Abstract
BackgroundThis cross-sectional and prospective study used a variety of psychological inventories to evaluate the relationship between psychosocial factors and the glycemic control of patients with type 2 diabetes.MethodsParticipants were 304 patients with type 2 diabetes who were treated as outpatients at diabetes clinics. All participants were assessed for HbA1c and completed the following self-report psychological inventories: 1) Diabetes Treatment Satisfaction Questionnaire (DTSQ), 2) Problem Areas in Diabetes Survey (PAID), 3) Well-being Questionnaire 12 (W-BQ12), 4) Self-Esteem Scale (SES), 5) Social Support Scale, and 6) Self-Efficacy Scale. HbA1c was again measured one year later. The relationships between the psychosocial variables obtained by analysis of the psychological inventories and baseline or one-year follow-up HbA1c were determined.ResultsBaseline HbA1cwas significantly correlated with age, diet treatment regimen, number of microvascular complication of diabetes, and the total scores of DTSQ, W-BQ12, PAID, SES and the Self-Efficacy Scale. Hierarchical stepwise multiple regression revealed that significant predictors of baseline HbA1c were total DTSQ and PAID scores, along with age, diet treatment regimen, and number of microvascular complication of diabetes after adjustment for demographic, clinical and other psychosocial variables. Two hundred and ninety patients (95.4% of 304) were followed and assessed one year after baseline. Hierarchical stepwise multiple regression analysis showed the significant predictors of follow-up HbA1c to be total DTSQ and PAID scores, along with age and diet treatment regimen. However, the correlation between baseline and follow-up HbA1c was so high that the only other variable to retain significance was diet treatment regimen once baseline HbA1c was included in the regression of follow-up HbA1c.ConclusionThe DTSQ and the PAID predicted both current and future HbA1c to a similar and significant degree in patients with type 2 diabetes.
Highlights
This cross-sectional and prospective study used a variety of psychological inventories to evaluate the relationship between psychosocial factors and the glycemic control of patients with type 2 diabetes
Anxiety was associated with hyperglycemia [9], diabetes-specific distress influenced poor adherence and poor glycemic control [10,11], and high selfesteem [12] and social support [13] were found to relate to good adherence
There were no significant differences in any demographic, clinical, or psychosocial factors between patients followed for one year (n = 290) and those who could not be followed (n = 14)
Summary
This cross-sectional and prospective study used a variety of psychological inventories to evaluate the relationship between psychosocial factors and the glycemic control of patients with type 2 diabetes. The clinical course of diabetes, especially glycemic control, is largely influenced by patient self-management. In cross-sectional research on type 2 diabetes, self-efficacy [1,2,3] and diabetes coping [4] were associated with good treatment adherence and good glycemic control, whereas stressful life events [5] and daily environmental stress factors [6] have been shown to be associated with poor metabolic control. Anxiety was associated with hyperglycemia [9], diabetes-specific distress influenced poor adherence and poor glycemic control [10,11], and high selfesteem [12] and social support [13] were found to relate to good adherence. Only a few longitudinal [1,15]studies have examined the relationship between psychosocial factors and glycemic control in type 2 diabetes
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