Factors Related to Perceived Diabetes Control Are Not Related to Actual Glucose Control for Minority Patients With Diabetes

Abstract

OBJECTIVETo examine variables associated with perceived diabetes control compared with an objective measure of glucose control (A1C).RESEARCH DESIGN AND METHODSBeliefs about diabetes were assessed among 334 individuals with diabetes living in a primarily low-income, minority, urban neighborhood. Regression analyses tested associations between disease beliefs and both participants' perceptions of control and actual control (A1C).RESULTSPoorer perceived diabetes control was associated with perceiving a greater impact of diabetes, greater depressive symptoms, not following a diabetic diet, A1C, and a trend toward less exercise. Variables associated with better actual control (A1C) included higher BMI, older age, and not using insulin.CONCLUSIONSPatients' perceptions of their diabetes control are informed by subjective diabetes cues (e.g., perceived impact of diabetes and adherence to a diabetic diet), which are not related to A1C. Clinicians should take into account what cues patients are using to assess their diabetes control.

Influence of dietary therapy appraisal on future perceived control of type 2 diabetes

“…Rather, we found that HbA1C was associated with dietary appraisal. These results are consistent with the conclusion reached by McAndrew et al (2010), who stated that perceived control is not always congruent with actual glucose control in minority patients with diabetes in the United States. This indicates the importance of differentiating between dietary appraisal and perceived control when dealing with mutually close constructs of control.…”

“…In this study none of the possible confounders reported in previous research (De Ridder et al, 2007;Hampson et al, 1990;Lange and Piette, 2006;Lawson et al, 2007;McAndrew et al, 2010;Skinner and Hampson, 1998;Skinner et al, 2000) were associated with perceived control. Rather, we found that HbA1C was associated with dietary appraisal.…”

“…Objective measures such as HbA1C should be included in this process, because perceived control is not always congruent with actual glucose control (McAndrew et al, 2010). Interestingly, although the regimen for diabetes also includes exercise and/or medication, dietary selfappraisal was a determinant of the overall control of the illness.…”

“…Second, we mainly focused on two forms of diabetes control. Other clinical measurements in diabetes should also be considered because perceived control is not congruent with actual glucose control (McAndrew et al, 2010). Further studies are needed to determine whether the feedback effect of dietary appraisal on perceived control can foster actual control of the disease, such as dietary behavior and the subsequent biomedical and psychological outcomes.…”

“…To critically test this causal relationship, we used a crosslagged panel model incorporating two waves of data over a one-year period. Empirical investigation suggests that perceived control of the IRs or treatment-effectiveness beliefs of the PMs among patients with type 2 diabetes can be influenced by the patient's age (Hampson et al, 1990), gender (Lawson et al, 2007), educational level (Lange and Piette, 2006;Lawson et al, 2007), glycemic control (McAndrew et al, 2010), social support (Skinner and Hampson, 1998;Skinner et al, 2000), and patient-provider communication (De Ridder et al, 2007). The present study controlled for these possible confounders to correctly estimate the effect of the patients' self-appraisal of their dietary regimen on their overall control beliefs of diabetes.…”