Type 2 Diabetes: Model of Factors Associated with Glycemic Control.
OBJECTIVE
The purpose of this study was to evaluate the related factors and their intercorrelated impacts on glycemic control in people with type 2 diabetes mellitus.


METHODS
Patients with type 2 diabetes were recruited for this study during their regular clinic visits at a major medical centre in Iran. Glycated hemoglobin (A1C) levels were used as the indicator of glycemic control. Regression analysis was used to determine the relationships between glycemic control and demographics, self-care behaviours, resources and affective variables. Moreover, the associations between diabetes-related distress and measured variables were tested.


RESULTS
Three hundred eighty people with type 2 diabetes completed the study. The mean duration of diabetes was 8.94±6.57 years, and the mean A1C levels were 7.78%±1.7%. Diabetes-related distress was significantly associated with A1C levels, controlling for all other variables (p=0.01). On the other hand, depression (p<0.001), self-management (p<0.001), anxiety (p<0.001) and patient-physician relationship (p=0.023) were significantly associated with diabetes-related distress.


CONCLUSIONS
Diabetes-related distress was found to be associated with glycemic control in people with type 2 diabetes, whereas age, depression, anxiety, self-management and family and social support may affect glycemic control indirectly through diabetes-related distress. Thus, it is important to assess and, if appropriate, treat people with diabetes for diabetes-related distress in order to identify and help them overcome barriers to optimal glycemic control.
Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
Rokhsareh
R
Aghili
Behavioral Diabetes Institute, San Diego, California, United States.
William H
WH
Polonsky
Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
Ameneh Ebrahim
AE
Valojerdi
Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
Mojtaba
M
Malek
Osteoporosis Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Abbas Ali
AA
Keshtkar
Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Alireza
A
Esteghamati
Department of Psychiatry, UCSD School of Medicine, San Diego, California, United States.
Mark
M
Heyman
Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. Electronic address: khamseh.m@iums.ac.ir.
Mohammad Ebrahim
ME
Khamseh
D001007:Anxiety; D001786:Blood Glucose; D003863:Depression; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000523:psychology; D006442:Glycated Hemoglobin / Q000378:metabolism*; D015438:Health Behavior; D006801:Humans; D012044:Regression Analysis; D012648:Self Care; D013315:Stress, Psychological
D001786:Blood Glucose; D006442:Glycated Hemoglobin
diabetes mellitus; diabète de type 2; diabète sucré; distress; détresse; glycemic control; psychosocial; régulation de la glycémie; type 2 diabetes