Gender differences in the selection of an action plan for patients with type 2 diabetes mellitus

Objective: To assess differences between women and men in developing an action plan for the management of their type 2 diabetes mellitus (DM). Methods: We chose a convenience sample of the first 153 patients who participated in a four-part educational class focused on the management of type 2DM. The classes are run by a certified diabetes educator and have a specific format. We use a decision wheel to assist in the development of a patient-generated action plan to address a specific health behavior change. For each patient we documented age, gender, and glycosylated hemoglobin (HbA_1c) level. Results: There was a difference in choice of action plan based on gender (p = 0.014). For women the distribution of action plans was exercise 38%, nutrition 22%, medication 20%, no action plan 13%, and monitoring 7%. For men the distribution of action plans was exercise 26%, nutrition 26%, medication 6%, no action plan 26%, and monitoring 16%. Age did not affect the choice of an action plan (p = 0.964); however, patients with a lower HbA_1c level chose exercise more frequently (p < 0.002). Conclusions: The results of this study suggest there may be gender-based differences affecting the selection of an action plan for patients with type 2 DM. Further research is needed to determine the relative weight of other important factors on the decision for a particular action plan; e.g. sociodemographic factors, stage of readiness to change, and comorbid conditions.