Adherence to Self-Care and Associated Factors Among Patients with Type 2 Diabetes in Southwestern Iran

Effective self-care is essential for managing type 2 diabetes and preventing complications. However, adherence remains suboptimal. This study assessed self-care behaviors and associated factors among patients with type 2 diabetes in southwestern Iran.

A cross-sectional study was conducted on 153 patients (selected from 160 invited individuals; response rate: 95.6%) in Behbahan and Susangerd between October 2023 and March 2024. Questionnaires were checked for completeness, and complete-case analysis was performed. Self-care was assessed using the Persian version of the Summary of Diabetes Self-Care Activities (SDSCA). Differences among components were tested using Cochran's Q, and multivariate logistic regression identified factors associated with adherence, with significance set at p < 0.05. An operational cutoff of ≥3.5 days per week was used to define "adequate" self-care.

Adherence differed significantly among components (p < 0.001). It was highest for Diabetes Diet (OR 7.57, 4.63-12.39) and Non-Smoking (OR 5.23, 3.25-8.41) compared with General Diet (39.2%), whereas Glucose Monitoring (OR 0.41, 0.25-0.67), Foot Care (OR 0.07, 0.03-0.17), and Physical Activity (OR 0.03, 0.01-0.10) were substantially lower. Only 8.5% adhered to five or more components. Higher income, older age, longer disease duration, and being single were associated with better adherence to specific behaviors.

Overall self-care was suboptimal, particularly for physical activity and foot care. Targeted interventions focusing on patient education and follow-up, especially for individuals with lower income or education, are urgently needed to improve adherence and reduce diabetes-related complications.