# Lifestyle Behavioral Self-Care Practices and Their Determinants Among Type 2 Diabetes Patients Attending a Non-communicable Disease Clinic in Agra District: A Cross-Sectional Study

## TL;DR

This study examines lifestyle self-care practices among type 2 diabetes patients in Agra, finding that many have poor self-care habits, especially in physical activity and foot care.

## Contribution

The study identifies sociodemographic predictors of poor self-care in type 2 diabetes patients in an Indian setting.

## Key findings

- Only 2.1% of patients engaged in adequate physical activity.
- Male gender, lower education, and unemployment were linked to poor self-care.
- Urban residence and higher occupational status were associated with better self-care scores.

## Abstract

Background: Type 2 diabetes (T2D) requires sustained self-care practices to achieve optimal glycemic control and prevent complications. In India, adherence to diabetes self-management remains suboptimal and is influenced by various sociodemographic and lifestyle behavioral factors. Therefore, the present study aimed to assess lifestyle-related self-care practices among patients with T2D attending a non-communicable disease (NCD) clinic in Agra District and to examine their association with sociodemographic characteristics.

Materials and methods: A cross-sectional study was conducted among 340 patients with T2D aged 30-60 years who attended the NCD clinic at District Hospital in Agra from May to October 2024. Using systematic random sampling, data were collected through a semi-structured questionnaire based on the modified Summary of Diabetes Self-Care Activities tool, adapted to the local context. Lifestyle self-care scores were calculated across four domains: diet, physical activity, foot care, and addiction. Logistic regression was used to identify factors associated with self-care scores.

Results: The mean age of participants was 51.3 ± 10.6 years, and 56.5% were female. Overall, 73.2% demonstrated moderate self-care, while 21.2% had poor self-care. Lack of daily foot inspection was reported by 77.9%, and only 2.1% engaged in adequate physical activity. Significant predictors of poor self-care included male gender, lower educational attainment, and unemployment (p < 0.05). Urban residence and higher occupational status were associated with better self-care scores.

Conclusions: Self-care practices were moderately adhered to, with particularly low levels of physical activity and medication adherence. Strengthening the communication of diabetes self-management education and support should be prioritized to promote sustained lifestyle modification and proactive self-care, especially among men, individuals with lower education, and those who are unemployed.