The proposed study will investigate the usefulness of a model based on Roy's nursing adaptation theory and Carver and Scheir's control theory and self-regulation to unstandard symptom usage in Type II diabetics. The model explains how diabetics use symptoms as signals for blood glucose levels and take action based on these symptoms. The proposed study will investigate the usefulness of the symptom self-regulation model to explain variations in diabetes-relevant behavior and in metabolic control in Type II diabetics. In Phase I of the proposed study, the Diabetes Symptom Belief Interview will be administered to Type II diabetics in order to describe symptoms they associate with variation in blood glucose levels and actions they take in response to symptoms. Subject's metabolic control will be determined by glycosylated hemoglogin, and the relationship between metabolic control and symptom self-regulation examined. In Phase II of the proposed study accuracy of symptoms belief will be examined in a subset of the sample used in Phase I. Accuracy will be measured by comparing subjects's symptom beliefs with actual blood glucose measured by reflectance meters. Subjects will monitor their symptoms and measure their blood glucose 4-7 times daily for 7 days. The hypothesis that Type II diabetics with accurate symptom beliefs will have better metabolic control than Type II diabetics with less accurate symptom beliefs will be tested. The proposed study will verify the critical role of symptom usage in diabetes. If symptom usage and symptom accuracy are related to metabolic control, nurses and other health professionals could focus on symptom usage and appropriate self-management actions as valid indicators of blood glucose.
