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Research ArticleOriginal Article

How Much Time Do Patients with Diabetes Spend on Self-Care?

Monika M. Safford, Louise Russell, Dong-Churl Suh, Sheila Roman and Leonard Pogach
The Journal of the American Board of Family Practice July 2005, 18 (4) 262-270; DOI: https://doi.org/10.3122/jabfm.18.4.262
Monika M. Safford
MD
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Louise Russell
PhD
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Dong-Churl Suh
PhD
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Sheila Roman
MD
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Leonard Pogach
MD
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    Figure 1.

    Composition of Final Study Sample.

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    Figure 2.

    Number of People Reporting Various Times Spent on Foot Care, Exercise, and Food Shopping/Preparation, Minutes per Day.

Tables

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    Table 1.

    Demographic Characteristics of 1482 Persons with Diabetes and Time Spent on Foot Care, Exercise, Food Preparation, and in Total Self-Care

    Characteristic (%)*Foot CareExerciseShopping and CookingTotal Time Spent†
    % Not Engaging‡Mean Non-Zero Time, min/day (25%, 75%)% Not EngagingMean Non-Zero Time, min/day (25%, 75%)% Not EngagingMean Non-Zero Time, min/day (25%, 75%)Mean min/day (25%, 75%)
    All Patients37.913 (5, 15)37.732 (15, 38)54.448 (30, 60)58 (19, 84)
    Age, years
        <45 (15.1%)35.910 (5, 15)§37.733 (15, 38)§51.244 (20, 60)§56 (21, 77)
        45 to 54 (27.0%)39.612 (5, 15)§34.833 (15, 40)§53.044 (20, 60)§60 (21, 87)
        55 to 64 (32.2%)37.913 (5, 15)§37.534 (20, 45)§57.547 (20, 60)§58 (19, 80)
        >65 (25.7%)37.217 (5, 30)§41.028 (15, 30)§54.155 (30, 60)§58 (15, 89)
    Sex
        Female (51.6%)32.3§14 (5, 20)40.7§29 (15, 30)§46.0§51 (30, 60)§63 (22, 90)§
        Male (48.3%)43.8§13 (5, 15)34.4§35 (15, 45)§63.6§42 (15, 60)§53 (15, 75)§
    Education
        <High school (52.6%)35.8§15 (5, 20)§41.5§31 (15, 30)51.8§52 (30, 60)§60 (19, 89)§
        Some college (25.5%)35.5§13 (5, 15)§34.9§33 (18, 45)53.9§46 (20, 60)§59 (20, 82)§
        >4 years college (21.4%)45.3§9 (5, 10)§31.7§33 (15, 45)61.6§38 (15, 60)§52 (18, 73)§
    Ethnicity
        African American (36.2%)29.9§17 (5, 20)§36.632 (15, 30)49.4§52 (30, 60)§65 (22, 95)§
        White (47.0%)43.1§10 (5, 10)§37.433 (15, 45)60.9§39 (15, 60)§51 (16, 74)§
        Others (13.4%)40.9§14 (5, 15)§42.131 (15, 30)44.8§55 (30, 60)§65 (24, 93)§
    • * Percentage of the total study sample (n = 1482) with this characteristic. For example, 36.2% of the sample was African American.

    • † Total time spent is for the 3 listed elements plus self-testing and insulin injection (see text).

    • ‡ Percentage of the individuals with each characteristic that did not engage in this activity. For example, 29.9% of African Americans did not engage in foot care.

    • § P <.05.

    • View popup
    Table 2.

    Clinical Characteristics of 1482 Persons with Diabetes and Time Spent in Foot Care, Exercise, Shopping and Cooking, and in Total Self-Care

