Assessing Disparities in Type II Diabetes Care: Self-Care Behaviours and Glycemic Outcomes in Public and Private Hospitals in India

Abstract

This cross-sectional study investigated disparities in self-care behaviours and glycemic control among 303 Type II diabetes patients treated at public and private hospitals in rural India. Participants were assessed using the Diabetes Self-Management Questionnaire (DSMQ) and their most recent HbA1c level. Results indicated that patients treated at private hospitals exhibited significantly better self-care behaviors (p < 0.001) and marginally better glycemic control (p < 0.05) than those treated at public hospitals. Strong negative correlations were observed between HbA1c levels and glucose monitoring (r = -0.692), physician contact (r = -0.557), overall self-care management perception (r = -0.632), diet adherence (r = -0.455), and physical activity (r = -0.455). Regression analysis revealed that glucose monitoring, physical activity, and overall self-care management perception accounted for 51.5% of the variance in the HbA1c levels. These findings suggest that public healthcare systems need to address disparities in diabetes management by providing comprehensive care, including psychological support and improved access to resources. Enhancing patients' self-care behaviors and creating supportive healthcare environments may reduce the burden of Type II diabetes and improve health outcomes for all patients regardless of their socioeconomic status.