Health-promoting behavior is positively associated with diabetic control among type 2 diabetes patients


Background: The increasing prevalence of type 2 diabetes mellitus (T2DM) poses a major public health challenge throughout the world. It is a major healthcare issue among the elderly. This study was to identify the association between the health promoting behaviors and the diabetic control of type 2 diabetes mellitus (T2DM) patients. Methods: Cross sectional and descriptive research designs were used in this study. Participants were enrolled from three medical centers in northern, central and southern Taiwan during August, 2010 and June, 2011. The instruments encompassed biochemical indicators, and the preliminary developed scale of diabetes mellitus and health promotion (DMHP). Results: A total of 323 participants with T2DM were included in this study. The results showed 1) a high percentage of the participants used cigarette smoking, alcohol drinking and betel nut chewing, which were not conducive to adopting health promoting behaviors; 2) a high percentage of patients showed abnormal blood glucose, dyslipidemia, and elevated blood pressure; 3) few of the participants practiced ideally health promoting behaviors; and 4) practicing health-promoting behavior was positively associated with fasting blood glucose (FBG) and HbA1c levels. Conclusions: Patients with higher health promotion scores had better diabetic control. Less physical activity was found among those addicted to cigarette, alcohol and betel nut consumption. The findings suggest that health care providers should assess health promoting behaviors first for each diabetic patient.

Share and Cite:

Chen, C. , Peng, Y. , Weng, H. , Yen, H. and Chen, M. (2013) Health-promoting behavior is positively associated with diabetic control among type 2 diabetes patients. Open Journal of Nursing, 3, 274-280. doi: 10.4236/ojn.2013.32037.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Department of Health (DOH), Executive Yuan, Taiwan (2001) Annual report for health statistics of national health insurance.
[2] DeFronzo, R. (2009) From the triumvirate to the ominous octet: A new paradigm for the treatment of type 2 diabetes mellitus. Diabetes, 58, 773. doi:10.2337/db09-9028
[3] World Health Organization (WHO) (2011) Diabetes.
[4] American Diabetes Association (ADA) (2008) Standards of medical care in diabetes. Diabetes Care, 32, S62-S63.
[5] Aikens, J.E., Bingham, R., Piette, J.D. (2005) Patient- provider communication and self-care behavior among type 2 diabetes patients. The Diabetes Educator, 31, 681- 690. doi:10.1177/0145721705280829
[6] Haskell, W.L. and Lee, I.M. (2007) Physical activity and public health: Updated recommendation for adults from the American college of sports medicine and the American Heart Association. Circulation, 116, 1081-1093. doi:10.1161/CIRCULATIONAHA.107.185649
[7] Miller, D.K. and Fain, J.A. (2006) Diabetes self-management education. NCNA, 41, 655-666. doi:10.1016/j.cnur.2006.07.010
[8] Singh, N., Armstrong, D.G. and Lipsky, B.A. (2005) Preventing foot ulcers in patients with diabetes. JAMA, 293, 217-228. doi:10.1001/jama.293.2.217
[9] Wang, H.F., Tang, W.R. and Liu, H.E. (2008) Related factors of diabetes mellitus disease features and quality of life: The report of a regional teaching hospital in central Taiwan. Endocrinology & Diabetology, 21, 1-15.
[10] Scollan-Koliopoulos, M. (2004) Consideration for legacies about diabetes and self-care for the family with a multigenerational occurrence of type 2 diabetes. Nursing & Health Sciences, 6, 223-227. doi:10.1111/j.1442-2018.2004.00196.x
[11] American Association of Diabetes Educators (AADE) (2008) AADE7TM Self-Care Behaviors. The Diabetes Educator, 34, 445-449. doi:10.1177/0145721708316625
[12] The Diabetes Association of the Republic of China (2010) Clinical care guidelines for diabetes. The Diabetes Association of the Republic of China, Taipei.
[13] Hamman, R.F., Wing, R.R. and Edelstein, S.L. (2006) Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care, 29, 2102-2107. doi:10.2337/dc06-0560
[14] Laaksonen, D.E., Lindstrom, J. and Lakka, T.A. (2005) Physical activity in the prevention of type 2 diabetes: The Finnish diabetes prevention study. Diabetes, 54, 158-165. doi:10.2337/diabetes.54.1.158
[15] Knowler, W.C., Barrett-Connor, E. and Fowler, S.E. (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. The New England Journal of Medicine, 346, 393-403. doi:10.1056/NEJMoa012512
[16] Tuomilehto, J., Lindstro, J. and Eriksson, J.G. (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. The New England Journal of Medicine, 344, 1343-1350. doi:10.1056/NEJM200105033441801
[17] Chang, H.Y., Chiou, C.J. and Lin, M.C. (2004) A population study of the self-care behaviors and their associated factors of diabetes in Taiwan: Results from the 2001 national health interview survey in Taiwan. Preventive Medicine, 40, 344-348. doi:10.1016/j.ypmed.2004.06.012
[18] Gleeson-Kreig, J., Bernal, H. and Woolley, S. (2002) The role of social support in the self-management of diabetes mellitus among a Hispanic population. Public Health Nursing, 19, 215-222. doi:10.1046/j.0737-1209.2002.19310.x
[19] Kim, J., Kim, K. and Moon, J. (2011) Alcohol use behaviors and risk of metabolic syndrome in South Korean middle-aged men. BMC Public Health, 11, 489. doi:10.1186/1471-2458-11-489
[20] Harwood, G.A., Salsberry, P. and Ferketich, A.K. (2007) Cigarette smoking, socioeconomic status, and psychosocial factors: Examining a conceptual framework. Public Health Nursing, 24, 361-371. doi:10.1111/j.1525-1446.2007.00645.x
[21] Chen, M.Y., Huang, W.C., Peng, Y.S., Guo, J.S., Chen, C.P., Jong, M.C. and Lin, H.C. (2011) Effectiveness of a health promotion program for farmers and fishermen with type 2 diabetes in Taiwan. Journal of Advanced Nursing, 67, 2060-2067. doi:10.1111/j.1365-2648.2011.05678.x
[22] Aljasem, L.I., Peyrot, M., Wissow, L., et al. (2001) The impact of barriers on self-efficacy and self-care behavior in type 2 diabetes. The Diabetes Educator, 27, 393-404. doi:10.1177/014572170102700309
[23] Irwin, M.L., Mayer-Davis, E.J., Addy, C.L., et al. (2000) Moderate-intensity physical activity and fasting insulin levels in women: The cross-cultural activity participation study. Diabetes Care, 23, 449-454. doi:10.2337/diacare.23.4.449
[24] Jones, H., Edwards, L. and Vallis, T.M. (2003) Changes in diabetes self-care behaviors make a difference in glycemic control: The diabetes stages of change study. Diabetes Care, 26, 732-737. doi:10.2337/diacare.26.3.732
[25] Yokoyama, H., Emoto, M. and Araki, T. (2004) Effect of aerobic exercise on plasma adiponectin levels and insulin resistance in type 2 diabetes. Diabetes Care, 27, 1756- 1758. doi:10.2337/diacare.27.7.1756

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.