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Cited by 130Diabetes Management and EducationDiabetes Treatment and ManagementDiabetes Management and Research

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Predictors of glycemic control in insulin-using adults with type 2 diabetes.

Nichols, G A, Hillier, T A, Javor, K, Brown, J B·2000·Diabetes Care
DOI 10.2337/diacare.23.3.273
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Abstract

OBJECTIVE: To determine the characteristics that influence glycemic control among insulin-using adults with type 2 diabetes. RESEARCH DESIGN AND METHODS: We studied all 1,333 eligible members of a large not-for-profit health maintenance organization who responded to a 1997 survey. We tested associations among demographic, treatment, and psychometric variables with mean 1997 HbA1c values. The Problem Areas in Diabetes (PAID) instrument was used to assess the emotional effect of living with diabetes, and the Short Form 12 Physical Function Scale was used to assess the effect of physical limitations on daily activities. Based on differences between and within treatment groups, we built models to predict glycemic control for subgroups of subjects who were using insulin alone and those who were using insulin in combination with an oral hypoglycemic agent. RESULTS: Younger age, lower BMI, and increased emotional distress about diabetes (according to the PAID scale) were all significant predictors (P < 0.05) of worse glycemic control. However, except among individuals with an HbA1c level of >8.0 who were receiving combination therapy, only approximately 10% of the variance in glycemic control could be predicted by demographic, treatment, or psychometric characteristics. CONCLUSIONS: Personal characteristics explain little of the variation in glycemic control in insulin-using adults with type 2 diabetes. Possible explanations are that the reduced complexity of control in type 2 diabetes makes the disease less sensitive to personal factors than control in type 1 diabetes, that health-related behavior is less driven by personal and environmental characteristics among older individuals, or that, in populations exposed to aggressive glycemic control with oral hypoglycemic agents and nurse care managers, personal differences become largely irrelevant.

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Metadata

Authors
Nichols, G. A., Hillier, T. A., Javor, K., & Brown, J. B.
Affiliations
Kaiser Permanente (US)
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2000-03-01
Volume
23
Issue
3
Pages
273-277
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.23.3.273
OpenAlex
W2024618354
Cited by
130
References
0
Citations by year
2026: 2 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 6 · 2019: 5 · 2018: 7 · 2017: 6 · 2016: 10 · 2015: 8 · 2014: 10 · 2013: 3 · 2012: 14
FWCI
3.28
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
glycemic control, type 2 diabetes, insulin therapy, HbA1c, predictors of glycemic control, emotional distress, diabetes distress, physical function, oral antidiabetic drugs, combination therapy, body mass index, age, health maintenance organizations
MeSH terms
Activities of Daily Living, Adult, Diabetes Mellitus, Type 2, Emotions, Female, Health Maintenance Organizations, Glycated Hemoglobin, Humans, Insulin, Male, Middle Aged, Oregon, Regression Analysis, Biomarkers, Health Behavior, Body Mass Index

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