    Characteristic (%)*Foot CareExerciseShopping and CookingTotal Time Spent†
    % Not Engaging‡Mean Non-Zero Time, min/day (25%, 75%)% Not EngagingMean Non-Zero Time, min/day (25%, 75%)% Not EngagingMean Non-Zero Time, min/day (25%, 75%)Mean min/day (25%, 75%)
    All patients37.913 (5, 15)37.732 (15, 38)54.448 (30, 60)58 (19, 84)
    BMI, kg/m2
        <30 (46.3%)38.313 (5, 15)32.6§34 (15, 45)53.946 (25, 60)59 (20, 85)
        30 to 34 (27.6%)39.514 (5, 20)35.2§32 (15, 38)54.947 (30, 60)59 (22, 89)
        35 to 40 (14.5%)36.914 (5, 20)46.8§31 (15, 45)49.849 (25, 60)57 (15, 85)
        >40 (11.5%)33.512 (5, 15)52.4§26 (15, 30)61.052 (30, 60)51 (15, 74)
    Neuropathy symptoms‖
        Most (13.5%)24.1§16 (5, 20)§38.1§33 (15, 45)46.3§46 (20,60)66 (30, 89)§
        Moderate (14.2%)30.1§17 (5, 20)§46.2§33 (15, 30)48.5§53 (30, 60)63 (20, 94)§
        Mild (21.9%)35.9§13 (5, 15)§33.6§29 (15, 30)52.8§45 (30, 60)58 (19, 85)§
        None (44.5%)45.5§11 (5, 15)§37.2§33 (15, 45)59.7§44 (20, 60)53 (15, 77)§
    Diabetes treatment
        Diet only (5.5%)42.0§14 (5, 15)34.229 (18, 30)40.3§46 (20, 60)55 (16, 80)§
        Oral only (63.4%)41.9§13 (5, 15)38.833 (15, 45)57.4§48 (30, 60)55 (15, 79)§
        Insulin (31.1%)29.0§14 (5, 15)35.932 (15, 30)50.6§46 (30, 60)66 (24, 90)§
    Self-testing
        Never (20.8%)50.2§12 (5, 15)47.3§29 (15, 30)60.4§50 (20, 60)42 (4, 64)§
        <1/day (27.0%)42.1§13 (5, 15)43.0§31 (15, 30)55.8§45 (20, 60)47 (9, 68)§
        1/day (12.3%)35.2§14 (5, 15)33.5§35 (20, 60)53.9§48 (20, 60)66 (23, 87)§
        >2/day (39.8%)29.4§14 (5, 15)30.5§33 (15, 40)50.5§48 (30, 60)71 (35, 95)§
        Others (13.4%)40.9§14 (5, 15)§42.131 (15, 30)44.8§55 (30, 60)§65 (24, 93)§
    • * Percentage of the total study sample (n = 1482) with this characteristic. For example, 31.1% of the sample used insulin.

    • † Total time spent is for the three listed elements plus self-testing and insulin injection (see text).

    • ‡ Percentage of individuals with each characteristic that did not engage in this activity. For example, 29.0% of insulin-users did not engage in foot care.

    • ‖ Based on foot neuropathy symptom score (see text). Most symptoms = 3 to 10; moderate = 11 to 12; mild = 13 to 14; none = 15.

    • § P <.05.

    • View popup
    Table 3.

    Adjusted Odds Ratios* and 95% CI for Spending Any Time Daily on Foot Care, Exercise, and Food Shopping/Preparation

    ContrastFoot CareExerciseFood Shopping/Preparation
    Sex: male vs female0.7 (0.5, 0.9)†1.1 (0.9, 1.5)0.5 (0.4, 0.7)
    Body mass index (kg/m2)
        >40 vs 30 to 341.1 (0.7, 1.6)0.5 (0.4, 0.9)0.7 (0.4, 1.0)
        35 to 40 vs 30 to 341.1 (0.7, 1.6)0.6 (0.4, 0.9)1.4 (1.0, 2.1)
    Amputees vs non-amputees4.7 (1.3, 16.4)1.3 (0.6, 3.0)2.2 (1.0, 5.0)
    Foot neuropathy: no symptoms vs most0.5 (0.4, 0.8)1.1 (0.7, 1.6)0.7 (0.5, 1.1)
    Physical functioning: best vs worst quartile0.7 (0.4, 1.0)1.3 (0.9, 2.0)0.8 (0.5, 1.3)
    Mental functioning: best vs worst quartile1.0 (0.6, 1.4)1.2 (0.8, 1.7)0.7 (0.5, 4.0)
    Self-testing
        Never vs ≥2 times daily0.4 (0.3, 0.6)0.4 (0.3, 0.6)0.7 (0.5, 1.0)
        Rarely (<daily) vs >2 times daily0.5 (0.4, 0.7)0.5 (0.4, 0.7)0.9 (0.6, 1.2)
    Race/ethnicity
        Whites vs African Americans0.5 (0.4, 0.7)0.7 (0.5, 1.0)0.7 (0.5, 0.9)
        Other races vs African Americans0.6 (0.4, 0.9)0.6 (0.4, 0.9)1.1 (0.8, 1.7)
    • * Each column presents adjusted odds ratios from a separate logistic regression model that also included age, sex, body mass index, diabetes duration, amputation status, neuropathy symptom score, Physical Component Summary-12 quartile, Mental Component Summary-12 quartile, diabetes treatment, self-testing frequency, education, income, and race/ethnicity. Only predictors with significant findings on at least 1 element are presented.

