Diabetes Empowerment Research Articles

Feasibility and effectiveness of diabetes peer coaches

This was a two-year project funded by a grant from the Lawson Foundation involving a university and 11 Diabetes Centres. One hundred nine persons with type 2 diabetes or who were familiar with type 2 diabetes (e.g., family member) were trained to use Self-Management behavioural change strategies and to navigate the healthcare system. Diabetes educators recruited 115 adults with type 2 diabetes who were experiencing difficulty. Coaches and subjects were paired and over a 6-month period coaches telephoned subjects once each week and engaged in a 30-minute conversation. Both the coaches and subjects completed questionnaires at baseline, and at 6 and 12 months. A one-way repeated-measures analysis of variance was used to investigate change with 14 measures. To investigate process, a grounded theory qualitative analysis was conducted to obtain information on how the coaching process worked. The analysis showed statistically significant improvements in A1 C, patient activation, depression, self-efficacy, communication with health care professionals, and diabetes empowerment. Improvement levels were sustained at 12 months and these results were not influenced by covariates of age, gender, number of chronic health conditions and education level. The study also obtained information on recruiting coaches and participants, training coaches, pairing coaches with participants, length and intensity of the intervention, liaising with diabetes health professionals and monitoring and supporting coaching integrity. This pilot “pragmatic” study demonstrated that peer coaches are acceptable to clinicians and clients and have an important role in the continuity of care for persons experiencing chronic conditions. At study completion the program protocol was modified slightly and is currently being implemented on a permanent basis to persons experiencing various types of chronic condition, and the program is currently being evaluated in a randomized controlled trial.

Effectiveness and Applicability of Self-Management Peer Coaching in the Continuity of Diabetes Care

The goal of this 2-year research project was to investigate the feasibility and effectiveness of telephone peer coaching for persons with type 2 diabetes. It involved a partnership between a university and 11 diabetes centers. One hundred nine persons with type 2 diabetes or who were familiar with type 2 diabetes (e.g., family members) were trained as coaches and learned how to use self-management behavioral change strategies and to navigate the healthcare system. Diabetes educators recruited 115 adults with type 2 diabetes who were experiencing difficulty managing. Coaches and subjects were paired, and over a 6-month period, coaches telephoned subjects once each week and engaged in a 30 minute conversation focusing on managing their condition, their medications and on their family and work life. Both coaches and subjects completed questionnaires at baseline, and at 6 and 12 months. A one-way repeated-measures analysis of variance was used to investigate change with 14 measures. To investigate the peer coaching process, a grounded theory qualitative analysis was conducted to obtain information on the coaching process. The analysis showed statistically significant improvements between baseline and 12 months, namely: A1c (-9%), patient activation (+15%), depression (-24%), self-efficacy (+23%), communication with health care professionals (+23%), and diabetes empowerment (+10%). Further analysis found that these results were not influenced by covariates of age, gender, number of chronic health conditions and education level. The main themes found in the qualitative study which contributed to participant improvements were: learning self-management skills, personal accountability, encouragement, finding resources, and the boundary between the coach and participant. This pilot “pragmatic” study demonstrated that peer coaches are acceptable to clinicians and clients and have an important role in the continuity of care for persons experiencing diabetes. Disclosure P. McGowan: None.

Depression and Self-Efficacy in Patients with Type 2 Diabetes in Northern Greece.

