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Exploring Multidimensional Diabetes Self-Management and Health-Related Functioning in Relation to Vascular
Claudiu Cobuz1, Mădălina Ungureanu-Iuga2, Iuliana Costescu1
1Faculty of Medicine and Biological Sciences, Ştefan cel Mare University of Suceava, 13th Universităţii Street, 720229 Suceava, Romania.
Journal of Clinical Medicine
|August 13, 2026
Summary
Patients with diabetes experiencing functional limitations and challenges with glycemic control are more likely to have macrovascular complications. Integrating functional and psychosocial assessments is key for comprehensive diabetes care.
Area of Science:
- Endocrinology and Metabolism
- Behavioral Medicine
- Health Services Research
Background:
- Diabetes mellitus presents complex challenges impacting disease burden and complications.
- Understanding self-management and functioning dimensions is crucial for patient outcomes.
Purpose of the Study:
- To identify latent dimensions of diabetes self-management and health-related functioning.
- To evaluate the association between these dimensions and diabetes-related complication types.
Main Methods:
- Cross-sectional study of 300 type 2 diabetes patients (microvascular vs. macrovascular complications).
- Utilized a questionnaire with diabetes self-management questionnaire (DSMQ) and SF-36 derived items.
- Exploratory factor analysis and logistic regression models were employed.
Main Results:
- Six latent factors identified: Emotional Burden, Dietary Self-Management, Functional Limitations, Glycemic Control Challenges, Glucose Monitoring, and General Health Perception.
- Functional Limitations showed the strongest association with complication type; macrovascular patients reported greater impairment.
- Higher adherence to meal plans and greater functional limitations were key differences between complication groups.
Conclusions:
- Functional Limitations Score remained independently associated with complication type.
- Findings support integrating functional, psychosocial, and behavioral assessments in diabetes care.
- Highlights differences in patient-reported outcomes across diabetes complication groups.
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