    • † Adjusted odds ratios in bold had P <.05.

    • View popup
    Table 4.

    Multiple Linear Regression Coefficients (P)* for Minutes Spent on Daily Foot Care, Exercise, Food Shopping/Preparation and Total Time Spent by Patients Spending Any Time on Each Activity

    ContrastFoot Care (P)†Exercise (P)Food Shopping/Preparation (P)Total Time Spent (P)
    Age
        <45 vs >65 years−3.7 (.02)3.9 (.26)−9.5 (.08)−6.9 (.22)
        45 to 54 vs >65 years−1.3 (.33)5.0 (.10)−7.4 (.14)0.6 (.90)
    Sex: male vs female0 (.98)5.5 (<.01)−1.4 (.66)−5.6 (.07)
    Body mass index >40 vs 30 to 34 kg/m2−2.6 (.06)−8.0 (.02)9.3 (.09)−11.6 (.02)
    Amputees vs non-amputees11.4 (<.01)1.1 (.84)−11.7 (.14)16.2 (.09)
    Foot neuropathy: no symptoms vs most−2.3 (.07)−2.6 (.34)3.2 (.50)−4.5 (.35)
    Physical functioning
        Best vs worst quartile−3.8 (<.01)7.1 (.02)1.1 (.83)0.50 (.92)
        Second best vs worst quartile−4.1 (<.01)0.8 (.76)3.0 (.50)0.1 (.99)
        Third best vs worst quartile−2.8 (.02)−3.2 (.24)4.0 (.35)0.8 (.85)
    Self-testing
        Never vs >2 times daily−3.5 (<.01)−3.6 (.19)−5.7 (.21)−29.9 (<.01)
        Rarely (<daily) vs >2 times daily−2.6 (.02)−3.8 (.10)−9.1 (.01)−26.8 (<.01)
    Education
        >4 years college vs <high school−2.8 (.02)−2.7 (.27)−7.0 (.11)−6.8 (.10)
    Income
        >$75,000 vs $40 to 75,000−3.5 (<.01)−3.0 (.21)−3.6 (.43)−5.9 (.15)
    Race/ethnicity
        White vs African Americans−4.2 (<.01)−4.3 (.05)−7.7 (.03)−15.1 (<.01)
        Other races vs African Americans−0.05 (.72)−5.2 (.08)9.5 (.04)−3.1 (.52)
    • * Coefficients in bold had P <.05.

    • † Each column presents results of separate linear regression models including age, sex, body mass index, diabetes duration, amputation status, neuropathy symptom score, Physical Component Summary-12 quartile, Mental Component Summary-12 quartile, diabetes treatment, self-testing frequency, education, income and race/ethnicity. Only predictors with significant findings on at least one element are presented.

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The Journal of the American Board of Family Practice: 18 (4)
The Journal of the American Board of Family Practice
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July-August 2005
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How Much Time Do Patients with Diabetes Spend on Self-Care?
Monika M. Safford, Louise Russell, Dong-Churl Suh, Sheila Roman, Leonard Pogach
The Journal of the American Board of Family Practice Jul 2005, 18 (4) 262-270; DOI: 10.3122/jabfm.18.4.262

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How Much Time Do Patients with Diabetes Spend on Self-Care?
Monika M. Safford, Louise Russell, Dong-Churl Suh, Sheila Roman, Leonard Pogach
The Journal of the American Board of Family Practice Jul 2005, 18 (4) 262-270; DOI: 10.3122/jabfm.18.4.262
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