title: Glycemic outcome not predicted by baseline psychological measures in a diabetes management program.
abstract: The Northern Health Diabetes Hospital Admission Risk Program is a chronic disease management program that aims to improve the glycemic management of patients with diabetes. The aim of this project was to determine if there was any relationship between psychological characteristics and glycemic outcome in a diabetes management program. A prospective study of patients attending the diabetes management program investigated validated measures of cognition, stage of change, locus of control, self-efficacy, depression and anxiety, and quality of life. The study investigated 86 type 2 diabetes patients (mean age 59 years, 49% female). Glycemic control (HbA1c) was measured at baseline and after 12 months in the program. Glycemic control was poor on admission to the service with a mean HbA1c of 8.9%. The measures of cognition, self-efficacy, locus of control, mental health, and quality of life were not associated with improvements in HbA1c. Those participants with shorter duration of disease and more contacts with the service were significantly more likely to experience improvements in HbA1c. Psychometric data were not predictive of glycemic outcome. Rather, in this chronic disease management program, glycemia improved more in patients who were seen earlier in their disease course and managed more intensively, regardless of their psychometric status.
authors.affiliation: Dept of Medicine, Northern Clinical Research Centre, Northern Health and The University of Melbourne, Melbourne, Australia. marnie.graco@nh.org.au
authors.forename: Marnie
authors.initials: M
authors.lastname: Graco
authors.forename: Anastasia
authors.initials: A
authors.lastname: Hutchinson
authors.forename: Anna
authors.initials: A
authors.lastname: Barker
authors.forename: Vicki
authors.initials: V
authors.lastname: Lawlor
authors.forename: Rita
authors.initials: R
authors.lastname: Wong
authors.forename: Spiros
authors.initials: S
authors.lastname: Fourlanos
mesh_terms: D001315:Australia; D001786:Blood Glucose / Q000032:analysis*; D002908:Chronic Disease; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control / Q000523:psychology*; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D007722:Health Knowledge, Attitudes, Practice; D006305:Health Status Indicators; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin