Associations of Self-Management Care and Shared Decision-Making with Glycemic Control and Psychosocial Outcomes in Type 2 Diabetes Mellitus

This study explored the associations of Self-Management Care (SMC) and Shared Decision-Making (SDM) with clinical outcomes, specifically glycated hemoglobin (HbA1c) levels, and non-clinical outcomes (psychosocial Outcomes) in patients with type 2 Diabetes Mellitus (T2DM). A cross-sectional design was employed, involving 200 patients with T2DM, recruited through convenience sampling. Data were collected from the two healthcare facilities in Dammam, Saudi Arabia, between March and June 2020. Statistical analyses, including independent sample t-tests, one-way ANOVA, and multiple linear regression, were conducted using Statistical Package for the Social Sciences (SPSS) version 26.0. The findings showed that Increased SMC levels were associated with improved clinical outcomes, particularly lower HbA1c levels (p < 0.01). Additionally, SMC was positively associated with psychosocial outcomes (ie, quality of life and mental health; p < 0.05). In contrast, SDM was significantly associated with psychosocial outcomes (p < 0.05), its relationship with HbA1c was non-significant (p= 0.300), indicating only a minor explanatory effect. Additionally, demographic and clinical factors such as sex and lipid levels were found to influence glycemic outcomes, with males and patients with better lipid profiles showing lower HbA1c levels. This study reinforces the pivotal role of SMC in achieving optimal glycemic control and improving the overall well-being of T2DM patients. While shared decision-making (SDM) enhances patient-reported outcomes, its impact on clinical outcomes such as HbA1c was not statistically significant. These findings support patient-centered approaches and highlight the need for further longitudinal research to confirm causal relationships. The results highlight the value of integrating comprehensive self-management support and patient-centered decision-making in diabetes care to optimize both clinical and psychosocial outcomes for patients.