Effects of perceived competence, negative appraisal, and motivation orientation on glycemic stability in individuals with type 2 diabetes :A prospective cohort study

Aims: HbA1c variability is targeted as a part of clinical risk assessment in type 2 diabetes. Psychological factors such as patient competence, adjustment to diabetes, and motivation, may influence glycemic control. The objective of the present study was to determine if perceived competence, diabetes appraisal, and motivation predicted HbA1c variability, and to examine differences regarding these factors in relation to diabetes duration, in individuals with type 2 diabetes. Methods: Data on perceived competence, appraisal of diabetes, and motivation orientation from 158 individuals with type 2 diabetes were analyzed as potential predictors of HbA1c at five measurement points over a time period of 24 months. Associations between psychological factors and HbA1c variability were examined through multiple linear regression analyses, and differences in psychological measures between groups with different diabetes duration were examined using ANOVA. Results: Negative appraisal of diabetes predicted higher HbA1c variability and was associated with higher baseline HbA1c, and greater perceived competence predicted lower HbA1c variability. Conclusions: The results indicate that lower levels of diabetes distress, as well as confidence in one's ability to manage diabetes, could potentially predict better glycemic control.