Keke Lin1, Chang Park2, Mingzi Li3, Xiudong Wang4, Xiushu Li5, Wei Li6, Laurie Quinn2. 1. College of Nursing, University of Illinois at Chicago, Chicago, IL, USA; School of Nursing, Peking University Health Science Center, Beijing, China. 2. College of Nursing, University of Illinois at Chicago, Chicago, IL, USA. 3. School of Nursing, Peking University Health Science Center, Beijing, China. Electronic address: limingzi@bjmu.edu.cn. 4. Department of Endocrinology, Beijing Jingmei Group General Hospital, Beijing, China. 5. Emergency Room, Peking University People's Hospital, Beijing, China. 6. Department of Endocrinology, Peking University First Hospital, Beijing, China.
Abstract
AIM: To examine the direct and indirect effects of depression, diabetes distress, diabetes self-efficacy and diabetes self-management on glycemic control among a group of T2DM patients in China. METHOD: A convenience sample of 254 participants were selected from three outpatient departments in Beijing, China. They were surveyed using a self-administered questionnaire. Diabetes-related information was retrieved from their medical records. Descriptive statistics, independent student t tests, Chi-square tests, correlation analyses and Generalized Structural Equation Modeling were used. RESULTS: Only 91 (35.82%) participants achieved optimal glycemic control of HbA1c<7.0% (53mmol/mol). Only diabetes self-management had a direct effect on glycemic control (OR=0.95, P<0.001). Depression and diabetes distress had only indirect effects on glycemic control through both diabetes self-efficacy and diabetes self-management. Diabetes self-efficacy only had an indirect effect on glycemic control through diabetes self-management. CONCLUSIONS: Glycemic control among Chinese population with T2DM was suboptimal. Future interventions should focus on decreasing depressive symptoms and diabetes distress levels, and, therefore, improve diabetes self-efficacy and self-management practices and, ultimately, reach the optimal goal of glycemic control.
AIM: To examine the direct and indirect effects of depression, diabetes distress, diabetes self-efficacy and diabetes self-management on glycemic control among a group of T2DM patients in China. METHOD: A convenience sample of 254 participants were selected from three outpatient departments in Beijing, China. They were surveyed using a self-administered questionnaire. Diabetes-related information was retrieved from their medical records. Descriptive statistics, independent student t tests, Chi-square tests, correlation analyses and Generalized Structural Equation Modeling were used. RESULTS: Only 91 (35.82%) participants achieved optimal glycemic control of HbA1c<7.0% (53mmol/mol). Only diabetes self-management had a direct effect on glycemic control (OR=0.95, P<0.001). Depression and diabetes distress had only indirect effects on glycemic control through both diabetes self-efficacy and diabetes self-management. Diabetes self-efficacy only had an indirect effect on glycemic control through diabetes self-management. CONCLUSIONS: Glycemic control among Chinese population with T2DM was suboptimal. Future interventions should focus on decreasing depressive symptoms and diabetes distress levels, and, therefore, improve diabetes self-efficacy and self-management practices and, ultimately, reach the optimal goal of glycemic control.
Authors: Xian-Liang Liu; Karen Willis; Chiung-Jung Jo Wu; Paul Fulbrook; Yan Shi; Maree Johnson Journal: BMJ Open Date: 2019-09-17 Impact factor: 2.692