An Assessment of Attitudes, Behaviors, and Outcomes of Patients with Type 2 Diabetes
Open accessAbstract
OBJECTIVES: Patient self-care behaviors, including taking medication, following a meal plan, exercising regularly, and testing blood glucose, influence diabetes control. The purpose of this research was to identify (1) which barriers to diabetes management are associated with problem behaviors and (2) which patient behaviors and barriers are associated with diabetes control. METHODS: This was a cross-sectional study of linked medical record and self-reported information from patients with type 2 diabetes. A randomly selected sample of 800 clinic patients was mailed an investigator-developed survey. The study sample consisted of 253 (55%) individuals who had measured glycosylated hemoglobin (HbA1c) within 3 months of the survey date. RESULTS: The barriers to each diabetes self-care behavior differed. Cost was the most common barrier to the 4 self-care behaviors. In a multivariable regression model, the belief that type 2 diabetes is a serious problem and depression were strongly associated with higher HbA1c levels. Lower HbA1c levels were significantly associated with being married and greater self-reported adherence-satisfaction with taking medication and testing blood glucose. CONCLUSION: This study expanded earlier research by focusing on 4 specific self-care behaviors, their barriers, and their association with HbA1c. Barriers that were significantly associated with HbA1c were specific to the behavior and varied across behaviors.
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Depression, poor general health, high stress, and obesity result in poor glycemic control.
“risk factors such as depression, poor general health, high-stress levels, and obesity result in poor glycemic control.”
From Factors Associated with Long-Term Control of Type 2 Diabetes Mellitus (2016) · cites this paper as [10]
The Discussion (page not provided) reports that depression, BMI, and physical health were associated with HbA1c, and suggests that improving health and weight control could improve glycemic control. But this cross-sectional study does not establish that those factors cause poor control, and the cited passages do not identify high stress as a factor. (LLM, conf=0.88)
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- Authors
- Daly, J. M., Hartz, A. J., Xu, Y., Levy, B. T., James, P. A., Merchant, M. L., & Garrett, R. E.
- Affiliations
- University of Iowa (US)
- Corresponding author
- Daly, J. M.
- Venue
- The Journal of the American Board of Family Medicine
- Published
- 2009-05-01
- Volume
- 22
- Issue
- 3
- Pages
- 280-290
- ISSN
- 1557-2625 (ISSN-L)
- 1558-7118
- OpenAlex
- W2148244769
- Cited by
- 101
- References
- 48
- Citations by year
- 2024: 2 · 2023: 2 · 2022: 5 · 2021: 3 · 2020: 7 · 2019: 3 · 2018: 8 · 2017: 8 · 2016: 14 · 2015: 7 · 2014: 7 · 2013: 5 · 2012: 10
- FWCI
- 7.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of the American Board of Family Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Health and Human Services
- Agency for Healthcare Research and Quality (5 RO3 HS014410)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, diabetes self-care, barriers to self-care, HbA1c, medication adherence, blood glucose monitoring, cost barriers, depression, marital status, diabetes management
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Depression, Diabetes Mellitus, Type 2, Diet, Diabetic, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Monitoring, Physiologic, Patient Compliance, Population Surveillance, Surveys and Questionnaires, Self Care, Blood Glucose Self-Monitoring, Exercise, Comorbidity, Logistic Models, Treatment Outcome
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