Relationships of diabetes self-care behaviours to glycaemic control in adults with type 2 diabetes and comorbid heart failure.
Fekadu Aga, Sandra B Dunbar, Tedla Kebede and 2 others
PMID 32802365WHAT IT FOUND
In adults with type 2 diabetes and heart failure, diabetes self-care behaviours did not remain linked to blood sugar control after accounting for medications and other conditions.
General diet and exercise were linked to lower HbA1c, but medication categories and comorbidities remained linked.
Key findings
01After demographic, clinical, comorbidity and psychosocial variables were controlled, none of the diabetes self-care behaviours predicted HbA1c or fasting glucose.
02In simple comparisons, more days of general dietary self-care were linked with lower HbA1c, while more days of diabetes-specific dietary self-care were linked with higher HbA1c.
03Participants who did not exercise for at least one day per week had higher HbA1c than participants who exercised one day or more per week.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot show that self-care behaviours caused better or worse glucose control. It was a secondary analysis of baseline data from a parent trial, so it was limited to measures chosen for that trial. Participants were recruited from hospitals after heart failure admission or discharge, so findings may not apply to community-dwelling adults with type 2 diabetes and heart failure. The sample was mainly African American and male, with 118 men and 119 African American participants, so results may not generalize to other groups. The final adjusted HbA1c model was not statistically significant despite adding self-care behaviours, so the adjusted HbA1c findings should be read cautiously.
Declared interests
The authors declared no conflicts of interest. The supplied publication types list NIH and U.S. government non-P.H.S. research support.
The easy way to misread this
Do not conclude that diabetes self-care behaviours are useless for people with type 2 diabetes and heart failure. The study did not test whether changing self-care improves glucose control, and simple comparisons linked general diet and exercise to lower HbA1c. The null result is that self-care behaviours did not remain linked to glucose control after adjustment for clinical and demographic factors.