopathy outpatient clinic and at a private clinic. Demographic data, recent records of HbA1cand Self-Monitored Blood glucose (SMBG), and other self-care variables were obtained. SPSS was used to assess correlations and to compare group characteristics.

Correlations between HbA1c and DSMQ-subscales revealed non-significant correlations for Sum scale (SS), Glucose management (GM), Physical activity (PA), and Health-care use (HU) [Spearman's ρ=.017;.080;.095 and-.054 respectively], however there was a significant correlation with Dietary control (DC) subscale [Pearson's r=-.209; p-value=.037]. Premixed versus basal-bolus comparisons showed significant differences in mean HbA1c (± SD) 10.82% ± 2.33 vs. 9.28% ± 2.19; p-value=.002 and mean DSMQ-subscales scores except DC-subscale. There were non-significant differences regarding random SMBG, BMI, and score of DSMQ-DC subscale.

Non-significant relation between glycemic control and self-care except dietary control which was negative. Basal-bolus regimen was superior in long-term glycemic control despite lower self-care compared with premixed regimen.