Dietary self-care and hospital readmission among individuals with diabetes mellitus

Diabetes mellitus is one of the main public health problems worldwide. One important strategy for increasing the effectiveness for controlling diabetes mellitus and preventing complications is self-care supported by healthcare professionals. The aim of the study was to analyze dietary self-care strategies performed by individuals with diabetes mellitus (DM) after hospitalization and their possible influence on hospital readmissions. A cross-sectional study was conducted in the public health services qualified to hospitalize individuals with DM in a medium-sized municipality of Brazil. Adults were evaluated 24 months after discharge, assessing self-care strategies (dimensions: diet, physical activity, blood glucose monitoring, foot care, medication, and smoking); and clinical, anthropometric, and biochemical measurements. A high death rate (33.7%) was verified after 24 months of hospitalization. Almost half (45.9%) of the 37 remaining patients were readmitted to hospital; however, during the 24 month period, only 42.0% received guidance about DM self-care from healthcare professionals. In the evaluation of dietary self-care, only 35.1% of the individuals reported taking care of their diet on 5 or more days a week. Individuals who adhered to self-care guided by health professionals presented twice the prevalence of not being readmitted to hospital (Prevalence ratio = 2.52; 1.27–5.01). After hospital discharge, individuals with DM presented poor adherence to self-care, especially regarding diet. However, when these individuals adhered to nutritional guidance, there were fewer hospital readmissions. These results reinforce the importance of interdisciplinary educational actions for DM management. However, due to the small sample size because of the high mortality, further studies for this purpose should be conducted.