The Relationship Of Self-management And Gastrointestinal Symptoms Among Patients With Type 2 Diabetes

Obiective: The objective of this research was to look into gastrointestinal symptoms,self-management level,and dietary fiber intake in elderly people with type 2 diabetes.In elderly patients with type 2 diabetes,the impact factors of gastrointestinal symptoms,self-management level,and dietary fiber intake were investigated.To explore the pair relationship among the three,establish an intermediary model of self-management level,dietary fiber intake,and gastrointestinal symptoms to explore the pathway of action and intermediary effect,and put forward feasible suggestions to improve the symptoms and quality of life of elderly diabetes mellitus complicated with gastrointestinal symptoms,and provide a theoretical basis for future intervention studies.Methods: In this cross-sectional study,239 elderly patients.with type 2 diabetes were enrolled in the outpatient and inpatient departments of a 3A hospital in Wuxi City between December 2021 and December 2022.Using the general data questionnaire,the GI symptom scale,the simplified assessment of self-management knowledge,attitude,and behavior,and the 24-hour dietary Review scale,the status of gastrointestinal symptoms,self-management level,and fiber intake were examined.To investigate the influencing factors of gastrointestinal symptoms,self-management level,and fiber intake,univariate,multivariate,and correlation analyses were used.The mediation model of the three major study variables was established,and the Process plug-in was used to test the mediation effect model.Results:(1)In this study,186 patients had gastrointestinal symptoms,with 14.6% having abdominal pain and 27.6% having reflux symptoms.There was dyspepsia in 38.9%,diarrhea in 31.4%,and constipation in 42.7%.Age,education,income,family history,and the number of complications were found to explain 38.0% of the variation(F= 17.193,P < 0.001).(2)In elderly patients with type 2 diabetes,the total score of self-management level was 73.78(69.23,79.81),knowledge score was 72.39(58.33,87.50),attitude score was 83.93(80.00,92.00),and behavior score was 69.96(65.45,74.55).The total score in good water accounted for 9.6%,while the total score in poor water accounted for 12.1%;knowledge scores in good water accounted for 29.3%,while knowledge scores in poor water accounted for 25.9%;and attitude scores in good water accounted for 36.0%,while attitude scores in poor water accounted for 25.9%.Attitude scores in the good category accounted for 36.0%,while those in the poor category accounted for 5%;behavioral scores were good at 5.4% and bad at 11.3%.Multiple linear regression revealed that education level,income level,personality,complications,and smoking status could explain 55.2% of the variation in the equation(F= 37.718,P < 0.001).(3)The dietary fiber intake of elderly type 2 diabetes patients was 4.55 grams(3.35,5.11).Education,income,family history,and complications were found to account for 24.5%of the variation(F= 14.084,P < 0.001).(4)Correlation analysis revealed that self-management level was negatively correlated with gastrointestinal symptoms(r=-0.662,P < 0.01)and positively correlated with dietary fiber intake(r= 0.607,P < 0.01),dietary fiber intake was negatively correlated with gastrointestinal symptoms(r=-0.775,P < 0.01).(5)According to the results of the mediating effect test,the self-management level had a negative effect on digestive tract symptoms(Coeff=-0.169,P < 0.001),a positive effect on fiber intake(Coeff=-0.095,P < 0.001),and a negative effect on digestive tract symptoms(Coeff=-0.500,P 0.001),P < 0.001).The standardized indirect effect of fiber intake on self-management was-0.047(95% CI:-0.067～-0.034),and the standardized direct effect of self-management on patients’ gastrointestinal symptoms was-0.122(95% CI:-0.152～-0.091),accounting for 27.8% of the total effect.Conclusions(1)The prevalence of gastrointestinal symptoms in elderly type 2 diabetes patients was77.8%.Age,education level,income,family history,and the number of complications all had an impact on the gastrointestinal symptoms in elderly type 2 diabetes patients.(2)The self-management level of elderly type 2 diabetes patients was in the middle.The factors influencing the self-management level of elderly patients with type 2 diabetes included education level,income,family history,personality,complications,and smoking status.(3)Dietary fiber intake is severely deficient in elderly patients with type 2 diabetes.Dietary fiber intake in type 2 diabetes patients is influenced by factors such as education level,income,family history,and complications.(4)In elderly type 2 diabetes patients,self-management level,dietary fiber intake,and gastrointestinal symptoms were all related.(5)Dietary fiber intake played a partial mediating role in self-management and gastrointestinal symptoms in elderly type 2 diabetes patients,accounting for 27.8% of the total effect.