Depression represents one of the most common disorders in diabetic patients and frequently complicates the health care of this population. Poor self-efficacy has been associated with increased depressive symptoms as well as poor glycemic control. To assess depression and self-efficacy in adults with type 2 diabetes in Northern Greece and to explore the factors which may affect them in this group of population. A descriptive study was conducted in a tertiary hospital in the largest city of Northern Greece. The study group included a convenience sample of 170 adults with type 2 diabetes mellitus who completed the General Health Questionnaire-28 (GHQ-28) and the Diabetes Empowerment Scale- short form (DES) questionnaire. The overall rate of diabetic patients showing psychological distress in the present study was 50.6%. Adults with low and moderate income experienced higher levels of depression and anxiety, compared to those with high economical status (p<0,001). Also, adults who graduated elementary education experienced higher levels of depressive and anxiety symptoms than those with a higher educational level (p =0,038). There was a statistically significant difference between age (p<0.001), type of residence (p=0.019), family status (p=0,002), financial status (p<0.001) and self-efficacy. Also, there was a negative correlation between BMI and self-efficacy (r=-0.206, p<0.001) and a negative correlation between depression and self-efficacy scale (r=-0.439, p<0.001). The results of the present study highlight the importance of well-planned interventions in order to reduce depression and increase self-efficacy in diabetic adults and to help them further improve their quality of life.

Self-care management of Thai Buddhists and Muslims with type 2 diabetes after an empowerment education program.

The aim of the present study was to explore self-care management of Thai Buddhists and Muslims with type 2 diabetes and inadequate blood glucose levels, after they had been subjected to a 6-month diabetes empowerment education program. Twenty-seven participants (male and female) were selected through purposive convenience sampling for an explorative qualitative study. Semistructured focus group interviews with four open-ended questions were used to study the participants' self-care behavior at the beginning and the end of the program, and the data obtained were subjected to content analysis. At the end, one third of the participants had been able to reduce their blood glucose to acceptable levels. Most of the others had achieved reduced but irregular blood glucose levels; however, some did not achieve any reduction. Diet was the most difficult problem, and economic difficulties, incorrect knowledge, and misleading beliefs were barriers. In conclusion, an empowerment education program can substantially improve the outcome of self-care management for many people with type 2 diabetes. In the planning of such programs, barriers should be taken into account.

INCREASING SELF EMPOWERMENT AND QUALITY OF LIFE OF PATIENTS WITH TYPE 2 DIABETES MELLITUS WITH DIABETES EMPOWERMENT EDUCATION BASED ON HEALTH PROMOTION MODEL

Introduction. Diabetes Mellitus (DM) is a chronic disease that requires individual ability of patients to adhere treatment of the disease recommended by doctors. The purpose the study was to analyze the effect of diabetes empowerment education to self empowerment and quality of life of patients with type 2 DM.Method. This study used quasy experiment design with non randomized control group pretest posttest design. Total sampel was 32 respondents divided into control group and experiment group, sample recruited by purposive sampling. Data were collected using questionnaire with DES (Diabetes Empowerment Scale) and DQoL (Diabetes Quality of Life). Data were then analyzed using Wilcoxon Sign rank test and Mann Whitney with level of significance of 0,05.Result. The results showed that there were differences in self empowerment and quality of life of patients with type 2 DM after intervention. Mann Whitney analysis result`s showed that there are differences in self empowerment between control and experiment groups (p = 0,029) and there was a difference in the quality of life between control and experiment groups (p = 0,022). It can be referred from it that DEE influences self empowerment and quality of life of type 2 DM patients.Discussion. It can be concluded that diabetes empowerment education increasing selfempowerment and quality of life of patients with DM type 2. Keywords: diabetes, education, self empowerment, quality of life, DEE, HPM

Diabetes Empowerment Council: Integrative Pilot Intervention for Transitioning Young Adults With Type 1 Diabetes.

