Diabetes self-management

An adapted version of the Diabetes Self-care Activities (SDSCA) measure, which consists of items covering diet, exercise, blood sugar testing, foot care, and smoking, was used to assess the level of DSM in this study⁴⁵. After the pilot study, some changes were made as follows: (1) The term “checking your foot” was removed because participants could not understand and communicate the true meaning. (2) Several specific food names were supplemented behind the word “high-fat food” to ensure participants’ better understanding of the item. Finally, the adapted version of the SDSCA measure included 7 items from three dimensions, and all items were measured on an eight-point scale ranging from 0 to 7. Of these, five items were about diet, one item was about exercise, and one item was about self-monitoring blood glucose (SMBG). If a participant exercised three days or more a week, he or she was deemed to have a high level of DSM; otherwise, he or she had a low level of DSM. Similarly, examining FBG twice a week or more was defined as a high level of SMBG; otherwise, it was a low level.