Self-care behaviors and glycemic control in type I diabetes

This study investigated the degree of adherence to different aspects of the diabetic treatment regimen (insulin injections, glucose testing, diet, and exercise), the consistency of adherence across different regimen areas, and relationships between adherence and glycemic control. A predominantly adult community sample of 93 insulin dependent outpatients participated in the prospective study that involved two series of home interviews separated by a 6-month interval. Multiple measures of adherence (e.g. self-report, interview/recall, self-monitoring, and objective indices) were collected for each regimen area. Results indicated that the degree of adherence was higher for medication taking and glucose testing than for regimen tasks requiring greater lifestyle modifications such as diet and exercise; there were few strong relationships between subjects' adherence to one area of the regimen and the extent to which they adhered to other regimen tasks; and no clear relationship between adherence and glycemic control could be demonstrated through either bivariate or multivariate analyses. It is recommended that regimen adherence be considered in the context of other factors that may influence glycemic control (e.g. stress, individual metabolic factors, appropriateness of regimen prescriptions) rather than assuming a one-to-one relationship between adherence and control.