OBJECTIVES: This study aims to examine the association between self-monitoring behaviors – physical activity, self-monitoring of blood glucose and foot sores – and diabetes self-management education (DSME).

METHODS: Data from the 2013 Behavioral Risk Factor Surveillance System (BRFSS), a random-digit-dialed telephone survey of the civilian, noninstitutionalized adult population aged 18 years, were analyzed. 62,345 individuals self-reported diabetes. The outcome variable was DSME engagement, which was dichotomized as “yes” or “no.” The independent variables were self-monitoring of blood glucose and foot sores per the American Diabetes Association’s recommended frequencies, and physical activity. Weighted, multivariate logistic regression models were constructed to examine the association between self-management behaviors and DSME.

RESULTS: Adjusted logistic regression revealed that all three self-management behaviors were significantly associated with diabetes education. Respondents who reported not engaging in physical activity were significantly less likely to engage in diabetes education compared to those that engaged in physical activity (aOR = 0.73; 95% CI: 0.66 – 0.81). Respondents who reported never checking their feet for sores compared to those that reported checking their feed one or more times per day were significantly less likely to engage in diabetes education (aOR = 0.40; 95% CI: 0.34 – 0.47). Respondents who reported checking blood sugar once a week, month or year (aOR = 0.78; 95% CI: 0.69 – 0.87), and respondents who reported  never checking their blood sugar (aOR = 0.44; 95% CI: 0.36 – 0.54) were significantly less likely to engage in diabetes education compared to those that reported checking their blood sugar one or more times per day.

CONCLUSIONS: Self-management behaviors are strongly associated with diabetes education. Increasing public health interventions aimed at educating diabetics would provide a means for improving outcomes and decreasing costs.