BackgroundThe transition of young adults with type 1 diabetes (T1D) from pediatric to adult care is challenging and frequently accompanied by worsening of diabetes-related health. To date, there are no reports which prospectively assess the effects of theory-based psycho-behavioral interventions during the transition period neither on glycemic control nor on psychosocial factors that contribute to poor glycemic control. Therefore, the overall aim of this study was to develop and pilot test an integrative group intervention based on the underlying principles of self-determination theory (SDT), in young adults with T1D.MethodsFifty-one young adults with T1D participated in an education and case management-based transition program, of which 9 took part in the Diabetes Empowerment Council (DEC), a 12-week holistic, multimodality facilitated group intervention consisting of “council” process based on indigenous community practices, stress-reduction guided imagery, narrative medicine modalities, simple ritual, and other integrative modalities. Feasibility, acceptability, potential mechanism of effects, and bio-behavioral outcomes were determined using mixed qualitative and quantitative methods.ResultsThe intervention was highly acceptable to participants, though presented significant feasibility challenges. Participants in DEC showed significant reductions in perceived stress and depression, and increases in general well-being relative to other control participants. Reduction in perceived stress, independent of intervention group, was associated with reductions in hemoglobin A1C. A theoretical model explaining the effects of the intervention included the promotion of relatedness and autonomy support, 2 important aspects of SDT.ConclusionsThe DEC is a promising group intervention for young adults with T1D going through transition to adult care. Future investigations will be necessary to resolve feasibility issues, optimize the multimodality intervention, determine full intervention effects, and fully test the role of the underlying theoretical model of action.ClinicalTrials.gov Registration Number NCT02807155; Registration date: June 15, 2016 (retrospectively registered)

Predictors of Empowerment in Individuals With Type 2 Diabetes Mellitus.

Type 2 diabetes is a chronic, progressive disease that has reached pandemic proportions. In Turkey, the frequency of diabetes in individuals aged 20 years or older has been reported to be 13.7% compared with the worldwide prevalence of 8.5%. Empowerment has been correlated with improvement in diabetic self-management capabilities and glycemic control. The purpose of this study was to examine predictors of "empowerment" in individuals with type 2 diabetes from Turkey. This was a secondary analysis with a cross-sectional correlation design using stepwise linear regression to evaluate previously collected data from 220 type 2 diabetic individuals in Turkey from January through July 2014. Demographic and Disease-Related Information Form, Diabetes Empowerment Scale, and Multidimensional Scale of Perceived Social Support were used to collect the research data. Being educated about diabetes (β = .22, p < .001), high school (β = .16, p = .007), university (β = .12, p = .046), age (β = -.18, p = .003), social support (β = .15, p = .027), employment status (β = .13, p = .045), and A1C (β = -.12, p = .046) were statistically significant predictors of empowerment of type 2 diabetic individuals, and these variables explained 30% of the common variance. It is important for nurses to assess sources of social support and integrate the results of this assessment to ensure the empowerment of the patient during diabetes education. For the empowerment of diabetic individuals, attempts should be made to increase the diabetes literacy levels of diabetic individuals who have low level of education and who are in the older age group, and patients who can get employed could be directed to work life.

Patient-Centered Care, Diabetes Empowerment, and Type 2 Diabetes Medication Adherence Among American Indian Patients.

IN BRIEF Type 2 diabetes has been labeled an epidemic in many American Indian communities. Thus, identifying factors that improve medication adherence for American Indian patients is crucial. We found significant and positive relationships among patient-centered care, medication adherence, and diabetes empowerment. In addition, diabetes empowerment partially mediated the relationship between patient-centered care and medication adherence.

The effectiveness of the Diabetes Empowerment Self-management Interactive Research (DESIRE) programme on diabetes distress in patients with poorly controlled type 2 diabetes: secondary analysis of a multicentre, single-blind, randomised controlled trial

