The influence of diabetes psychosocial attributes and self-management practices on change in diabetes status

TitleThe influence of diabetes psychosocial attributes and self-management practices on change in diabetes status
Publication TypeJournal Article
Year of Publication2012
AuthorsZulman, DM, Rosland, A-M, Choi, H, Langa, KM, Heisler, M
JournalPatient Educ Couns
KeywordsHealth Conditions and Status, Healthcare

OBJECTIVE: To examine the influence of diabetes psychosocial attributes and self-management on glycemic control and diabetes status change. METHODS: Using data from the Health and Retirement Study, a nationally representative longitudinal study of U.S. adults 51 years, we examined cross-sectional relationships among diabetes psychosocial attributes (self-efficacy, risk awareness, care understanding, prioritization of diabetes, and emotional distress), self-management ratings, and glycemic control. We then explored whether self-management ratings and psychosocial attributes in 2003 predicted change in diabetes status in 2004. RESULTS: In multivariate analyses (N=1834), all diabetes psychosocial attributes were associated with self-management ratings, with self-efficacy and diabetes distress having the strongest relationships (adj coeff=8.1, p 0.01 and -4.1, p 0.01, respectively). Lower self-management ratings in 2003 were associated cross-sectionally with higher hemoglobin A1C (adj coeff=0.16, p 0.01), and with perceived worsening diabetes status in 2004 (adj OR=1.36, p 0.05), with much of this latter relationship explained by diabetes distress. CONCLUSION: Psychosocial attributes, most notably diabetes-related emotional distress, contribute to difficulty with diabetes self-management, poor glycemic control, and worsening diabetes status over time. PRACTICE IMPLICATIONS: Self-management and adherence interventions should target psychosocial attributes such as disease-related emotional distress.


Zulman, Donna M Rosland, Ann-Marie Choi, Hwajung Langa, Kenneth M Heisler, Michele U01 AG09740/AG/NIA NIH HHS/ Ireland Patient Educ Couns. 2012 Apr;87(1):74-80. Epub 2011 Aug 15.

Endnote Keywords

Diabetes/glycemic control/glycemic control/psycho-social/self-management

Endnote ID


Citation Key7718
PubMed ID21840149
PubMed Central IDPMC3229832