How Much Do We Know about the Biopsychosocial Predictors of Glycaemic Control? Age and Clinical Factors Predict Glycaemic Control, but Psychological Factors Do Not.

Mohammad Farris Iman Leong Bin Abdullah,Nurul Hazwani Hatta,Hatta Sidi,Roslyn Laurie Mainland,Arun Ravindran,Luke Sy-Cherng Woon,Norlaila Mustafa,Puteri Arnawati,Emily Samantha Kaunismaa,Paula Junggar Gosse,Amelia Yasmin Zulkifli

doi:10.1155/2020/2654208

Abstract

Objective Diabetes mellitus is one of the most common noncommunicable diseases in Malaysia. It is associated with significant complications and a high cost of treatment, especially when glycaemic control is poor. Despite its negative impact on health, data is still lacking on the possible biopsychosocial predictors of poor glycaemic control among the diabetic population. This study is aimed at determining the prevalence of poor glycaemic control as well as its association with biopsychosocial factors such as personality traits, psychiatric factors, and quality of life (QOL) among Malaysian patients with diabetes. Methods A cross-sectional study was conducted at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using outpatient population diabetic patients. Demographic data on social and clinical characteristics were collected from participants. Several questionnaires were administered, including the Beck Depression Inventory-II (BDI-II) to measure depressive symptoms, the Generalized Anxiety Disorder-7 (GAD-7) to assess anxiety symptoms, the Big Five Inventory (BFI) to evaluate personality traits, and the WHO Quality of Life-BREF (WHOQOL-BREF) to assess QOL. Multivariate binary logistic regression was performed to determine the predictors of poor glycaemic control. Results 300 patients with diabetes mellitus were recruited, with the majority (90%) having type 2 diabetes. In this population, the prevalence of poor glycaemic control (HbA1C ≥ 7.0%) was 69%, with a median HbA1C of 7.6% (IQR = 2.7). Longer duration of diabetes mellitus and a greater number of days of missed medications predicted poor glycaemic control, while older age and overall self-perception of QOL protected against poor glycaemic control. No psychological factors were associated with poor glycaemic control. Conclusion This study emphasizes the importance of considering the various factors that contribute to poor glycaemic control, such as duration of diabetes, medication adherence, age, and QOL. These findings should be used by clinicians, particularly when planning a multidisciplinary approach to the management of diabetes.

Highlights

Diabetes mellitus is one of the most common chronic diseases worldwide, affecting 422 million people in 2014
Much of the research on diabetes as it relates to biopsychosocial factors has been conducted in higher-income countries, despite the strong need to understand these relationships in lower- and middle-income countries where individuals often face significant barriers to care
The aim of this study was to determine the prevalence of poor glycaemic control among Malaysian diabetic patients and its association with biopsychosocial factors, such as personality traits, psychiatric factors, and quality of life (QOL)

Summary

Introduction

Diabetes mellitus is one of the most common chronic diseases worldwide, affecting 422 million people in 2014. It is expected to increase in prevalence, with an estimated 629 million people affected by 2045 [1]. While diabetes is a worldwide health crisis, the prevalence of diabetes is increasing at a more rapid rate in lower- and middle-income countries [2]. Patients in these countries often have limited access to healthcare resources, potentially exacerbating both their diabetes and its associated comorbidities [3]. This study was conducted in Malaysia, a middle-income country where the estimated prevalence of diabetes is 17.5% [2], over 10% higher than the global average [4]

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Discussion

Conclusion