Abstract
BackgroundSense of coherence (SOC) has been associated with various self-care behaviours in the general population. As the management of type 1 diabetes heavily relies on self-management, the SOC concept could also prove important in this population. This paper is a report of a study conducted among patients with type 1 diabetes to assess the associations between SOC and glycaemic control, microvascular complications, and patients' conceptions of their disease.MethodsAltogether 1,264 adult patients (45% men, age range 18-82 years) with type 1 diabetes participated in this cross-sectional study. SOC was evaluated using a 13-item SOC questionnaire. Standardized assays were used to determine HbA1c. Nephropathy status was based on albumin excretion rate and retinal laser-treatment was used as an indication of severe retinopathy. Patients' subjective conceptions of diabetes were studied using a questionnaire.ResultsHigher SOC scores, reflecting stronger SOC, were associated with lower HbA1c values. Strong SOC was independently associated with reaching the HbA1c level <7.5%. Adjusting for diabetes duration, age at onset, socioeconomic status and HbA1c, weak SOC was associated with the presence of nephropathy among men, but not women. No associations were observed between SOC and severe retinopathy. Four dimensions describing patients' conceptions of HbA1c, complications, diabetes control and hypoglycaemia were formed from the diabetes questionnaire. Weak SOC was independently associated with worse subjective conceptions in the dimensions of HbA1c and hypoglycaemia. Furthermore among men, an association between weak SOC and the complications factor was observed.ConclusionInterventions to improve patients' SOC, if available, could improve patients' metabolic control and therefore also reduce the incidence of diabetic complications.
Highlights
Type 1 diabetes is a chronic disease that is frequently associated with severe vascular complications [1]
Due to the limited and conflicting evidence obtained far, we aimed to investigate whether weak Sense of coherence (SOC) is associated with glycaemic control and microvascular complications among patients with type 1 diabetes
SOC, nephropathy and retinopathy Nephropathy status was evaluated in 1,118 patients
Summary
Type 1 diabetes is a chronic disease that is frequently associated with severe vascular complications [1]. Diabetic complications account for the major morbidity and mortality associated with the disease [2]. Antonovsky identified and advocated the use of SOC as a central part of his salutogenic approach that explains why some individuals stay healthy despite of encountering major stressors, while others do not [10]. In this model, health and disease form a continuum from “ease” to “disease”, rather than are seen as a dichotomous variable. As the management of type 1 diabetes heavily relies on self-management, the SOC concept could prove important in this population. This paper is a report of a study conducted among patients with type 1 diabetes to assess the associations between SOC and glycaemic control, microvascular complications, and patients’ conceptions of their disease
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