Patient factors and glycaemic control - associations and explanatory power
Diabet. Med. 29, e382–e389 (2012) Aims To investigate the association between glycaemic control and patient socio‐demographics, activation level, diabetes‐related distress, assessment of care, knowledge of target HbA1c, and self‐management behaviours, and to determine to what extent these factors e...
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| Veröffentlicht in: | Diabetic medicine 2012-10, Vol.29 (10), p.e382-e389 |
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| container_title | Diabetic medicine |
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| creator | Rogvi, S. Tapager, I. Almdal, T. P. Schiøtz, M. L. Willaing, I. |
| description | Diabet. Med. 29, e382–e389 (2012)
Aims To investigate the association between glycaemic control and patient socio‐demographics, activation level, diabetes‐related distress, assessment of care, knowledge of target HbA1c, and self‐management behaviours, and to determine to what extent these factors explain the variance in HbA1c in a large Danish population of patients with Type 2 diabetes.
Methods Cross‐sectional survey and record review of 2045 patients from a specialist diabetes clinic. Validated scales measured patient activation, self‐management behaviours, diabetes‐related emotional distress, and perceived care. The electronic patient record provided information about HbA1c, medication, body mass index, and duration of diabetes. Data were analysed using multiple linear regression models with stepwise addition of covariates.
Results The response rate was 54% (n = 1081). Good glycaemic control was significantly associated with older age, higher education, higher patient activation, lower diabetes‐related emotional distress, better diet and exercise behaviours, lower body mass index, shorter duration of disease and knowledge of HbA1c targets (P |
| doi_str_mv | 10.1111/j.1464-5491.2012.03703.x |
| format | Article |
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Aims To investigate the association between glycaemic control and patient socio‐demographics, activation level, diabetes‐related distress, assessment of care, knowledge of target HbA1c, and self‐management behaviours, and to determine to what extent these factors explain the variance in HbA1c in a large Danish population of patients with Type 2 diabetes.
Methods Cross‐sectional survey and record review of 2045 patients from a specialist diabetes clinic. Validated scales measured patient activation, self‐management behaviours, diabetes‐related emotional distress, and perceived care. The electronic patient record provided information about HbA1c, medication, body mass index, and duration of diabetes. Data were analysed using multiple linear regression models with stepwise addition of covariates.
Results The response rate was 54% (n = 1081). Good glycaemic control was significantly associated with older age, higher education, higher patient activation, lower diabetes‐related emotional distress, better diet and exercise behaviours, lower body mass index, shorter duration of disease and knowledge of HbA1c targets (P < 0.05 for all). Patient socio‐demographics, behaviour; perceptions of care and diabetes distress accounted for 14% of the total variance in HbA1c levels (P = 0.0134), but the variance explained was higher for respondents treated with medications other than insulin.
Conclusions Our study emphasizes the complex relationships between patient activation, distress and behaviour, specific treatment modalities and glycaemic control. Knowledge of treatment goals, achieving patient activation in coping with diabetes, and lowering disease‐related emotional stress are important patient education goals. However, the large unexplained component of HbA1c variance highlights the need for more research to understand the mechanisms of glycaemic control.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/j.1464-5491.2012.03703.x</identifier><identifier>PMID: 22540962</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adaptation, Psychological ; Adult ; Aged ; Aged, 80 and over ; Anxiety - epidemiology ; Body Mass Index ; Cross-Sectional Studies ; Denmark - epidemiology ; Depression - epidemiology ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - epidemiology ; Female ; Glycated Hemoglobin A - metabolism ; Health Knowledge, Attitudes, Practice ; Humans ; Linear Models ; Male ; Middle Aged ; Risk Factors ; Self Care ; Young Adult</subject><ispartof>Diabetic medicine, 2012-10, Vol.29 (10), p.e382-e389</ispartof><rights>2012 The Authors. Diabetic Medicine © 2012 Diabetes UK</rights><rights>2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4073-42456e4fac6f56b6022237f4f989f752b04e6cf9416d00bde8a65d163dc277343</citedby><cites>FETCH-LOGICAL-c4073-42456e4fac6f56b6022237f4f989f752b04e6cf9416d00bde8a65d163dc277343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1464-5491.2012.03703.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1464-5491.2012.03703.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22540962$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rogvi, S.</creatorcontrib><creatorcontrib>Tapager, I.</creatorcontrib><creatorcontrib>Almdal, T. P.</creatorcontrib><creatorcontrib>Schiøtz, M. L.</creatorcontrib><creatorcontrib>Willaing, I.</creatorcontrib><title>Patient factors and glycaemic control - associations and explanatory power</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>Diabet. Med. 29, e382–e389 (2012)
Aims To investigate the association between glycaemic control and patient socio‐demographics, activation level, diabetes‐related distress, assessment of care, knowledge of target HbA1c, and self‐management behaviours, and to determine to what extent these factors explain the variance in HbA1c in a large Danish population of patients with Type 2 diabetes.
Methods Cross‐sectional survey and record review of 2045 patients from a specialist diabetes clinic. Validated scales measured patient activation, self‐management behaviours, diabetes‐related emotional distress, and perceived care. The electronic patient record provided information about HbA1c, medication, body mass index, and duration of diabetes. Data were analysed using multiple linear regression models with stepwise addition of covariates.
Results The response rate was 54% (n = 1081). Good glycaemic control was significantly associated with older age, higher education, higher patient activation, lower diabetes‐related emotional distress, better diet and exercise behaviours, lower body mass index, shorter duration of disease and knowledge of HbA1c targets (P < 0.05 for all). Patient socio‐demographics, behaviour; perceptions of care and diabetes distress accounted for 14% of the total variance in HbA1c levels (P = 0.0134), but the variance explained was higher for respondents treated with medications other than insulin.
