Relationship between diabetes knowledge, self-management practices, and glycaemic control among patients attending diabetic clinic at a tertiary level hospital in Johannesburg, South Africa.

BackgroundMethodResultsConclusionDiabetes mellitus (DM) has reached epidemic proportions in South Africa. Targets for adequate glycaemic control are rarely being met. DM self-management is a cornerstone of effective DM care and people with DM should be adherent to various self-care behaviours. This study aims to describe the behavioural factors contributing to DM management control and how they relate to glycaemic control.A cross-sectional survey used the Diabetes Self-Management Questionnaire (DSMQ) to assess knowledge and self-management behaviours of physical activity, glucose management, dietary control, and health care use amongst patients attending a diabetic clinic at a tertiary hospital in Johannesburg. Regression analysis models were used to determine the relationship between the independent variables of DM knowledge and self-care behaviours and the outcome variable glycaemic control.A total of 214 participants were enrolled; the majority were African (55.6%) and Coloured (30.4%). Only 14% of patients achieved a target HbA1c of less than 7%. Participants scored the highest average scores on the DSMQ for the healthcare use subscale, followed by glucose management, then physical activity. The lowest mean score was noted for the dietary subscale. The dietary control subscale of the DSMQ was most significantly associated with HbA1c (OR 0.79 [CI 0.64–0.96], <italic>p</italic>-value 0.020). Overall compliance with diabetes self-management behaviours is associated with improved glycaemic control, whereby patients who scored higher on the DSMQ were less likely to have poor glycaemic control (OR: 0.51 [CI 0.28–0.94], <italic>p</italic>-value 0.030).The barriers to effective DM control are vast and complex. This study shows that effective self-management overall is associated with better glycaemic control. Dietary control is most significantly associated with HbA1c. Most people living with DM find it challenging to adhere to a nutritious and diverse DM diet. There is room for further research and intervention regarding medical nutrition therapy that will be culturally and financially appropriate for the South African population. [ABSTRACT FROM AUTHOR]