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- Aghili, Rokhsareh, et al.
(författare)
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Psychosocial factors and glycemic control in insulin-naïve and insulin-experienced people with type 2 diabetes : a path analysis model
- 2018
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Ingår i: International Journal of Diabetes in Developing Countries. - : Springer Science and Business Media LLC. - 0973-3930 .- 1998-3832. ; 38:3, s. 289-297
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 2. |
- Aghili, Rokhsareh, et al.
(författare)
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The challenge of living with diabetes in women and younger adults : A structural equation model
- 2017
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Ingår i: Primary Care Diabetes. - : Elsevier BV. - 1751-9918. ; 11:5, s. 467-473
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Tidskriftsartikel (refereegranskat)abstract
- Background: Attitudes toward diabetes care are different between genders and age-groups. Furthermore, diabetes related challenges may cause psychosocial problems. Therefore, we were to compare the psychosocial status and glycemic control in women and men with type 2 diabetes (T2D) in different age-groups. Methods: 441 adults with T2D were recruited. Demographic, self-care behavior, resources and affective variables as well as the health related quality of life (HRQoL) were measured. The median age of 55 was used as the cut-off for the age comparison. Structured equation modeling (SEM) investigated the relationship between age, gender, psychosocial factors and glycemic control. Results: Finally, 203 women and 177 men completed the study (86.1%). There was no significant difference in mean duration of T2D, or glycemic control between genders or age-groups. Women, especially those below the median age of 55, had significantly higher level of diabetes-related distress (2.16. ±. 0.94 vs. 1.92. ±. 0.81), depression (9.67. ±. 5.37 vs. 7.54. ±. 5.06), and anxiety (19.81. ±. 12.04 vs. 12.81. ±. 9.04, P. <. 0.05 for all comparisons), while people above the age of 55 reported better self-management and patient-physician relationship. HRQoL was lower in women compared to men (0.77. ±. 0.23 vs. 0.81. ±. 0.18, P = 0.02). The final SEM suggested that the effect (standardized β coefficient) of gender and age on affective variables was 0.25 and -0.19 (P. <. 0.05), respectively, though psychosocial factors did not directly influence HbA1c. Conclusions: This study shows that psychosocial factors are associated with age and gender in patients with T2D; with younger women demonstrating higher level of depressive symptoms, anxiety, and diabetes-related distress independent of status of glycemic control.
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