Cognitive perspective of osteoporosis among adults with type 2 diabetes mellitus: The Malaysian case.

Introduction: Osteoporosis and diabetes are highly prevalent diseases. In addition, there is increasing evidence that diabetes is a common risk factor for decreasing bone mineral density and developing osteoporosis and fractures. Data on bone abnormalities in T2DM patients appear to be contradictory and complex, and the exact underlying mechanism is still unclear. Hence, the aims of this study were to assess cognitive perspective of osteoporosis among type 2 diabetes mellitus.

Methods: An observational, cross-sectional study design was chosen, where data were collected using a self-report structured questionnaire including osteoporosis self-efficacy (OSES-M), knowledge Malay version. Quantitative ultrasound was used as prescreening tool for measuring bone health by applying T-score.

Results: The results showed that about 231 (51.30%) were males. The average age of the DM patients was 62.67 ± 9.24 years. Moreover, the majority of T2DM patient (343, 76.20%) had poor glycaemic control. The mean ± SD OSES-M total score, OSES-M Exercise subscale and OSES-M Calcium subscale were 731.26 ± 209.83, 357.55 ± 121.23 and 373.71 ± 118.91, respectively. Overall, participants expressed a low self-efficacy for both exercise and calcium intake experiences. In addition, a significant and positive correlation was found between OSES-M and OKT-M total scores (n = 450, r  = 0.471, p < .05). Also, there were significant correlations between OKT-M subscales and OSES-M subscales. Furthermore, significant and positive correlations were found between T-scores and OSES-M total score (r = .191), OSES-M Exercise subscale (r = .209) and OSES-M Calcium subscale (r = .124). Moreover, significant associations, differences and correlations were found out between OSES-M with many demographic and clinical data.

Conclusion: Overall, participants expressed a low self-efficacy for both exercise and calcium intake experiences. In addition, only 28.70% of the study population was found to have high OSES-M level. Thus, self-efficacy is important and effective determinants for gaining positive health behaviours towards osteoporosis.