Doyle M Cummings1, Lesley D Lutes2, Kerry Littlewood3, Chelsey Solar4, Bertha Hambidge1, Peggy Gatlin1. 1. Departments of Family Medicine and Public Health and Center for Health Disparities, East Carolina University, Greenville, NC. 2. Department of Psychology, University of British Columbia, Canada. 3. School of Social Work, University of South Florida, Tampa, FL. 4. Department of Psychology, East Carolina University, Greenville, NC.
Abstract
OBJECTIVE: Symptoms of emotional distress related to diabetes have been associated with inadequate self-care behaviors, medication non-adherence, and poor glycemic control that may predispose patients to premature death. African American women, in whom diabetes is more common and social support is often insufficient, may be at particularly high risk. The objective of this study was to examine the impact of lowering diabetes-related emotional distress on glycemic control and associated behavioral correlates in rural African American women with uncontrolled type 2 diabetes (T2D). DESIGN: Post-hoc analysis of prospective, randomized, controlled trial. SETTING:Rural communities in the southeastern United States. PATIENTS: 129 rural middle-aged African American women with uncontrolled type 2 diabetes (T2D)(A1C ≥ 7.0). PRIMARY INDEPENDENT VARIABLE: Diabetes-related distress. MAIN OUTCOME MEASURES: Changes from baseline to 12-month follow-up in diabetes-related distress, and associated changes in medication adherence, self-care activities, self-efficacy, and glycemic control (A1C). RESULTS:Patients with a reduction in diabetes-related distress (n=79) had significantly greater improvement in A1C, medication adherence, self-care activities, and self-efficacy compared with those in whom diabetes distress worsened or was unchanged (n=50). Changes in distress were also significantly and inversely correlated with improvements in medication adherence, self-care activities, and self-efficacy. CONCLUSIONS: Among rural African American women, reductions in diabetes-related distress may be associated with lower A1C and improvements in self-efficacy, self-care behaviors, and medication adherence.
RCT Entities:
OBJECTIVE: Symptoms of emotional distress related to diabetes have been associated with inadequate self-care behaviors, medication non-adherence, and poor glycemic control that may predispose patients to premature death. African American women, in whom diabetes is more common and social support is often insufficient, may be at particularly high risk. The objective of this study was to examine the impact of lowering diabetes-related emotional distress on glycemic control and associated behavioral correlates in rural African American women with uncontrolled type 2 diabetes (T2D). DESIGN: Post-hoc analysis of prospective, randomized, controlled trial. SETTING: Rural communities in the southeastern United States. PATIENTS: 129 rural middle-aged African American women with uncontrolled type 2 diabetes (T2D)(A1C ≥ 7.0). PRIMARY INDEPENDENT VARIABLE: Diabetes-related distress. MAIN OUTCOME MEASURES: Changes from baseline to 12-month follow-up in diabetes-related distress, and associated changes in medication adherence, self-care activities, self-efficacy, and glycemic control (A1C). RESULTS:Patients with a reduction in diabetes-related distress (n=79) had significantly greater improvement in A1C, medication adherence, self-care activities, and self-efficacy compared with those in whom diabetes distress worsened or was unchanged (n=50). Changes in distress were also significantly and inversely correlated with improvements in medication adherence, self-care activities, and self-efficacy. CONCLUSIONS: Among rural African American women, reductions in diabetes-related distress may be associated with lower A1C and improvements in self-efficacy, self-care behaviors, and medication adherence.
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