Assessing the effect of psychosocial factors and individual indicators on status of metabolic control in subjects with Type 2 diabetes
Diabetes is a complex chronic illness that requires performing multiple daily self-management behaviors. People with diabetes often face challenges related to diet, physical activity, taking medications and stress management which may be barriers to optimal glycemic outcomes. These factors have been shown to lead to decreased adherence to medication and diabetes self-care behaviors, which increases the risk of diabetes-related complications, leading to higher healthcare costs, and an increased risk of mortality. Identifying the psychosocial and behavioral factors that affect glycemic control may potentially improve diabetes related outcomes. While the links between key psychosocial factors, more specifically diabetes related distress and glycemic control have been repeatedly studied in North American and European samples, there have been relatively few evaluations of these relationships outside of these geographic areas.
Therefore, the purpose of this project was to evaluate the related factors and their inter-correlated impacts on glycemic control in people with type 2 diabetes mellitus.
Data were collected from people with type 2 diabetes during regular clinic visits at a major medical center in Iran. All participants had been diagnosed with type 2 diabetes for at least 6 months, were between 30-65 years old. People with severe diabetes-related complications, active psychosis, history of psychiatric medications or documented psychiatric disease, history of substance use, dementia, and women who were pregnant were excluded from the study. Participants were selected from people coming in for regular clinic visits. An appointment was made for every eligible patient to explain the project and its goals in detail.. Then the patients were asked to fill out the booklet of questionnaires during the following 7 days. Level of physical activity was assessed with self-administered International Physical Activity Questionnaire (IPAQ). Self-management profile for type 2 diabetes, WHO-5 scale, PHQ-9, Diabetes Distress Scale, PACIC questionnaire, Brief Michigan Diabetes Knowledge Test, the Family Social Support Questionnaire (FSSQ), and Bortner Personality (A, B) questionnaire were filled out at the beginning of the study.
In the next visit, the patients went for an interview by a nutritionist to fill out 24-hour food recall questionnaire. Baseline demographic and anthropometric variables were checked and a serum sample was taken for measurement of HbA1c.
Demographic variables included age, gender, marital status, level of education, diabetes duration, type of treatment, smoking, body mass index (BMI), abdominal and hip circumference.
