Diabetes self-care activities: a community-based survey in urban southern India.

BACKGROUND: Diabetes is a lifestyle disease and can be successfully managed by good self-care activities such as diet, exercise, monitoring and drug adherence. Adequate baseline information about the prevalence of good self-care activities is not available from India. We aimed to estimate the existing self-care behaviours and factors influencing these behaviours among adult patients with type 2 diabetes in urban southern India. METHODS: A cross-sectional survey was conducted using a cluster design in an urban community in southern India. The Summary Diabetes Self-Care Activities questionnaire was used to collect information on diet, exercise, monitoring of blood sugars and adherence to drugs. Risk factors such as marital status, socioeconomic status, depression, benefit-finding and duration of illness, which are likely to influence self-care behaviour, were assessed. RESULTS: Good dietary behaviour was present in 29% (95% CI 20.8%-37.2%), good exercise behaviour in 19.5% (95% CI 17.4%-21.6%), regular blood sugar monitoring in 70% (95% CI 62.2%-77.8%) and drug adherence in 79.8% (95% CI 75.1%-84.5%). Being male (OR 3.38; 95% CI 1.541-7.407) and married (OR 5.60; 95% CI 1.242-25.212) significantly favoured good exercise behaviour. Being married (OR 2.322; 95% CI 1.104-4.883) and belonging to the higher socioeconomic status (OR 2.713; 95% CI 1.419-5.190) were significantly associated with monitoring of blood sugars. CONCLUSIONS: Self-care activities with respect to diet and exercise are poor in the population studied. The self-care activities relating to blood sugar monitoring and drug adherence are good. Improving self-care behaviour among patients with diabetes in India should start with adequate targeted health education.