A better model of diabetes self-management? Interactions between GP communication and patient self-efficacy in self-monitoring of blood glucose

Patient Educ Couns. 2009 Nov;77(2):260-5. doi: 10.1016/j.pec.2009.03.026. Epub 2009 Aug 31.


Objective: The aim of this exploratory study was to investigate the interaction between patient self-efficacy and GP communication in explaining diabetes self-management in a disadvantaged region of Sydney, Australia.

Methods: This study was undertaken in South West Sydney with the Fairfield Division of General Practice. We used a cross-sectional survey design to assess patients' self-reported beliefs and behaviours about diabetes self-management. We used hierarchical multiple linear regression to test for interaction effects in diabetes self-management, following tests for clustering using multilevel modeling.

Results: Of those eligible for survey, 105 patients completed the telephone survey (72%). There was a significant interaction between diabetes self-efficacy and GP communication in blood glucose testing; high-ratings of GP communication enhanced self-monitoring of blood glucose when patient self-efficacy was high but impeded self-monitoring of blood glucose when self-efficacy was low. There were no significant interaction effects for the general diet or exercise scales.

Conclusion: This exploratory study suggests a complex relationship between patient self-efficacy and GP communication in self-monitoring of blood glucose. It is likely optimal diabetes self-management behaviours are produced by a fit between high patient self-efficacy and high quality GP communication.

Practice implications: There is a risk that GPs who are sensitive to their patients' low self-efficacy in self-monitoring of blood glucose may step in and take over the monitoring role and inadvertently reduce self-management.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / analysis*
  • Communication*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • New South Wales
  • Patient Compliance
  • Patient Education as Topic
  • Physician-Patient Relations*
  • Self Care*
  • Self Efficacy
  • Surveys and Questionnaires


  • Blood Glucose