BackgroundPsychological distress remains a significant challenge for patients with poorly controlled type 2 diabetes. This study aimed to evaluate if an empowerment-based self-management programme would optimise psychological wellbeing in this vulnerable population of patients with diabetes. MethodsAdult patients with poorly controlled type 2 diabetes from two tertiary hospitals in Xi'an city, China, were randomly allocated to intervention or control groups using a computer-generated randomisation list with a block size of four. Participants in the intervention group received the DESIRE programme, which is a patient-centred consultation programme to empower and engage patients in self-management and active coping. The trial's primary outcome was effect on HbA1c. In this secondary analysis, we report findings for diabetes distress measured by the Diabetes Distress Scale [DDS]; patients with a mean score of three or higher were deemed to be those with diabetes distress worthy of clinical attention. Analysis was with a generalised estimating equation model according to the intention-to-treat method. Data were collected at baseline and at 8 and 20 weeks after randomisation by trained nurses who were masked to group assignment. Written consent was obtained from participants before study commencement. This trial is registered with the Chinese Clinical Trial Register, number ChiCTR-IPR-14005492. FindingsBetween April, 2014, and October, 2015, 242 patients were enrolled and randomised to control (n=121) or intervention (n=121) groups. Participants had similar social, demographic, and disease characteristics at baseline (mean diabetes duration 8·0 years [SD 6·0]; mean HbA1c 10·0% [SD 1·8]). Compared with participants in the control group, those in the intervention group had a significantly greater reduction in emotional-related distress (from mean score 3·24 [SD 1·19] to 2·54 [1·05] in the intervention group vs 3·45 [1·21] to 3·21 [1·23] in the control group; effect size 0·59, 95% CI 0·45–0·73, p=0·027) and regimen-related distress (from 3·45 [1·28] to 2·97 [0·96] vs 3·68 [1·14] to 3·55 [1·13]; effect size 0·56, 95% CI 0·42–0·69, p=0·011) after 20 weeks of follow-up. These reductions were clinically significant. InterpretationThe empowerment-based, patient-centred DESIRE programme could significantly reduce diabetes distress in patients with poorly controlled type 2 diabetes. Our findings provide a basis for integrating the DESIRE programme into routine care. FundingNo funding.

Reliability and Validity of Korean version of Diabetes Empowerment Scale Short Form

Reliability and Validity of Korean version of Diabetes Empowerment Scale Short Form

Research progress on the empowerment ability in diabetic patients

Empowerment ability, which centers on patients, can promote patients to actively participate in the decision-making and change their behavior so as to enhance their health through helping them to rebuild themselves, stimulate the potential and exhibit their unique social values and spiritual values. Researches on the empowerment ability of diabetic patients in China started late and developed slowly. This paper reviewed relative researches and pointed out the concept, diabetes authorization scales, research status of diabetes empowerment ability and way to improve the empowerment ability, so as to provide references for the clinical establishment of measures to improve the empowerment ability of diabetic patients in China. Key words: Diabetes mellitus; Empowerment ability; Review

The effect of peer support in adults with insulin pump-treated type 1 diabetes: a pilot study of a flexible and participatory intervention

AimThe aim of this study was to explore the effects of a flexible and participatory peer support intervention in a clinical setting for adults with type 1 diabetes treated with an insulin pump, focusing on enhancing diabetes-specific social capital. The key questions were as follows: 1) what effects are appropriate to expect, according to participants? and 2) to what extent did these effects occur?MethodsTwo peer support intervention programs were conducted in a diabetes specialist clinic (N=30). A participatory and adaptable approach allowed flexibility in the content of peer support meetings, which were facilitated by a diabetes nurse. Individual interviews explored participants’ perception of effects of the intervention. Interview data were analyzed qualitatively. Participants (n=27) completed a baseline and postintervention questionnaire that included items assessing diabetes empowerment, diabetes distress, diabetes-specific social support, and diabetes loneliness. HbA1c levels were compared before and after the intervention.ResultsParticipants experienced enhanced diabetes-specific social capital, diabetes motivation, awareness of personal diabetes practices, and serenity and openness in life with diabetes. They also became more aware of treatment and support possibilities. Negative effects included feeling sad or upset after the meetings or feeling different than and not as well-controlled as other participants. Quantitative analyses showed enhanced social support, decreased eating distress and trends toward enhanced diabetes empowerment, decreased diabetes loneliness, and decreased diabetes distress (powerlessness). We found fewer positive and/or negative outcomes among participants who felt no need for peer support or felt that the group was not a unit or that important issues were not addressed.ConclusionThe study indicated that flexible and participatory peer support can strengthen diabetes-specific social capital and improve participants’ well-being and diabetes empowerment. Awareness of participants’ incentives for attending peer support, as well as the risk of people feeling isolated within peer support groups, is essential to creating effective diabetes-specific social support.

