Research

Relation between psychosocial variables and the glycemic control of patients with type 2 diabetes: A cross-sectional and prospective study

Takehiro Nozaki¹ , Chihiro Morita^1,2 , Sunao Matsubayashi³ , Koich Ishido¹ , Hiroaki Yokoyama^1,2 , Keisuke Kawai¹ , Masahiro Matsumoto² , Masato Takii¹ and Chiharu Kubo¹

¹  Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan

²  Kitakyushu Municipal Medical Center, Kitakyushu, Japan

³  Fukuoka Tokushukai Hospital, Fukuoka, Japan

author email corresponding author email

BioPsychoSocial Medicine 2009, 3:4doi:10.1186/1751-0759-3-4

Published:	19 March 2009

Abstract

Background

This cross-sectional and prospective study used a variety of psychological inventories to evaluate the relationship between psychosocial factors and the glycemic control of patients with type 2 diabetes.

Methods

Participants were 304 patients with type 2 diabetes who were treated as outpatients at diabetes clinics. All participants were assessed for HbA_1c and completed the following self-report psychological inventories: 1) Diabetes Treatment Satisfaction Questionnaire (DTSQ), 2) Problem Areas in Diabetes Survey (PAID), 3) Well-being Questionnaire 12 (W-BQ12), 4) Self-Esteem Scale (SES), 5) Social Support Scale, and 6) Self-Efficacy Scale. HbA_1c was again measured one year later. The relationships between the psychosocial variables obtained by analysis of the psychological inventories and baseline or one-year follow-up HbA_1c were determined.

Results

Baseline HbA_1cwas significantly correlated with age, diet treatment regimen, number of microvascular complication of diabetes, and the total scores of DTSQ, W-BQ12, PAID, SES and the Self-Efficacy Scale. Hierarchical stepwise multiple regression revealed that significant predictors of baseline HbA_1c were total DTSQ and PAID scores, along with age, diet treatment regimen, and number of microvascular complication of diabetes after adjustment for demographic, clinical and other psychosocial variables. Two hundred and ninety patients (95.4% of 304) were followed and assessed one year after baseline. Hierarchical stepwise multiple regression analysis showed the significant predictors of follow-up HbA_1c to be total DTSQ and PAID scores, along with age and diet treatment regimen. However, the correlation between baseline and follow-up HbA_1c was so high that the only other variable to retain significance was diet treatment regimen once baseline HbA_1c was included in the regression of follow-up HbA_1c.

Conclusion

The DTSQ and the PAID predicted both current and future HbA_1c to a similar and significant degree in patients with type 2 diabetes.