Conclusions Our study emphasizes the complex relationships between patient activation, distress and behaviour, specific treatment modalities and glycaemic control. Knowledge of treatment goals, achieving patient activation in coping with diabetes, and lowering disease‐related emotional stress are important patient education goals. However, the large unexplained component of HbA1c variance highlights the need for more research to understand the mechanisms of glycaemic control.</description><subject>Adaptation, Psychological</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anxiety - epidemiology</subject><subject>Body Mass Index</subject><subject>Cross-Sectional Studies</subject><subject>Denmark - epidemiology</subject><subject>Depression - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Female</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Humans</subject><subject>Linear Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Risk Factors</subject><subject>Self Care</subject><subject>Young Adult</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1PwyAYgInRuDn9C6ZHL618sx48mDmnxq9kGo-EUWo6uzKhy9p_L7VzZ7lAwvPwkgeACMEEhXW5TBDlNGY0RQmGCCeQCEiS5gAM9xeHYAgFxTGBAg3AifdLGMiUpMdggDGjMOV4CB5eVV2Yqo5ypWvrfKSqLPosW63MqtCRtlXtbBnFkfLe6iLAtuoh06xLVakgtdHabo07BUe5Kr052-0j8H47fZvcxY8vs_vJ9WOsKRQkppgybmiYx3PGFxxijInIaZ6O01wwvIDUcJ2nFPEMwkVmxoqzDHGSaSwEoWQELvp3185-b4yv5arw2pThN8ZuvESQIoIZYjyg4x7VznrvTC7Xrlgp1wZIdiXlUnbBZBdMdiXlb0nZBPV8N2WzWJlsL_6lC8BVD2yL0rT_fljePE27U_Dj3i98bZq9r9yX5IIIJj-eZ1LA-ZxRksoJ-QEc1Y_Q</recordid><startdate>201210</startdate><enddate>201210</enddate><creator>Rogvi, S.</creator><creator>Tapager, I.</creator><creator>Almdal, T. P.</creator><creator>Schiøtz, M. L.</creator><creator>Willaing, I.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201210</creationdate><title>Patient factors and glycaemic control - associations and explanatory power</title><author>Rogvi, S. ; Tapager, I. ; Almdal, T. P. ; Schiøtz, M. L. ; Willaing, I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4073-42456e4fac6f56b6022237f4f989f752b04e6cf9416d00bde8a65d163dc277343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adaptation, Psychological</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anxiety - epidemiology</topic><topic>Body Mass Index</topic><topic>Cross-Sectional Studies</topic><topic>Denmark - epidemiology</topic><topic>Depression - epidemiology</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Female</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Humans</topic><topic>Linear Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Risk Factors</topic><topic>Self Care</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rogvi, S.</creatorcontrib><creatorcontrib>Tapager, I.</creatorcontrib><creatorcontrib>Almdal, T. P.</creatorcontrib><creatorcontrib>Schiøtz, M. L.</creatorcontrib><creatorcontrib>Willaing, I.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rogvi, S.</au><au>Tapager, I.</au><au>Almdal, T. P.</au><au>Schiøtz, M. L.</au><au>Willaing, I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient factors and glycaemic control - associations and explanatory power</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2012-10</date><risdate>2012</risdate><volume>29</volume><issue>10</issue><spage>e382</spage><epage>e389</epage><pages>e382-e389</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><abstract>Diabet. Med. 29, e382–e389 (2012)
Aims To investigate the association between glycaemic control and patient socio‐demographics, activation level, diabetes‐related distress, assessment of care, knowledge of target HbA1c, and self‐management behaviours, and to determine to what extent these factors explain the variance in HbA1c in a large Danish population of patients with Type 2 diabetes.
Methods Cross‐sectional survey and record review of 2045 patients from a specialist diabetes clinic. Validated scales measured patient activation, self‐management behaviours, diabetes‐related emotional distress, and perceived care. The electronic patient record provided information about HbA1c, medication, body mass index, and duration of diabetes. Data were analysed using multiple linear regression models with stepwise addition of covariates.
Results The response rate was 54% (n = 1081). Good glycaemic control was significantly associated with older age, higher education, higher patient activation, lower diabetes‐related emotional distress, better diet and exercise behaviours, lower body mass index, shorter duration of disease and knowledge of HbA1c targets (P < 0.05 for all). Patient socio‐demographics, behaviour; perceptions of care and diabetes distress accounted for 14% of the total variance in HbA1c levels (P = 0.0134), but the variance explained was higher for respondents treated with medications other than insulin.
Conclusions Our study emphasizes the complex relationships between patient activation, distress and behaviour, specific treatment modalities and glycaemic control. Knowledge of treatment goals, achieving patient activation in coping with diabetes, and lowering disease‐related emotional stress are important patient education goals. However, the large unexplained component of HbA1c variance highlights the need for more research to understand the mechanisms of glycaemic control.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>22540962</pmid><doi>10.1111/j.1464-5491.2012.03703.x</doi><tpages>8</tpages></addata></record> |
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| subjects | Adaptation, Psychological Adult Aged Aged, 80 and over Anxiety - epidemiology Body Mass Index Cross-Sectional Studies Denmark - epidemiology Depression - epidemiology Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - epidemiology Female Glycated Hemoglobin A - metabolism Health Knowledge, Attitudes, Practice Humans Linear Models Male Middle Aged Risk Factors Self Care Young Adult |
| title | Patient factors and glycaemic control - associations and explanatory power |
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