As a diabetes educator, one of the most powerful tools I’ve found in supporting lasting lifestyle change is helping individuals uncover their personal “why”, the deeper reason they want to improve or maintain their health. Whether its avoiding complications experienced by their family members, staying active to travel the world, or simply feeling better day-to-day, connecting behavior change to meaningful personal values gives purpose to the daily decisions that diabetes management demands. This internal purpose often drives more sustainable outcomes than external pressures or goals set by others.
A key component of this approach is the concept of self-efficacy. Unlike other social-cognitive theories examining how beliefs, social norms, and expectations influence behavior, the self-efficacy model specifically focuses on an individual’s belief and sense of control in their ability to take action and influence outcomes.¹ Self-efficacy can influence coping, motivation and management of diabetes care needs and is directly correlated to improved A1c outcomes.² It is not just about knowing what to do or believing something is important—it’s about believing you can do it. In diabetes care, self-efficacy is associated with increased engagement in self-care activities², but can be impacted by several factors. Emotional distress, including depression, anxiety, or diabetes-related burnout, can also reduce a person’s confidence in their ability to manage their condition. Negative past experiences, such as repeated failures with weight loss or glycemic management, can lead to feelings of helplessness and discourage future efforts. Additionally, lack of support, confusion about care needs, or inconsistent healthcare access can further erode a sense of control and self-efficacy.
Understanding that systemic barriers may be greater than an individual’s responsibility for change, we can appropriately address and build self-efficacy using a variety of strategies. One effective strategy is to build on small wins. When individuals recognize that their efforts make a difference, no matter how small, their confidence grows. Using reflection and supporting self-acknowledgment of the changes that led to achievements reinforces the idea that change is possible, and progress is happening. This practice can be supported by helping individuals become aware of their mindset and self-talk.³ Using strength-based coaching, focusing on strengths and reframing negative thoughts, individuals can overcome self-doubt and build greater confidence in their ability to manage diabetes effectively.
Another effective strategy is using motivational interviewing techniques to help individuals explore their goals and values.⁴ Open-ended questions like, “What matters most to you about your health?” or “What would success look like for you?” can open conversations that help individuals connect the dots between their personal motivations and diabetes care. When the goals come from within, individuals are more likely to initiate and sustain behavior change further building self-efficacy.
Lastly, peer support and modeling can enhance self-efficacy, especially when applied to cultural needs.² Whether it’s engaging with community health workers and peers, a diabetes support group, online community, or shared stories during appointments, seeing others with diabetes manage their condition successfully can normalize challenges and help make goals seem more attainable. Supporting individuals in identifying their “why” becomes even more potent when coupled with systemic strategies and fostering interventions that increase ability to apply change. Self-efficacy is fluid and can be reinforced and cultivated through consistent, compassionate support. By facilitating individuals with diabetes to reflect, build on their strengths, and gain confidence through action and interactions, we can empower self-management.
- Juarez LD, Presley CA, Howell CR, et al. The Mediating Role of Self-Efficacy in the Association Between Diabetes Education and Support and Self-Care Management. Health Education & Behavior. 2021;49(4):689-696.
- Ataya, J., Soqia, J., Albani, N. et al. The role of self-efficacy in managing type 2 diabetes and emotional well-being: a cross-sectional study. BMC Public Health. 2024; 24: 3471. https://doi.org/10.1186/s12889-024-21050-2
- Lo, C.J., Lee, L., Yu, W. et al. Mindsets and self-efficacy beliefs among individuals with type 2 diabetes. Sci Rep. 2023; 13: 20383. https://doi.org/10.1038/s41598-023-47617-4
- Bilgin A, Muz G, Yuce GE. The effect of motivational interviewing on metabolic control and psychosocial variables in individuals diagnosed with diabetes: Systematic review and meta-analysis. Patient Education and Counseling. 2022;105(9): 2806-2823. https://doi.org/10.1016/j.pec.2022.04.008
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