Declining structured diabetes education in those with type 2 diabetes: A plethora of individual and organisational reasons

Objectiveto identify the expressed reasons adults with type 2 diabetes decline structured diabetes education (SDE). Methodscross sectional survey of 335 adults with type 2 diabetes who had declined SDE within the past two years, from across Northern Ireland and England.Standardised instruments comprising The Diabetes Attitude Scale, Diabetes Empowerment Scale (Short Form), and Diabetes Knowledge Test plus a questionnaire to elicit the reasons for declining SDE were used. ResultsMean age 57.6 years (±21.1) 50.7% males, predominantly of White ethnicity (85.7%). They were most frequently invited to attend by a diabetes specialist nurse (36%), general practitioner (27%) or practice nurse (19%).Although a diversity of reasons for declining SDE were cited the most common were; ‘The course was too long’ (47.2%), ‘I have other health problems’ (41.2%) and they had other priorities (33.4%).Hierarchical cluster analysis revealed that expressed reasons for declining SDE were highly individualised. ConclusionThe wide range of reasons that impeded attendance suggests there is no simple solution that will improve attendance rates. Practice implicationsIn the same way that medical treatment for diabetes is becoming increasingly individualised, educational provision should be encouraged to move away from a one size fits all model.

Adapting and validating a measure of diabetes-specific self-compassion

AimsSelf-compassion (SC), or treating oneself with kindness when dealing with personal challenges, has not been rigorously examined in people with T1D. SC has been shown to buffer against negative emotions and to be linked to improved health outcomes, but diabetes-specific SC has not been studied. This study aimed to adapt the Self-Compassion Scale and validate it for a diabetes-specific population. MethodsWe developed and validated a diabetes-specific version of the Self-Compassion Scale (Neff, 2003) in a sample of adults with T1D (N=542; 65% female; 97% non-Hispanic White; M age 41, SD=15.7; M A1c=7.3, SD=1; 72% insulin pump users; 50% continuous glucose monitoring [CGM] users). Confirmatory factor analyses (CFA), and reliability and construct validity analyses were conducted. Validity measures included diabetes distress, diabetes empowerment, diabetes numeracy, and A1c. ResultsA two-factor bi-factor structure showed best fit, providing support for use of the adapted scale (SCS-D) as a unitary construct. The 19-item unidimensional SCS-D demonstrated excellent internal consistency (ɑ=0.94; range of item-total correlations: 0.52–0.71) and construct validity. As hypothesized, higher SCS-D was associated with less distress, greater empowerment, and lower A1c, and was not associated with numeracy. ConclusionsThe SCS-D is a reliable and valid measure of diabetes-specific self-compassion in adults with T1D.

EXPANSION of diabetes education in a United States–Mexico border community (Expanding Services for Patients to Acquire New Skills, Set Goals, and Improve Overall Knowledge)

ObjectivesTo describe the process used by a pharmacy team at a community health center to coordinate and expand diabetes education services (English and Spanish) for a predominantly Hispanic, Spanish-speaking population. SettingThe project was implemented at 2 clinics in a federally qualified community health center system based in a low-income southwest U.S.–Mexico border community. Practice innovationThis project enhanced accessibility to diabetes education to improve knowledge, skills, and goal setting through existing pharmacy services at the primary clinic and 1 rural satellite clinic. EvaluationThe success of the project was evaluated quantitatively. Metrics used to evaluate enhancement of existing practices included enrollment and completion rates, number of sessions, and diabetes leadership meetings. ResultsOver the 5-month project period assessed, 7 interdisciplinary professionals were certified as Diabetes Empowerment Education Program educators. Four sessions were conducted at both clinics. A total of 31 participants completed the diabetes classes. An educational attainment of 8th grade or less was reported in 91% of the rural participants compared with 50% of the urban participants. Ten interdisciplinary leadership meetings centered on recruitment, progress toward goals, and action items to ensure quality of classes. A nurse practitioner and pharmacist piloted a shared-visit model with 5 patients during a 45-minute time period. ConclusionSuccessful diabetes education services occurred by implementing an evidence-based curriculum, identifying provider champions, increasing patient enrollment through provider referrals, and generating reports. Patient accountability was facilitated by setting patient-centered goals for knowledge and skills. Last, support groups provided ongoing support once patients graduated from a structured diabetes program.

