Diabetes Empowerment, Medication Adherence and Self-Care Behaviors in Adults with Type 2 Diabetes

BACKGROUND: Evidence suggests that empowerment is an important factor to address everyday aspects of dealing with a chronic disease. This study evaluated the effect of diabetes empowerment on medication adherence and self-care behaviors in adults with type 2 diabetes. SUBJECTS AND METHODS: Data on 378 subjects with type 2 diabetes recruited from two primary care clinics in the southeastern United States were examined. Previously validated scales were used to measure diabetes empowerment, medication adherence, diabetes knowledge, and diabetes self-care behaviors (including diet, physical activity, blood sugar testing, and foot care). Multiple linear regression was used to assess the independent effect of diabetes empowerment on medication adherence and self-care behaviors controlling for relevant covariates. RESULTS: Eighty-three percent were non-Hispanic blacks, 69% were women, 22% were 65 years or older, 68% were not married, 26% had less than high school education, 60% were unemployed, 39% were uninsured, and 47% had a yearly income <10, 000. Empowerment had significant correlations with medication adherence (r=0. 17, P<0. 003), diabetes knowledge (r=0. 16, P=0. 007), diet (r=0. 24, P<0. 001), exercise (r=0. 25, P<0. 001), blood sugar testing (r=0. 12, P=0. 043), and foot care (r=0. 18, P=0. 002). In the regression model, diabetes empowerment was significantly associated with medication adherence (β=-0. 04, P=0. 001), diabetes knowledge (β=0. 09, P=0. 012), diet (β=0. 09, P<0. 001), exercise (β=0. 10, P<0. 001), blood sugar testing (β=0. 07, P=0. 016), and foot care (β=0. 08, P=0. 001). CONCLUSIONS: In this sample, diabetes empowerment was related to better diabetes knowledge, medication adherence and improved self-care behaviors. Emphasis on empowerment and self-efficacy is relevant to improve outcomes in the management of diabetes.