Introduction
Diabetes refers two different types of diseases that cause a disruption of blood glucose levels.
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People with type 1 diabetes need to inject insulin to replace the lack of insulin produced by the body.
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People with type 2 diabetes suffer from insulin resistance and need to manage this.
People with diabetes need to manage their diabetes, which is not easy. How well people self-manage their diabetes can be measured with the DSMQ-R designed by Schmitt and colleagues (2022).
Scores and interpretation
Higher scores indicate better self management. Apart from using the total scale, there are several self-explanatory subscales:
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Eating behavior
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Medication taking
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Glucose monitoring
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Physical activity
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Cooperation with diabetes team
The total score for type 1 and type 2 diabetes is slightly differently calculated.
All scores are scale 0 to 10 for ease of interpretation.
In the paper, the authors suggest the scale wording from "Does not apply to me" to "Applies to me very much". The authors, however, have chosen this for the write up of their English paper and used German terminology in their original study.
| PsyToolkit choose the scale to run from Disagree very much to Agree very much. This in part because this leads to a symmetrical scale of wording, whereas it is not entirely clear what the middle scores for the original would be (the DSMQ-R was oringally in German). |
| Think about the wording of the scale yourself before adopt the scale in your own work. If you want the paper’s suggestion, you could instead use this scale (replace this with what is further below): |
scale: dsmqrAgree
- {score=0} does not apply to me
- {score=1} ..
- {score=2} ..
- {score=3} applies to me very much
Type 1 vs Type 2
There are several questions about the use of insulin which only apply to people with type 1 and which are only included in the total score, and not in the subscales.
For this, use the score dsmrqTotaltype1 or dsmrqTotaltype1.
Population averages
It is best to check the open access link listed below to see all the averages. In short, the total score for people with diabetes in one of the first studies using this scale was 6.4 points (on a 0-10 scale).
Run the demo
Legal stuff
It seems that the the five need satisfaction measures can be used for research, but you need to acknowledge the authors and their research paper when writing about it (References).
Technically
This is a simple scale question with reversed items coded in.
The survey code for PsyToolkit
scale: dsmqrAgree
- {score=0} Disagree very much
- {score=1} Disagree
- {score=2} Agree
- {score=3} Agree very much
l: type
t: radio
q: Which type of diabetes do you have?
- Type 1
- Type 2
l: dsmqr
t: scale dsmqrAgree
o: buildup
q: How much do you agree to each of the following questions
- {1} I check my glucose levels with care and attention.
- {2} The foods I choose to eat make it easy for me to achieve good glucose levels.
- {3} I regularly see the doctor (or diabetes specialist) regarding my diabetes.
- {4} I take my diabetes medication (e.g., insulin, tablets) consistently and reliably.
- {5,reverse} I occasionally eat large amounts of sweets or other foods rich in carbohydrates.
- {6} I keep a diary/log of my glucose levels to inform and improve my diabetes management.
- {7,reverse} I tend to avoid seeing the doctor (or diabetes specialist) regarding my diabetes.
- {8} I am regularly physically active to improve my diabetes and health.
- {9} I follow the current dietary recommendations for people with diabetes (e.g., given to me by my doctor or diabetes specilist).
- {10,reverse} I do NOT check my glucose levels frequently enough for achieving good blood glucose control.
- {11,reverse} I avoid physical activity although it would be good for my diabetes.
- {12,reverse} I tend to forget or skip taking my diabetes medication (e.g., insulin, tablets).
- {13,reverse} Sometimes I have real ‘food binges’ (not triggered by hypoglycemia).
- {14,reverse} Regarding my diabetes, I should see my doctor (or diabetes specialist) more often.
- {15,reverse} I am less physically active than would be good for my diabetes.
- {16,reverse} I could improve my diabetes self-care considerably.
- {17} I estimate the carbohydrate content of my meals/foods (to improve my diabetes control).
- {18,reverse} I eat without regard to my diabetes.
- {19} I check and discuss my diabetes treatment with the doctor (or diabetes specialist) regularly.
- {20,reverse} My diabetes self-care is poor.
l: part1
t: set
- sum $dsmqr
j: if $type == 2 then skip 2
l: dsmqrInsulin
t: scale dsmqrAgree
o: buildup
q: There are now a few more questions for those who use insulin
How much do you agree to each of the following questions
- {21} I check my glucose levels before each meal.
- {22} I adjust my insulin doses to the carbohydrate content of my meals.
- {23} I adjust the timing of my insulin injections to the start of my meals.
- {24} I adjust my insulin doses according to the current glucose levels and preceding or planned activities.
- {25} I correct elevated glucose levels consistently whenever necessary.
- {26} I carry fast carbohydrates to enable quick treatment of low blood glucose.
- {27} In case of low blood glucose, I take appropriate amounts of carbohydrates to avoid causing high blood glucose.
l: part2
t: set
- sum $dsmqrInsulin
l: dsmqrTotaltype1
t: set
- calc ( $part1 + $part2 ) / 81 * 10
l: dsmqrTotaltype2
t: set
- calc $part1 / 60 * 10
l: dsmqrEating
t: set
- calc ( $dsmqr.2 + $dsmqr.5 + $dsmqr.9 + $dsmqr.13 + $dsmqr.17 + $dsmqr.18 ) / 18 * 10
l: dsmqrMedication
t: set
- calc ( $dsmqr.4 + $dsmqr.12 ) / 6 * 10
l: dsmqrMonitor
t: set
- calc ( $dsmqr.1 + $dsmqr.6 + $dsmqr.10 ) / 9 * 10
l: dsmqrActive
t: set
- calc ( $dsmqr.8 + $dsmqr.11 + $dsmqr.15 ) / 9 * 10
l: dsmqrCoop
t: set
- calc ( $dsmqr.3 + $dsmqr.7 + $dsmqr.14 + $dsmqr.19 ) / 12 * 10
l: feedback_subscales
t: info
q: The self management scores for the following sub-scales rank from 0 to 10.
Eating behavior: {$dsmqrEating}
Medication taking: {$dsmqrMedication}
Glucose monitoring: {$dsmqrMonitor}
Physical activity: {$dsmqrActive}
Cooperation with diabetes team: {$dsmqrCoop}
j: if $type == 2 then skip 2
l: feedback1
t: info
q: You said you have type 1 diabetes
The self-management total score range from 0 to 10.
Your self-management scores are as follows:
Total score: {$dsmqrTotaltype1}
j: end
l: feedback2
t: info
q: You said you have type 2 diabetes
The self-management total score range from 0 to 10.
Your self-management scores are as follows:
Total score: {$dsmqrTotaltype2}
References
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Schmitt A, Kulzer B, Ehrmann D, Haak T, Hermanns N. A self-report measure of diabetes self- management for type 1 and type 2 diabetes: the Diabetes Self-Management Questionnaire-Revised (DSMQ-R) – Clinimetric evidence from five studies. Front Clin Diabetes Healthc (2022). Free Open Access Link