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Low self-efficacy, high diabetes distress associated with poor glycemic control
Older adults with type 2 diabetes who report poor self-efficacy and diabetes distress are more likely to have a higher HbA1c, whereas depression and anxiety symptoms were not associated with glycemic control, according to findings from a cross-sectional study in Italy.
Liliana Indelicato, Psy.D, PhD, of the division of endocrinology, diabetes and metabolism at the University of Verona and Hospital Trust of Verona, Italy, and colleagues analyzed data from 172 patients with type 2 diabetes without chronic complications recruited between 2012 and 2015 from the Diabetes Center of Verona City Hospital (mean age, 64 years; mean BMI, 31 kg/m²; mean HbA1c, 7.3%). Patients completed the Beck Depression Inventory II, the Beck Anxiety Inventory and the Multidimensional Diabetes Questionnaire.
Within the cohort, 14.5% and 18.6% of patients reached the cutoffs of moderate to severe levels of anxiety and depression, respectively. Those with higher levels of anxiety or depression tended to be younger and have shorter disease duration and lower levels of self-efficacy and social support vs. those without psychological distress.
Researchers found that HbA1c was associated with several dimensions of the Multidimensional Diabetes Questionnaire, including higher perceived interference with daily activities (P < .001), higher perceived diabetes severity (P < .001) and lower self-efficacy (P < .001), but not with depression or anxiety.
In multiple regression analysis to test independent predictors of glycemic control, researchers found that perceived interference (standardized beta = 0.17), perceived severity (standardized beta = 0.16), self-efficacy (standardized beta = -0.15) and diabetes duration (standardized beta = 0.22) were independent predictors of higher HbA1c, with an overall explained variance of 15.8%.
“Psychological interventions designed to reduce the diabetes-specific distress and to reduce diabetes specific self-efficacy might be of benefits for both the metabolic and psychological diabetes outcomes in patients with diabetes,” Indelicato told Endocrine Today. “Diabetes is a complex disease characterized by a peculiar psychological architecture where several cognitive and social factors are in play. Clinical diabetologists and psychologists dealing with diabetic patients should be aware that specific psychological constructs have a pivotal role in diabetes self-management. Ignoring these constructs could negatively affect the clinical outcomes.”– by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.