Relationship Between Psychosocial Factors and Glucose Control in Adults With Type 2 Diabetes

Despite significant advances in medical therapy and unrestricted access to health care, >50% patients with type 2 diabetes (T2D) cannot maintain their blood glucose target levels. This cross-sectional study investigated the association between psychosocial behaviour and diabetes management in Newfoundland and Labrador, where the prevalence of T2D is the highest in Canada.

Data were collected from 165 adult T2D patients. Four sets of self-administered standardized questionnaires, a study-specific data form and electronic health records were utilized to obtain psychosocial information, patient characteristics and glycated hemoglobin (A1C) levels.

The group of participants with emotional burnout due to diabetes-related stress showed poor glycemic control (89.4%) compared to the group with low stress (55.6%). The group with higher stress appraised T2D negatively (correlation coefficient r=0.719, and p<0.01), and had a tendency to use emotion-oriented coping (r=0.542, p<0.01) and had a poor perception of autonomous supportiveness (r=-0.300, p<0.01). A path model showed that stress, appraisal and coping explained 7.4% of the variance in A1C. Appraisal plays the role of mediator and explained 5.8% of the variance in A1C.

A high prevalence of poor glycemic control was found in participants with a body mass index of ≥35. Participants with higher stress had a negative appraisal of T2D. The highly stressed group tended to use emotion-oriented coping and have a poor perception of autonomous supportiveness.