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Type 2 Diabetes: Model of Factors Associated With Glycemic Control Publisher Pubmed



Aghili R1 ; Polonsky WH2 ; Valojerdi AE1 ; Malek M3 ; Keshtkar AA4 ; Esteghamati A5 ; Heyman M6 ; Khamseh ME1
Authors
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Authors Affiliations
  1. 1. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Behavioral Diabetes Institute, San Diego, California, United States
  3. 3. Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
  4. 4. Osteoporosis Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Psychiatry, UCSD School of Medicine, San Diego, California, United States

Source: Canadian Journal of Diabetes Published:2016


Abstract

Objectives 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. © 2016 Canadian Diabetes Association