Effects of personality on metabolic control in IDDM patients

Effect of individualized diabetes education for type 2 diabetes mellitus: a single-center randomized clinical trial

BACKGROUND

To evaluate the effect of individualized education for patients with type 2 diabetes mellitus (T2DM).

METHODS

A total of 280 patients (158 males, mean age 63 ± 10 years) with T2DM were randomly divided into study and control group. Eysenck Personality questionnaire was used to assess the personality of the patients in the study group, which was provided us one-on-one counseling and individualized management plan. Group education was provided to the control group.

RESULTS

At the end of the study, the body mass index (21.5±2.5 vs 23.6±1.6 kg/m², P =0.002), waist circumference (83.7±6.4 vs 85.7±7.7 cm, P =0.03), fasting blood glucose (6.0±0.8 vs 6.9±2.1 mmol/L, P =0.004), HbA1c (6.2±0.6% vs 6.9±3.1%, P =0.03), systolic blood pressure (130.1±8.8 vs 135.1±8.4 mmHg, P =0.003),triglyceride (1.21±0.66 vs 1.46±0.58 mmol/L) and low-density lipoprotein (2.36±0.44 vs 2.84±0.64 mmol/L, P =0.03) in the study group was lower than in the control group.

CONCLUSION

Individualized diabetes education is more effective than group education in facilitating the control of type 2 diabetes.

The consequences of anxious temperament for disease detection, self-management behavior, and quality of life in Type 2 diabetes mellitus

OBJECTIVE

The purpose of this study is to examine the consequences of anxious temperament for disease detection, self-management behavior, and quality of life in Type 2 diabetes mellitus (T2DM).

METHOD

A sample of 204 individuals newly diagnosed with T2DM completed measures of anxious temperament, self-management behavior, and quality of life; participants also supplied a blood sample for glycated hemoglobin (A1C) analysis at initial diagnosis (baseline) and at 6-month follow-up (as indicators of disease progression at diagnosis and achieved glycemic control, respectively).

RESULTS

Anxious temperament was inversely associated with A1C at both baseline and at 6-month follow-up. However, the association between anxious temperament and A1C at follow-up was mostly accounted for by the association between anxious temperament and baseline A1C and not by the uptake of self-management behaviors after diagnosis. Higher levels of anxious temperament were also associated with an increased likelihood of having been diagnosed with a prediabetic condition but were associated with poorer quality of life at both time points.

CONCLUSION

Anxious temperament appears to be a double-edged sword that may facilitate early detection but not subsequent behavioral or emotional adjustment to T2DM.

Anxious temperament and disease progression at diagnosis: the case of type 2 diabetes

OBJECTIVE

To examine the association between anxious temperament and disease progression at diagnosis for individuals with Type 2 diabetes mellitus (T2DM).

METHODS

A sample of 204 individuals, newly diagnosed with T2DM, completed the Behavioral Inhibition and Activation Scales (BIS/BAS) and provided an A1C reading. Regression analyses were used to predict A1C levels from individual differences in BIS and BAS.

RESULTS

Individual differences in BIS were inversely related to A1C at diagnosis in the sample as a whole, and this association remained strong after controlling for demographic variables and body mass index. Most importantly, temperamentally anxious individuals had low A1C levels at diagnosis in all age groups, in contrast to their nonanxious counterparts who showed increasing A1C at diagnosis as a function of decreasing age. BAS scores were unrelated to A1C.

CONCLUSIONS

Although older age is generally associated with lower disease progression at diagnosis, high BIS individuals show uniformly lower disease progression across all age groups. High levels of temperamental anxiety may facilitate early diagnosis of T2DM, particularly among younger individuals who are not subject to routine screening.

Coping with type 2 diabetes: do race and gender matter?

OBJECTIVE

The aim of this study was to identify the coping methods of adults with type 2 diabetes, explore whether patient race (African-American vs. white, non-Latino) and gender (female vs. male) influenced coping style, and then analyze the relationship between coping and self-assessed diabetic control (self-management success).

RESEARCH DESIGN AND METHODS

From an exploratory research design using a mixed-methodological approach, in-depth interviews were conducted with 34 interviewees--9 black females, 5 black males, 15 white females, and 5 white males--living in a large mid-South city. Interviews were audio-taped, transcribed, then unitized and codified for analysis.

