The individual contribution and relative importance of self-management and quality of care on glycaemic control in type 2 diabetes.
OBJECTIVE
To evaluate the relative importance of selfmanagement (SM) and quality of care (QoC) inpredicting glycaemic control in patients with type 2 diabetes.


METHODS
A longitudinal cohort study was conducted in 204 adults diagnosed with type 2 diabetes. Self-management and quality of care were measured at baseline. HbA1c was measured at baseline and at six-month follow-up.


RESULTS
None of the measures of self-management were significantly associated with HbA1c.Treatment intensification (TI) (a proxy for quality of care) resulted in lower HbA1c at follow-up. Other variables were associated with HbA1c at follow-up: HbA1c at baseline, age, diabetes duration, and combination of oral glucose-lowering medications. An exploratory analysis showed that patients who did not receive treatment intensification but performed more self-management behaviours had lower HbA1c levels at follow-up.


CONCLUSIONS
Treatment intensification might be more important for glycaemic control than self-management but the interaction between treatment intensification and self-management needs further research.
Yolanda V
YV
Martínez
Stephen M
SM
Campbell
Mark
M
Hann
Peter
P
Bower
D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis*; D015438:Health Behavior; D057220:Health Literacy; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data; D020377:Self Efficacy; D012959:Socioeconomic Factors
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents