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Psychosocial factors and glycemic control in insulin-naïve and insulin-experienced people with type 2 diabetes : a path analysis model
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- Aghili, Rokhsareh (author)
- Iran University of Medical Sciences
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- Ridderstråle, Martin (author)
- Lund University,Lunds universitet,Genomik, diabetes och endokrinologi,Forskargrupper vid Lunds universitet,Genomics, Diabetes and Endocrinology,Lund University Research Groups
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- Farshchi, Amir (author)
- Iran University of Medical Sciences
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- (creator_code:org_t)
- 2017-11-25
- 2018
- English 9 s.
- In: International Journal of Diabetes in Developing Countries. - : Springer Science and Business Media LLC. - 0973-3930 .- 1998-3832. ; 38:3, s. 289-297
- Journal article (peer-reviewed)
Abstract
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- The purpose of this study was to compare the status of psychosocial factors and glycemic control in insulin-naïve and insulin-experienced people with type 2 diabetes (T2D). In this observational study on people with T2D, demographic, self-care behavior, resources, and affective variables as well as health-related quality of life were assessed and compared in insulin-naïve and insulin-experienced considering the number of oral glucose-lowering drugs (OGLDs). Measured variable path analysis was used to test the association among variables and their effect on HbA1c in both groups. In total, 215 insulin-naïve and 165 insulin-experienced patients were recruited in this study. The mean duration of diabetes was 11.7 ± 7.0 years in insulin-experienced and 6.8 ± 5.4 years in insulin-naïve (p < 0.001). The mean hemoglobin A1c (HbA1c) was significantly higher in insulin-experienced subjects irrespective of the number of OGLDs [68 ± 20 mmol/mol (8.4 ± 1.8%) vs. 56 ± 16 mmol/mol (7.3 ± 1.4%); p < 0.001]. Moreover, insulin-experienced subjects had significantly higher level of diabetes-related distress (2.2 ± 0.9 vs. 1.9 ± 0.8), depression (9.5 ± 5.5 vs. 8.1 ± 5.1), anxiety (18.3 ± 12.0 vs. 15.1 ± 10.5), and lower knowledge of insulin use considering the results of 9-item insulin-use subscale of Michigan diabetes knowledge test (mean 3.9 ± 1.8) compared to insulin-naïve subjects (p < 0.05). Higher levels of distress, depression, and anxiety are found in insulin-experienced people with T2D. Therefore, one should be aware that, at the time of insulin need/initiation, people with T2D have reached a more vulnerable state and this should be taken into consideration when implementing a complex insulin initiation plan.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Keyword
- Diabetes, type 2
- Glycemic control
- Psychosocial
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- art (subject category)
- ref (subject category)
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