Relations of Well-Being, Coping Styles, Perception of Self-Influence on the Diabetes Course and Sociodemographic Characteristics with HbA1c and BMI Among People with Advanced Type 2 Diabetes Mellitus

Abstract

Purpose

Assessment of the relationship between psychological and sociodemographic factors with the levels of glycated hemoglobin (HbA1c) and Body Mass Index (BMI) among people with advanced type 2 diabetes mellitus (T2DM).

Patients and Methods

A total of 2574 persons, among them 1381 (53.7%) women, with type 2 diabetes, during the period of switching from biphasic mixtures of human insulin to insulin analogues. The age of participants ranged from 22 to 94 years (M = 63.5; SD = 9.58), and their treatment period was in the time frame from 2 years to 43 years (M = 10.2; SD = 6.1). Participants filled out a Scale for Perception of Self-Influence on the Diabetes Course, Well-Being Index WHO-5, two questions from the Brief Method of Evaluating Coping with a Disease.

Results

Statistically significant correlations were found between the HbA1c levels and (1) disease duration (r_s=0.067; p < 0.001); (2) number of complications (r_s = 0.191, p < 0.001) (3) the perception of self-influence on the diabetes course (r_s=- 0.16; p < 0.001); (4) well-being (risk of depression) (r_s=- 0.10; p < 0.001). The regression analysis showed that 7% of HbA1c variability is explained by age, a perception of self-influence on the diabetes course, the number of complications, place of residence, education, BMI. The most important findings concerning BMI were found in regression analysis, which indicated a week relationship between BMI and a number of complications, perception of self-influence on the diabetes course and coping styles (3% of the resultes' variability). The group at high risk of depression had the highest levels of HbA1c.

Conclusion

Sociodemographic and psychological factors show weak but statistically significant relationships with the current levels of HbA1c and BMI.

Keywords:

• type 2 diabetes mellitus
• glycemic control
• psychosocial factors
• HbA1C
• BMI
• depression

Ethical Approval

The study was conducted in accordance with the Declaration of Helsinki. The study was approved by Bioethics Committee of Medical University of Warsaw.

Acknowledgments

The research uses some data from a database of the study “Psychosocial factors related to adherence to the recommendations of therapy with two-phase insulin analogues”.²² The study was carried out by the Foundation for the Development of Psychiatry and Psychotherapy in Warsaw, which was the sponsor of the project within the meaning of the GCP and approved by the Bioethics Committee of the Medical University of Warsaw. The paper is based on the data previously analysed by Agnieszka Łukasiewicz, M.D. in her PhD thesis “Relations of psychological and sociodemographic factors with general characteristics of the diabetes course: current – level of glycated hemoglobin and Body Mass Index and longterm – number of complications“, prepared under supervision of Łukasz Gawęda, and defended at the II Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland, in 2019.

Disclosure

Andrzej Kokoszka, applied for the research grant from Novo Nordisk, Poland for the Foundation for the Development of Psychiatry and Psychotherapy in Warsaw. He received honorarium as the principal investigator of study “Psychosocial factors related to adherence to the recommendations of therapy with two-phase insulin analogues”.

Novo Nordisk Poland sponsored participation of Andrzej Kokoszka in a meeting of Psychosocial Aspects of Diabetes (PSAD) Study Group. PSAD Study Group is an official Study Group of the European Association for the Study of Diabetes (EASD).