RESULTS

Interviewees reported 136 strategies, collapsed into 40 distinct coping methods. Race and gender differences first were observed in the frequency distributions of methods. Whites reported significantly more problem-focused methods than African-Americans. Males reported, overall, fewer methods, less emotion-focused, yet more problem-focused methods than females. Interviewees reporting emotion-focused methods were less likely to report problem-focused methods. Emotion-focused coping was associated with poorer self-assessed diabetic control; problem-focused coping was associated with better control.

CONCLUSIONS

Findings suggest that adults with type 2 diabetes use a variety of coping methods, with their basic coping styles influenced by race and gender. This study also demonstrated the usefulness of the problem/emotion-focused dichotomy as a coping method classification system and how these basic styles correlate with interviewees' diabetic control. Lastly, findings emphasize the complexity and importance of psychosocial coping in diabetes and the need for greater attention by clinicians and researchers.

Gender differences in the psychological adjustment to type 1 diabetes mellitus: an explorative study

This study examined gender differences in (1) the psychological adjustment to diabetes and (2) the relation between psychological adjustment and metabolic control in patients with type 1 diabetes. The 280 adult patients attending the outpatient diabetes clinic completed psychological self-rating questionnaires evaluating coping, depression, marital satisfaction, cognitive and emotional adjustment to diabetes. Glycaemic control was measured with HbA(1c)-values. This study revealed that men used significantly more active coping, less avoiding, less social support seeking and less depressive coping. Despite these differences, glycaemic control was not significantly better in men than in women. Women reported more depressive symptomatology than men did and more women were depressed. Significant gender differences were also found in psychological adjustment to diabetes. The psychological factors negatively related with the psychological adjustment to diabetes in men and women are depressive coping and depressive symptomatology.

Sexual dysfunction in women with type 1 diabetes: a controlled study

OBJECTIVE

This study aimed to 1) examine the prevalence of sexual problems in women with type 1 diabetes, 2) compare this prevalence rate with that of an age-matched control group, 3) study the influence of diabetes-related somatic factors on female sexuality, and 4) study the influence of psychological variables on the sexual functioning of both groups.

RESEARCH DESIGN AND METHODS

A total of 120 women with diabetes visiting the outpatient diabetes clinic completed questionnaires evaluating psychological adjustment to diabetes, marital satisfaction, depression, and sexual functioning. Medical records were used to obtain data on HbA(1c), use of medication, BMI, and early-onset microvascular complications. An age-matched control group of 180 healthy women attending an outpatient gynecological clinic for preventive routine gynecological assessment also completed the non-diabetes-related questionnaires.

RESULTS

More women with diabetes than control subjects reported sexual dysfunction (27 vs. 15%; P = 0.04), but a significant difference was found only for decreased lubrication. No association was found between sexual dysfunction and age, BMI, duration of diabetes, HbA(1c), use of medication, menopausal status, or complications. Women with more complications, however, reported significantly more sexual dysfunctions, and the presence of complications altered treatment satisfaction. Both diabetic and control women with sexual dysfunction mentioned lower overall quality of the marital relation and more depressive symptoms than their respective counterparts without sexual problems. Depression was a significant predictor for sexual dysfunction in both women with diabetes and control subjects.

CONCLUSIONS

Sexual problems are frequent in women with diabetes. They affect the overall quality of life and deserve more attention in clinical practice and research.

Factors influencing preference of insulin regimen in people with type 1 (insulin-dependent) diabetes

The two commonest insulin regimens in current use in the UK are twice daily administration of short- and intermediate-acting insulins in combination, and soluble insulin before meals with intermediate-acting insulin at bed-time (basal-bolus regimen). A cross-sectional sample of patients with type 1 diabetes was studied using either a twice daily insulin regimen (n = 30) or a basal-bolus regimen (n = 30), to assess their satisfaction with choice of insulin regimen and to examine the relationships between type of insulin regimen, personality, demographic variables and glycaemic control. Patients treated with a basal-bolus insulin regimen tended to be younger (P = 0.07), had an earlier onset of type 1 diabetes (P = 0.04), adjusted their dose of insulin more frequently (P = 0.01), had received more secondary and further education (P = 0.03), belonged to a higher socio-economic class, tended to be unmarried (P = 0.07) and were less likely to be smokers (P = 0.03), than the group treated with twice daily administration of insulin. Current and previous glycaemic control assessed by glycated haemoglobin concentration, showed no correlation with type of insulin regimen, demographic data or personality variables.