Avaliação da visita domiciliar para o empoderamento do autocuidado em diabetes

Resumo Objetivo Avaliar o efeito da visita domiciliar na adesão e empoderamento das práticas de autocuidado em diabetes mellitus tipo 2. Métodos Ensaio clínico randomizado por clusters, com a participação de 145 usuários com diabetes mellitus tipo 2, sendo 34 do Grupo intervenção e 111 do Grupo controle. Foram utilizados os questionários de Autocuidado com o diabetes e Diabetes Empowerment Scale-Short Form para comparação entre grupos na linha de base, assim como entre o antes e depois intragrupo. O nível de significância foi 0,05. Resultados O grupo intervenção apresentou aumento estatisticamente significativo do escore mediano referente à adesão às práticas de autocuidado em diabetes (p=0,005) e à escala de empoderamento (p&lt;0,001). Conclusão A visita domiciliar promoveu à adesão às práticas de autocuidado com diabetes mellitus tipo 2.

Exploring why young people with Type 1 diabetes decline structured education with a view to overcoming barriers.

To identify factors that influence lack of engagement of young adults with Type 1 diabetes (aged 13-21 years) with structured diabetes education (SDE) to inform and broaden the reach of future SDE. A quantitative, cross-sectional survey was undertaken of 227 young people with Type 1 diabetes drawn from 11 health trusts across Northern Ireland and England, deemed to be representative of the wider population. Participants were asked to complete a questionnaire exploring non-attendance, along with the Diabetes Care Profile, the Diabetes Empowerment Scale (Short Form), the Diabetes Knowledge Test and the 12-item General Health Questionnaire. Demographic, health and diabetes-specific variables including HbA1c were also collected. The five most commonly cited reasons for non-attendance were 'Had other things to do' (68.3%), 'No time' (62.2%), 'Could not get time off school/college or work' (60.8%), 'Learnt about diabetes from other sources' (55.5%) and 'Feel able to cope on own' (52.9%). Greater emphasis is required on communication with young people about the benefits of SDE. In addition, efforts need to be directed to making diabetes education more accessible without losing the quality of structured programmes.

Impact of a goal setting and decision support telephone coaching intervention on diet, psychosocial, and decision outcomes among people with type 2 diabetes

ObjectiveEvaluate a 16-week decision support and goal-setting intervention to compare diet quality, decision, and diabetes-related outcomes to a control group. MethodsAdults with type 2 diabetes (n=54) were randomly assigned to an intervention or control group. Intervention group participants completed one in-person motivational interviewing and decision support session followed by seven biweekly telephone coaching calls. Participants reported previous goal attempts and set diet- and/or physical activity-related goals during coaching calls. Control group participants received information about local health care resources on the same contact schedule. ResultsThere was a significant difference between groups for diabetes empowerment (p=0.045). A significant increase in diet quality, diabetes self-efficacy, and diabetes empowerment, and a significant decrease in diabetes distress and depressive symptoms (all p≤0.05) occurred in the intervention group. Decision confidence to achieve diet-related goals significantly improved from baseline to week 8 but then declined at study end (both p≤0.05). ConclusionsSetting specific diet-related goals may promote dietary change, and telephone coaching can improve psychosocial outcomes related to diabetes self-management. Practice implicationsInformed shared decision making can facilitate progressively challenging yet attainable goals tailored to individuals’ lifestyle. Decision coaching may empower patients to improve self-management practices and reduce distress.

