The Effect of Depression on Poor Glycemic Control in Adults with Type 2 Diabetes: The Mediating Roles of Self-Efficacy and Self-Management Behaviors

Background: High levels of depression and poor self-efficacy and self-management are associated with worse glycemic control, but the linkage and pathway between these variables are poorly understood. We conducted this study to investigate the hypothesis that self-efficacy and self-management mediate the influence of depression on poor glycemic control. Methods: We studied a purposive sample of 142 adults with type 2 diabetes attending a public clinic in Ilam, Iran. Hierarchical linear regression analysis and structural equation modeling were used to explore the relationships among the variables of interest. Result: Depression directly and negatively affects self-efficacy and indirectly affects self-management behaviors, which in turn have direct effects on hemoglobin A1c (HbA1c). Self-efficacy mediates the relationship between depression and self-management behaviors. Self-efficacy and self-management behaviors partially mediate the effect of depression on HbA1c. These results confirmed that the data fit the hypothesized model very well. Conclusion: Careful monitoring of glycemic control might be important in those individuals who exhibit clinical signs of depression. Effective treatment programs should probably pay close attention to not only screening and treatment of depression but also skills training to enhance patient self-efficacy and self-management of diabetes to improve HbA1c.

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Predictors of Diabetes Self-Management Behaviors in Type 2 Diabetes Patients

Iranian journal of diabetes and obesity ◽

10.18502/ijdo.v12i4.5180 ◽

2021 ◽

Author(s):

Golnaz Azami ◽

Soh Kim Lam ◽

Sazlina Shariff-Ghazali ◽

Salmiah Mohd Said ◽

Sanaz Aazami ◽

...

Keyword(s):

Quality Of Life ◽

Type 2 Diabetes ◽

Linear Regression Analysis ◽

Self Management ◽

P Value ◽

Efficacy Expectation ◽

The Mean ◽

Management Behaviors

Objective: Type 2 diabetes mellitus (T2DM) is a chronic condition that requires consistent medical care to help control glycemic indices. Diabetes self-management is found to be essential for optimal glycemic control. This study aimed to investigate the predictors of diabetes self-management in adult with T2DM. Materials and Methods: A cross-sectional study was conducted. A purposive sample of 142 adults with T2DM attended an outpatient endocrine clinic in an academic hospital in Ilam, Iran was invited to participate in this study from September to October 2016. The data were collected using a combination of validated questionnaires and the blood sample. IBM SPSS software version 22 used to conduct the analysis. Hierarchical linear regression analysis with the stepwise method was used to explore the predictors of diabetes self-management. Results: The mean age of participants was 54.2 ± (11.8) years. The mean duration of diabetes was 8.9 ± (7.4). Hierarchical linear regression analysis determined that self-management behaviors had positive relationship with efficacy expectation (B= 0.445, P-value< 0.01), quality of life (B= 0.222, P-value= 0.02), and has a negative relationship with HbA1c (B= -0.194, P-value= 0.01). Conclusion: The result of our study indicate that better diabetes self-management behaviors can be predicted by higher efficacy expectation, the better quality of life and lower HbA1c levels. Future interventions should focus on enhancing efficacy expectation, quality of life and optimizing glycemic control to improve self-management of diabetes.

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The Effect of Social Support on Glycemic Control in Patients with Type 2 Diabetes Mellitus: The Mediating Roles of Self-Efficacy and Adherence

Journal of Diabetes Research ◽

10.1155/2017/2804178 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 23

Author(s):

Yechang Shao ◽

Lu Liang ◽

Linjing Shi ◽

Chengsong Wan ◽

Shouyi Yu

Keyword(s):

Diabetes Mellitus ◽

Social Support ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Self Efficacy ◽

Goodness Of Fit ◽

Equation Modeling ◽

Ample Evidence

Ample evidence suggests that social support, self-efficacy, and adherence significantly, independently, and together affect glycemic control in patients with type 2 diabetes mellitus (T2DM), but the pathway from social support to glycemic control remains unclear. This study hypothesized that the effect of social support on glycemic control was mediated sequentially by self-efficacy and adherence. Patients with T2DM were recruited from two hospitals in Guangzhou, China, from January 1 to July 31, 2014, and their sociodemographic clinical data and their assessments on social support, self-efficacy, and adherence were obtained from medical records and self-completed questionnaires. Of the 532 patients who participated, 35% achieved glycemic control (i.e., HbA1c < 7%). Social support, self-efficacy, and adherence had significant correlations with each other and with glycemic control (P<0.05). Regression analyses and structural equation modeling showed that better social support was associated to better patient self-efficacy, which, in turn, was associated with better medical adherence, which was associated with improved glycemic control, and the relationship between social support and glycemic control was sequentially and completely mediated by self-efficacy and adherence. The five goodness-of-fit indices confirmed that our data fitted the hypothesized pathway model strongly.

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Factors associated with poor glycemic control among type-2 diabetes mellitus patients in Yemen

Tropical Journal of Pharmaceutical Research ◽

10.4314/tjpr.v18i7.26 ◽

2021 ◽

Vol 18 (7) ◽

pp. 1539-1546

Author(s):

Sultan A.M. Saghir ◽

Abdullah E.A. Alhariri ◽

Sameer A. Alkubat ◽

Amer A. Almiamn ◽

Saleem H. Aladaileh ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Glycosylated Hemoglobin ◽

Poor Glycemic Control ◽

Self Management ◽

Military Hospital ◽

Diabetic Patients

Purpose: To determine the status of glycemic control and its associated factors among adult patients with type 2 diabetes mellitus (T2DM) in Hodeidah City, Yemen. Methods: This cross-sectional study involved T2DM patients attending an outpatient clinic at the Military Hospital in Hodeidah, from January to March 2017. Relevant socio-demographic characteristics, clinical factors and self-management behaviours were recorded in face-to-face interviews. Blood pressure, body weight, and height measurements were also obtained. Glycosylated hemoglobin (HbA1c) and lipid profile were evaluated. Urine samples were also obtained and analysed by albuminuria assay. Results: Of 246 participants, 73.2 % showed poor glycemic control (HbA1c ≥ 7 %). Female patients, those aged ≥ 40 years, the illiterate, and Khat chewers were more likely to have poor glycemic control. Moreover, longer disease duration, insulin administration and albuminuria were significantly associated with poor glycemic control. In contrast, a healthy diet, physical exercise, proper self-monitoring of blood glucose levels and taking medicines as prescribed significantly increased the likelihood of good glycemic control. Conclusion: A majority of the Yemeni diabetic patients have poor glycemic control. To achieve better awareness, diabetes educational programs that highlight the benefits of self-management are recommended.

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