Relationship between resilience, self-care and metabolic control in patients with type 1 Diabetes Mellitus


  • Ana Cláudia M. Caetano Araujo
  • Izabelle M. R. Mesquita
  • Adriana Paula Silva
  • Alzira Maria Cussi Brasileiro Dias
  • Flávia A. Ribeiro
  • Janaíne M. Tom
  • Maria de Fátima Borge



type 1 Diabetes Mellitus, psychological resilience, self-care, glucose metabolism disorder, health education, health promotion


Objective: This research aimed to evaluate the profile and relevance of resilience in patients with type 1 diabetes mellitus, as well as its use in self-care behavior and metabolic control. Method: A descriptive cross-sectional study with a quantitative approach composed of a consecutive and non-probabilistic sample of 56 patients carried out in adult patients with type 1 diabetes mellitus who regularly attended an outpatient diabetic follow-up. Used in the present study, the Resilience Scale (RE), developed by Wagnild and Young, is one of the few instruments used to measure levels of positive psychosocial adaptation. Pesce et al. adapted and validated for Brazil. The Self-Care Activities Questionnaire (SAQ) was also used, which is a self-administered instrument, composed of six dimensions and distributed in fifteen items that assess adherence to self-care in diabetic patients, translated and validated for Brazil. The variables of interest were analyzed using validated instruments and the means of metabolic control were collected at three-month intervals between consultations. Results: There was a significant and positive association between resilience and diabetes self-care activities questionnaire (SAQ) dimensions represented by specific food and foot care and an inverse association between resilience and HbA1c. From the correlation of SAQ with metabolic control, significant associations were observed between foot care and LDL-cholesterol and NOT-HDL-cholesterol and an inverse relationship between HDL-cholesterol and physical activity. Conclusion: It is concluded that resilience helps in adapting to the numerous barriers faced by patients, demonstrating that diabetes care goes beyond metabolic control, in addition to providing conditions for self-care management.


International Diabetes Federation. IDF Diabetes Atlas 10th Edition [Accessed in September 2021]. Available from

World Health Organization. Innovative care for chronic conditions: structural components for action: world report. Brasilia: WHO; 2003. Available from:

Rezende Neta DS, Silva ARV da, Silva GRF da. Adherence to foot self-care in diabetes mellitus patients. Rev Bras Enferm. Jan-Feb 2015; 68(1): 111–6. doi: 10.1590/0034-7167.2015680115p

Coelho ACM, Boas LCGV, Gomides DS, Foss-Freitas MC, Pace AE, Coelho ACM, et al. Self-care activities and their relationship to metabolic and clinical control of people with diabetes Mellitus. Texto Contexto - enferm. July-Sep 2015; 24(3): 697–705. doi: 10.1590/0104-07072015000660014

Michels MJ, Coral MHC, Sakae TM, Damas TB, Furlanetto LM. Questionnaire of Diabetes Self-Care Activities: translation, cross-cultural adaptation and evaluation of psychometric properties. Arq Bras Endocrinol Metab. 2010; 54(7): 644–51. doi: 10.1590/S0004-27302010000700009

Tavares BC, Barreto FA, Lodetti ML, Silva DMGV, Lessmann JC. Resilience among people with Diabetes Mellitus. Texto Contexto - Enferm. 2011; 20(4): 751–7. doi: 10.1590/S0104-07072011000400014

Rosa JHS, Motta BFB. Social aspects of resilience in patients with type II diabetes mellitus. Scientific Journal FAGOC - Health [Internet]. August 12, 2016 [accessed in 13/05/2023]; 1(1). Available from:

Cardoso AF, Queirós P, Ribeiro CF. Therapeutic self‐care management interventions for individuals with diabetes mellitus: systematic review. Rev Port Saúde Pública. 2015; 33(2): 246–55. doi: 10.1016/j.rpsp.2015.04.001

Brazilian Association of Research Companies. Critério Brasil 2016. Brasília: ABEP; 2016. Available at:

Wagnild GM, Young HM. Development and psychometric evaluation of the Resilience Scale. J Nurs Meas. [Internet]. 1993 Winter;1(2):165-78. Available from:

Pesce RP, Assis SG, Santos N, Oliveira R de VC de. Risk and protection: looking for an equilibrium that provides resilience. Psic.: Teor. Pesq. 2004; 20(2): 135–43. doi: 10.1590/S0102-37722004000200006

Rosenberg AR, Yi-Frazier JP, Eaton L, Wharton C, Cochrane K, Pihoker C, et al. Promoting Resilience in Stress Management: A Pilot Study of a Novel Resilience-Promoting Intervention for Adolescents and Young Adults With Serious Illness. J Pediatr Psychol. 2015 October;40(9):992–9. doi: 10.1093/jpepsy/jsv004

Santos FRM, Bernardo V, Gabbay MAL, Dib SA, Sigulem D. The impact of knowledge about diabetes, resilience and depression on glycemic control: a cross-sectional study among adolescents and young adults with type 1 diabetes. Diabetol Metab Syndr. 2013 September 28; 5(1): 55. doi: 10.1186/1758-5996-5-55

Jaser SS, White LE. Coping and resilience in adolescents with type 1 diabetes. Child Care Health Dev. May 2011; 37(3): 335–42. doi: 10.1111/j.1365-2214.2010.01184

Peruzzo Lopes CC, do Monte Ribeiro Busato P, Michelin Mânica MF, Araújo MC, Marquez Zampiva MM, Bortolini BM, et al. Effect of basic periodontal treatment on glycemic control and inflammation in patients with diabetes mellitus type 1 and type 2: controlled clinical trial. J Public Health. 2017; 25(4): 443–9. doi: 10.1007/s10389-017-0792-5

Ortiz MS, Myers HF. Association between psychological stress and metabolic control in patients with type 1 diabetes mellitus. Rev Med Chile. April 2014; 142(4): 451–7. doi: 10.4067/S0034-98872014000400006

Duarte CK, Almeida JC, Merker AJS, Brauer FO, Rodrigues TC. Physical activity level and exercise in patients with diabetes mellitus. Rev Assoc Med Bras. 2012 April; 58(2): 215–21. doi: 10.1590/S0104-42302012000200018

Pena FPS. Resilience and Quality of Life of people suffering from Diabetes Mellitus in light of Health Promotion [thesis]. São Paulo: Nursing School, University of São Paulo; 2017.

Visentin A, Mantovani MF, Caveião C, Hey AP, Scheneider EP, Paulino V. Self-care of users with type 1 diabetes in a basic health unit. Journal of Nursing UFPE on line. 2016; 10(3): 991–8. doi: 10.5205/1981-8963-v10i3a11050p991-998-2016

Costa M, Gameiro MGH. Self-care of adolescents with type 1 diabetes: responsibility for disease management. Referência Revista de Enfermagem. 2016; IV(9): 9–19. doi: 10.12707/RIV16010

Greco-Soares JP, Dell’Aglio DD. Treatment adherence in adolescents with type 1 diabetes mellitus. Psicologia, Saúde e Doença. August 2017; 18(2): 322–34. doi: 10.15309/17psd180204

Torres H de C, Souza ER, Lima MHM, Bodstein RC. Educational intervention for self-care of individuals with diabetes mellitus. Acta Paul Enferm. 2011; 24(4): 514–9. doi: 10.1590/S0103-21002011000400011

Veras VS, Santos MA dos, Rodrigues FFL, Arrelias CCA, Pedersoli TAM, Zanetti ML. Self-care among patients enrolled in a self-monitoring blood glucose program. Rev Gaúcha Enferm. 2014; 35(4): 42–8. doi: 10.1590/1983-1447.2014.04.47820




How to Cite

ARAUJO, A. C. M. C.; MESQUITA, I. M. R.; SILVA, A. P.; DIAS, A. M. C. B.; RIBEIRO, F. A.; TOM, J. M.; BORGE, M. de F. Relationship between resilience, self-care and metabolic control in patients with type 1 Diabetes Mellitus. Journal Archives of Health, [S. l.], v. 5, n. 2, p. e1640, 2024. DOI: 10.46919/archv5n2-002. Disponível em: Acesso em: 25 may. 2024.