Date Presented 04/03/2025
This study explored how diabetes self-management (DSM) and optimism are associated with HbA1c among people with Type 2 diabetes mellitus with unbalanced HbA1c. Health care use, DSM, and optimism explain better HbA1c. Mind–body–spirit connection was reflected.
Primary Author and Speaker: Orit Segev-Jacubovski
Additional Authors and Speakers: Mansha Mirza, Deena Rozen
BACKGROUND: Diabetes is a challenging condition that brings psychological distress. Diabetes self-management (DSM) lifestyle is essential for achieving balanced glucose levels. DSM includes glucose monitoring, nutrition management, involvement in physical activity, medication management, regular healthcare checkups, emotional coping, educated problem-solving, and risk reduction for unexpected situations. This study explored the association between DSM, optimism, and blood glucose levels (HbA1c) to understand positive psychological resources among people with diabetes.
DESIGN: A prospective, cross-sectional cohort study was conducted with 99 participants (mean age = 65.61 years) with above-recommended glycemic levels (mean HbA1c = 7.98). Participants, received diabetes care at a public clinic in Meuhedet Health Services, Israel.
METHODS: Participants completed the DSMQ and Revised Life Orientation Test to assess optimism. Two hierarchical linear regressions were conducted to explain HbA1c levels.
RESULTS: In the first regression model, age, gender, employment, and support were entered first, followed by healthcare use, and finally optimism. Age significantly explained 4.9% of the variance, and healthcare use explained 22.9%, indicating a strong effect. In the second model, total DSM replaced healthcare use in the second step. Here, age was near significant, explaining 6.6% of the variance, and total DSM explained 4.4%, indicating an improvement in HbA1c. Optimism was significant, adding 3.3% of the variance beyond age and total DSM.
CONCLUSION: Healthcare use, including medication and regular health checkups, was the most essential DSM activity for better HbA1c. Therefore, people with diabetes need both access to care and active engagement with healthcare providers. Innovatively, optimism, though modest, contributes to better HbA1c. This indicates the potential benefit of education on strategies to boost optimism to enhance diabetes outcomes.
References
American Diabetes Association Professional Practice Committee (2024). 1. Improving Care and Promoting Health in Populations: Standards of Care in Diabetes-2024. Diabetes care, 47(Suppl 1), S11–S19. https://doi.org/10.2337/dc24-S001
Schmitt, A., Gahr, A., Hermanns, N., Kulzer, B., Huber, J., & Haak, T. (2013). The Diabetes Self-Management Questionnaire (DSMQ): development and evaluation of an instrument to assess diabetes self-care activities associated with glycaemic control. Health and quality of life outcomes, 11(1), 1–14. https://doi.org/10.1186/1477-7525-11-138
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