The effect of the BATHE interview technique on the empowerment of diabetic patients in primary care: A cluster randomised controlled study

AimTo investigate the effect of the BATHE therapeutic interview technique on the empowerment of diabetes mellitus patients in primary care. MethodA cluster randomised controlled study using the BATHE interview technique was conducted on diabetes mellitus patients in primary care. Physicians in the intervention group were trained in the BATHE interview technique and used it with their diabetic patients in addition to the usual care. In the control group physicians delivered only the usual care. A total of 112 diabetes mellitus patients who met the study criteria (57 intervention, 55 control) were included. Three interviews were conducted with the patients in both groups at the beginning, the 3rd and 6th months. The Diabetes Empowerment Scale (DES) was filled up at baseline and in the 6th month. ResultsDue to some drop outs, the study finished with 44 patients in the control and 49 in the intervention group. According to an ‘Intention to treat analysis’ increase in the DES total score for the intervention group was higher than for the control group (Δ=10.56±8.97; Δ=5.64±7.36; p<0.001). Using multiple regression analysis, the BATHE intervention showed a significant predictor of the DES difference (B: 8.861; CI: 6.092–11.629; p<0.001). ConclusionThe use of the BATHE technique in primary care has a positive effect on the empowerment of diabetes mellitus patients.

The complex interplay between clinical and person-centered diabetes outcomes in the two genders

BackgroundNew approaches to cope with clinical and psychosocial aspects of type 2 diabetes (T2DM) are needed; gender influences the complex interplay between clinical and non-clinical factors. We used data from the BENCH-D study to assess gender-differences in terms of clinical and person-centered measures in T2DM.MethodsClinical quality of care indicators relative to control of HbA1c, lipid profile, blood pressure, and BMI were derived from electronic medical records. Ten self-administered validated questionnaires (SF-12 Health Survey; WHO-5 well-being index; Problem Areas in Diabetes (PAID) 5, Health Care Climate Questionnaire, Patients Assessment of Chronic Illness Care, Diabetes Empowerment Scale, Diabetes Self-care Activities, Global Satisfaction for Diabetes Treatment, Barriers to Taking Medications, Perceived Social Support) were adopted as person-centered outcomes indicators.ResultsOverall, 26 diabetes clinics enrolled 2,335 people (men: 59.7%; women: 40.3%). Lower percentages of women reached HbA1c levels < =7.0% (23.2% vs. 27.8%; p = 0.03), LDL-cholesterol < 100 mg/dl (48.3 vs. 57.8%; p = 0.0005), and BMI <27 Kg/m2 (27.2 vs. 31.6%; p = 0.04) than men. Women had statistically significant poorer scores for physical functioning, psychological well-being, self-care activities dedicated to physical activities, empowerment, diabetes-related distress, satisfaction with treatment, barriers to medication taking, satisfaction with access to chronic care and healthcare communication, and perceived social support than men; 24.8% of women and 8.8% of men had WHO-5 < =28 (likely depression) (p < 0.0001); 67.7% of women and 55.1% of men had PAID-5 > 40 (high levels of diabetes-related distress) (p < 0.0001). At multivariate analysis, factors associated with an increased likelihood of having elevated HbA1c levels (≥8.0%) were different in men and women, e.g. having PAID-5 levels >40 was associated with a higher likelihood of HbA1c ≥8.0% in women (OR = 1.15; 95%CI 1.05–1.25) but not in men (OR = 1.00; 95%CI 0.93–1.08).ConclusionsIn T2DM, women show poorer clinical and person-centered outcomes indicators than men. Diabetes-related distress plays a role as a correlate of metabolic control in women but not in men. The study provides new information about the interplay between clinical and person-centered indicators in men and women which may guide further improvements in diabetes education and support programs.