Prevalence and predictors of self-care practices among diabetic patients in Southern Tunisia

Diabetic self-care practices (DSCP) refer to behavioral actions by people with diabetes to manage their condition effectively. This study aimed to determine the prevalence of inadequate DSCP among Tunisian diabetics and identify associated predictors.

A cross-sectional study was conducted from March to April 2022 at the University Hospital Center of Sfax, covering southern Tunisia. Adults with type 1 or type 2 diabetes attending the Endocrinology outpatient clinic during the study period were included. The validated SCODI questionnaire with a cut-off of 70 was used to assess DSCP.

A total of 200 patients were enrolled to the study with a response rate of 93.8%. Median age was 55 years with IQR= [42-63] years. There were 128 females (64%) and 153 married patients (76.5%). The prevalence of inadequate self-care practice was 51 % (N=102 cases). Inadequate self-care maintenance, inadequate self-care monitoring, inadequate self-care management and inadequate self-care confidence were noted in 35 cases (17.5%), 127 cases (63.5%), 155 cases (77.5%) and 73 cases (36.5%), respectively. Independent factors of inadequate DSCP were male gender (AOR=2.8; CI=[1.3-6.1]), low income (AOR=5; CI= [2-10]), irregular physical activity (AOR=4; CI= [2-8]), irregular follow-up (AOR=5; CI= [1.6-16.6]), and irregular blood sugar monitoring (AOR=11.3; CI=[5-25]). Besides, being on insulin (AOR=0.27; CI= [0.1-0.7]) or mixed regimen (AOR=0.35; CI=[0.15-0.9]) was independently associated with better DSCP.

This study revealed a high prevalence of inadequate DSCP. It highlights the need for targeted interventions to promote healthier lifestyles, improve patient education, and enhance disease self-management among patients with diabetes.