Relationship and influences of behavioral and psychological factors on metabolic control of patients with type 2 diabetes mellitus

Abstract

Background/Aim. Achieving good metabolic control, which play a key role in reducing or preventing macrovascular and microvascular complication of diabetes, requires continuous patient involvement in self-management of diabetes. This continued engagement, which makes type 2 diabetes (T2DM) one of most demanding diseases, physically and emotionally, can become, at certain periods of life, too severe and lead to emotional distress (symptoms of depression and diabetes-related distress) and deterioration of metabolic control. The aim of this study was to examine association and influence of behavioral and psychological factors on the metabolic control of patients with T2DM. Methods. The research was conducted as a descriptive-analytic cross-sectional study. The method of random sampling included 324 subjects with T2DM in research. The values of biochemical parameters of metabolic control were measured by standard laboratory methods. Blood pressure was measured in two times and the arithmetic mean was calculated. Anthropometric measurement were performed and Body Mass Index (BMI) was calculated. Attitudes toward medication adherence, adherence to dietary recommendations, level of physical activity, presence of depressive symptoms and level of diabetes-related distress were examined using standardized questionnaires. Results. The target values of metabolic control parameters were reached by 21.6% of respondents. Multivariate analysis as predictors of poor metabolic control identified: obesity, non-adherence toward dietary recommendations, insulin therapy, low level of physical activity and clinically significant diabetes-related distress. Conclusions. Routine application of the questionnaire used in this study in initial stages or critical moments of disease can assess patient?s attitudes and knowledge about behavioral determinants of diabetes self-management and timely detect psychological conditions that affect them. It would be realistic to expect that such a comprehensive holistic approach would contribute to lower incidence of complication and better metabolic control of T2DM.