How Much Do We Know about the Biopsychosocial Predictors of Glycaemic Control? Age and Clinical Factors Predict Glycaemic Control, but Psychological Factors Do Not

Abstract

Objective. Diabetes mellitus is one of the most common noncommunicable diseases in Malaysia. It is associated with significant complications and a high cost of treatment, especially when glycaemic control is poor. Despite its negative impact on health, data is still lacking on the possible biopsychosocial predictors of poor glycaemic control among the diabetic population. This study is aimed at determining the prevalence of poor glycaemic control as well as its association with biopsychosocial factors such as personality traits, psychiatric factors, and quality of life (QOL) among Malaysian patients with diabetes. Methods. A cross-sectional study was conducted at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using outpatient population diabetic patients. Demographic data on social and clinical characteristics were collected from participants. Several questionnaires were administered, including the Beck Depression Inventory-II (BDI-II) to measure depressive symptoms, the Generalized Anxiety Disorder-7 (GAD-7) to assess anxiety symptoms, the Big Five Inventory (BFI) to evaluate personality traits, and the WHO Quality of Life-BREF (WHOQOL-BREF) to assess QOL. Multivariate binary logistic regression was performed to determine the predictors of poor glycaemic control. Results. 300 patients with diabetes mellitus were recruited, with the majority (90%) having type 2 diabetes. In this population, the prevalence of poor glycaemic control (HbA1C≥7.0%) was 69%, with a median HbA1C of 7.6% (IQR=2.7). Longer duration of diabetes mellitus and a greater number of days of missed medications predicted poor glycaemic control, while older age and overall self-perception of QOL protected against poor glycaemic control. No psychological factors were associated with poor glycaemic control. Conclusion. This study emphasizes the importance of considering the various factors that contribute to poor glycaemic control, such as duration of diabetes, medication adherence, age, and QOL. These findings should be used by clinicians, particularly when planning a multidisciplinary approach to the management of diabetes.

Glycemic control and its determinants among patients with type 2 diabetes mellitus at Menelik II Referral Hospital, Ethiopia

“…A study done in Malaysia showed that a longer duration of DM was a predictor of poor glycemic control. 25 The finding is similar to the finding of this study in which inadequate blood sugar control was significantly associated with a longer duration of the disease. The negative relationship between longer duration of DM and blood glucose control may related to the resistance of insulin production over time which resulted from β-cell dysfunction.…”

“…The finding of this study showed that the prevalence of poor blood glucose control was 80.3% which was higher than a study done in Malaysia where the prevalence of poor glycemic control was 69%. 25 The discrepancy in those studies may also be explained by the fact that this study used Fasting Blood Sugar (FBS) for measuring glycemic control, whereas in other studies, they used hemoglobin A1c (HbA1c) test for measuring glycemic control. Furthermore, it may be due to differences in study participants’ social and economic class which may in turn influence access to health care, drug, and balanced nutrition.…”

The relationship between medical comorbidities and health-related quality of life among adults with type 2 diabetes: The experience of different hospitals in southern Bangladesh

“…The average annual expense of treatment and management of patients with diabetes in Bangladesh was estimated to be US$314, with the average direct cost being US$283 and the indirect being US$315 [ 7 ]. Apart from the economic standpoints, the mere existence of diabetes also takes a psychological toll on the individual diagnosed, due to this disease’s chronic manifestations and auxiliary clinical complications [ 8 – 10 ]. The continuous restrictions to food and medications often render a patient’s mind to think these efforts are futile, resulting in poor glycemic control, more complications and poor quality of life [ 11 – 13 ].…”

Identification of Subgroups with Poor Glycemic Control among Patients with Type 2 Diabetes Mellitus: Based on the Korean National Health and Nutrition Examination Survey from KNHANES VII (2016 to 2018)

“…, 젊은 연령 [10,11], 낮은 교육수준 [12], 흡연 [13], 긴 당뇨병 유병기간 [7], 경구용혈당강하제와 인슐린 복합치료인 경우 [9], 혈중지질이 높은 경우 [2], 비만 [7,11], 감소된 신체활동 [8]…”