Abstract
Introduction: Type 2 Diabetes Mellitus (T2DM) is a major global public health problem, affecting more than 537 million adults worldwide, with projections reaching 783 million by 2045. Effective self-management is essential to prevent complications; however, patients often face multiple barriers. Objective: To assess the challenges of diabetes self-management among patients with Type 2 Diabetes Mellitus in Kirkuk City, Iraq. Methods: A cross-sectional study was conducted in the outpatient clinics of Kirkuk City, Iraq, to assess challenges in diabetes self-management among adult patients with Type 2 Diabetes Mellitus (T2DM). A total of 336 patients were recruited using a convenience sampling technique, with sample size justified via standard formulas for population proportions at 95% confidence and 5% margin of error. Data were collected through a structured, validated, and reliable questionnaire covering demographics, clinical characteristics, and five domains of self-management (knowledge, medication adherence, diet, physical activity, and psychosocial challenges). Face-to-face interviews were conducted individually, with written informed consent obtained from all participants. Ethical approval was secured from the College of Nursing, Kirkuk University, and confidentiality and anonymity were ensured. Data were analyzed using SPSS 26.0, employing descriptive statistics, independent t-tests, and one-way ANOVA, with p < 0.05 considered statistically significant. Results: The mean age of participants was 51.9 ± 10.1 years, with females slightly predominating (52.4%). Overall knowledge of diabetes self-management was moderate (mean score = 3.46). Patients experienced moderate challenges related to medication adherence (mean = 2.94), dietary management (mean = 3.28), physical activity (mean = 3.15), and psychological and social factors (mean = 3.33). The most prominent barriers included dietary restrictions, lack of motivation for physical activity, medication costs, and psychological stress. Conclusion: Most participants were middle-aged to older adults, predominantly female and married, with moderate knowledge and self-management abilities. Challenges in medication adherence, lifestyle behaviors, and psychosocial aspects were evident and significantly associated with demographic factors, highlighting the need for tailored interventions.
Graphical abstract