# Explaining the Self‐Care Behaviors in Type 2 Diabetic Patients Based on Adverse Childhood Experiences, Subjective Socioeconomic Status, and Mindfulness in Isfahan, Iran

## TL;DR

This study explores how childhood trauma, socioeconomic status, and mindfulness affect self-care behaviors in young Type 2 diabetes patients in Iran.

## Contribution

The study identifies adverse childhood experiences as a novel predictor of poor diabetes self-care in a specific demographic and geographic context.

## Key findings

- 58.6% of participants reported at least one adverse childhood experience.
- Individuals with ACEs were more likely to engage in poor diabetes self-care behaviors.
- Mindfulness and socioeconomic status were considered in relation to self-care practices.

## Abstract

As reported by the World Health Organization, the prevalence of Type 2 diabetes has increased fourfold since 1980, with approximately 422 million individuals affected globally. Projections indicate that the number of people living with Type 2 diabetes could more than double in the next two decades. Given the expected increase in the prevalence of Type 2 diabetes in Iran, it is crucial to conduct a thorough investigation to evaluate the primary psychosocial factors associated with individuals suffering from Type 2 diabetes. Therefore, this study aims to investigate the relationship between mindfulness, subjective socioeconomic status (SES), and adverse childhood experiences (ACEs) in the context of self‐care practices among Type 2 diabetes patients in Isfahan, Iran.

A cross‐sectional study involving 350 Type 2 diabetic patients, aged 20–44, was undertaken in 2023. Participants were randomly selected from six comprehensive health centers located in Isfahan. Summary of Diabetes Self‐Care Activities (SDSCA) measure, Brown's Mindful Attention Awareness Scale, ACEs module (CDC, 2010), and socio‐demographic factors, including age, gender, education, and subjective SES, were employed to collect data. The data was analyzed using a multivariate logistic regression model.

The study results indicate that 58.6% of all participants reported experiencing at least one ACE, while 50.9% of individuals with Type 2 diabetes exhibited inadequate self‐care practices. After adjusting for demographic factors, individuals who reported experiencing one to four ACEs (OR: 0.38; 95% CI: 0.17–0.63) and those with six or more ACEs (OR: 0.32; 95% CI: 0.15–0.78) exhibited a higher likelihood of engaging in poor diabetes self‐care behaviors compared to those who had no ACEs.

Research suggests a strong correlation between childhood adversity and suboptimal self‐care practices in Type 2 diabetic patients. This finding underscores the importance of collaborative efforts between healthcare and social service organizations to implement effective screening, prevention, and early intervention strategies for individuals with Type 2 diabetes who have experienced ACEs.