Current Diabetes Self-Management and the Number of Documented Complications in Adults with Type 2 Diabetes: A Cross-Sectional Study.

Abstract

Background and Objectives: Current self-management behavior may not reflect the long-term exposures that led to established complications in people with type 2 diabetes (T2D). To assess whether Diabetes Self-Management Questionnaire (DSMQ) scores were associated with the number of documented diabetes-related and cardiovascular conditions and whether the finding was robust to alternative outcome constructions. Materials and Methods: This single-center cross-sectional reanalysis included 262 adults with T2D. The DSMQ was re-calculated from item-level responses. The primary outcome was an unweighted count of seven database-recorded conditions. Spearman correlation and multivariable Poisson regression with HC3 robust standard errors were used. Sensitivity analyses excluded heart failure, separated microvascular and cardiovascular counts, and substituted estimated glomerular filtration rate <60 mL/min/1.73 m² for the recorded chronic kidney disease field. Results: Median DSMQ Sum Scale was 5.10 (IQR 3.13-7.08), and median condition count was 3 (IQR 2-3). No evidence of an unadjusted association was identified (ρ = -0.056; p = 0.368). In the adjusted model (n = 260), the DSMQ estimate was IRR 0.988 per point (95% CI 0.962-1.014; p = 0.355). The result remained nonsignificant after excluding heart failure (IRR 0.993; 95% CI 0.960-1.027), for the microvascular count (IRR 0.993; 95% CI 0.964-1.024), and for the cardiovascular count including heart failure (IRR 0.980; 95% CI 0.945-1.015). Pearson dispersion was 0.587, providing no evidence of overdispersion. Conclusions: No evidence of an association between current DSMQ-measured self-management and the number of recorded conditions was identified in this cohort. The result does not demonstrate equivalence and does not imply that sustained self-management is unrelated to long-term complication risk. In practice, contemporary DSMQ scores should guide cur-rent education and support needs, not be used as a proxy for historical com-plication exposure.