Abstract
AimsHbA1c variability is targeted as a part of clinical risk assessment in type 2 diabetes. Psychological factors such as patient competence, adjustment to diabetes, and motivation, may influence glycemic control. The objective of the present study was to determine if perceived competence, diabetes appraisal, and motivation predicted HbA1c variability, and to examine differences regarding these factors in relation to diabetes duration, in individuals with type 2 diabetes. MethodsData on perceived competence, appraisal of diabetes, and motivation orientation from 158 individuals with type 2 diabetes were analyzed as potential predictors of HbA1c at five measurement points over a time period of 24 months. Associations between psychological factors and HbA1c variability were examined through multiple linear regression analyses, and differences in psychological measures between groups with different diabetes duration were examined using ANOVA. ResultsNegative appraisal of diabetes predicted higher HbA1c variability and was associated with higher baseline HbA1c, and greater perceived competence predicted lower HbA1c variability. ConclusionsThe results indicate that lower levels of diabetes distress, as well as confidence in one’s ability to manage diabetes, could potentially predict better glycemic control.
Highlights
Perceived competence to manage diabetes, diabetes appraisal, and motivation are psychological factors that target three important domains of diabetes self-care: patient competence, adjustment to diabetes, and patient autonomy (Table 1) [1,2,3]
Each analysis was stepwise adjusted for the potential confounders sex, age, diabetes duration, metformin treatment, and baseline HbA1c, using backwards elimination in order to only include control variables that significantly contributed to the variance of the dependent variable
53.8% had been diagnosed with type 2 diabetes for two years or less
Summary
Perceived competence to manage diabetes, diabetes appraisal, and motivation are psychological factors that target three important domains of diabetes self-care: patient competence, adjustment to diabetes, and patient autonomy (Table 1) [1,2,3]. Williams et al found that change in perceived competence predicted diabetes self-care behaviors (diet, exercise, and glucose monitoring) and sustained glycemic change, concluding that enhanced patient competence could benefit chronic disease management [4]. The objective of the present study was to examine if the psychological factors perceived competence, appraisal of diabetes, and motivation, are associated with HbA1c baseline levels or HbA1c variability in individuals with type 2 diabetes. The study further aimed to examine differences regarding perceived competence, appraisal, and motivation in relation to diabetes duration
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