Interdependence may hinder diabetes self-care in Japanese adults

Diabetes self-care in Japanese adults with type 2 diabetes can be negatively affected by interdependent tendencies, according to findings published in the Journal of Diabetes Investigation . Kaori Ikeda “Individual patient preferences, needs and values interact with contextual factors, such as culture, values, family, and social and community environment,” Kaori Ikeda , MD , PhD , assistant professor in the department of diabetes, endocrinology and nutrition in the graduate school of medicine at Kyoto University in Japan, and colleagues wrote. “An approach that is respectful of and responsive to a patient’s social and cultural context is helpful in leading patients to more successful diabetes self-care.”

Ikeda and colleagues conducted a cross-sectional survey of 161 adults with type 2 diabetes (mean age, 65.1 years; 35.4% women; mean HbA1c, 7.5%; mean duration of diabetes, 15.3 years) who were recruited as outpatients from Kyoto University Hospital from June to July 2016. All participants were aged at least 20 years and had type 2 diabetes for at least 1 year. Diabetes self-care , interdependent tendency, perceived emotional support and perceived diabetes self-care support were assessed via questionnaires. Examples of questions about interdependent tendency included, “I am not concerned if my ideas or behavior are different from those of other people,” indicating low interdependence, and “I often have the feeling that my relationships with others are more important than my own accomplishment,” indicating high interdependence.

The researchers found a negative correlation between diabetes self-care and interdependent tendency ( P = .047), but that was counterbalanced by a positive correlation with emotional support ( P = .001), diabetes self-care support ( P < .001) and age ( P < .001).

To further investigate the role that age played in the link between interdependent tendency and diabetes self-care, the researchers divided the cohort into two groups, with the younger made up of participants younger than 68 years (n = 88; 39.8% women) and the older (n = 73; 30.1% women) including all participants aged at least 68 years.

In the younger group, emotional support ( P = .028) and age ( P = .009) were positive predictors of diabetes self-care in multiple regression analysis in which emotional support was an independent variable. In the same analysis, interdependent tendency ( P = .048) and male sex ( P = .023) were negative predictors.

When diabetes self-care support was used as an independent variable, interdependent tendency ( P = .013) and male sex ( P = .045) were still negative predictors of diabetes self-care while diabetes self-care support ( P < .001) and age ( P = .005) were positive predictors. The researchers did not find any significant predictors in the older group, regardless of the variable.

Emotional support ( P = .007) and age ( P = .017) were both positive predictors of diabetes self-care in men in the younger group, whereas interdependent tendency was a negative predictor in women in the younger group ( P = .012).

“In Eastern cultures, the emphasis on harmonious relations can be a constraint on successful diabetes self-care,” Ikeda told Endocrine Today . “Our study demonstrated that the interdependent tendency was negatively associated with the achievement of diabetes self-care activities, especially in the relatively younger patients.” – by Phil Neuffer

Disclosure s : The authors report no relevant financial disclosures.

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