Association of HbA1c with emotion regulation, intolerance of uncertainty, and purpose in life in type 2 diabetes mellitus
The extant literature lacks breadth on psychological variables associated with health outcome for type 2 diabetes mellitus (T2DM). This investigation extends the scope of psychological information by reporting on previously unpublished factors. To investigate if intolerance of uncertainty, emotion r...
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| Published in | Primary care diabetes Vol. 7; no. 3; pp. 213 - 221 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Elsevier Ltd
01.10.2013
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1751-9918 1878-0210 1878-0210 |
| DOI | 10.1016/j.pcd.2013.04.006 |
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| Abstract | The extant literature lacks breadth on psychological variables associated with health outcome for type 2 diabetes mellitus (T2DM). This investigation extends the scope of psychological information by reporting on previously unpublished factors.
To investigate if intolerance of uncertainty, emotion regulation, or purpose in life differentiate T2DM adults with sustained high HbA1c (HH) vs. sustained acceptable HbA1c (AH).
Cross-sectional observational study. Adult patients with diagnosed T2DM meeting inclusionary criteria for AH, HH, or a nondiabetic reference group (NDR) were randomly selected and invited to participate. Patients who consented and participated resulted in a final sample of 312 subgrouped as follows: HH (n=108); AH (n=98); and NDR (n=106). Data sources included a survey, self-report questionnaires, and electronic medical record (EMR).
HH individuals with T2DM reported lower purpose in life satisfaction (p=0.005) compared to the NDR group. The effect size for this finding is in the small-to-medium range using Cohen's guidelines for estimating clinical relevance. The HH–AH comparison on purpose in life was nonsignificant. The emotion regulation and intolerance of uncertainty comparisons across the three groups were not significant.
The present study determined that lower purpose in life satisfaction is associated with higher HbA1c. In a T2DM patient with sustained high HbA1c, the primary care clinician is encouraged to consider screening for purpose in life satisfaction by asking a single question such as “Do the things you do in your life seem important and worthwhile?” The patient's response will assist the clinician in determining if meaning or purpose in life distress may be interferring with diabetes self-care. If this is the case, the clinician can shift the conversation to the value of behavioral and emotional health counseling. |
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| AbstractList | The extant literature lacks breadth on psychological variables associated with health outcome for type 2 diabetes mellitus (T2DM). This investigation extends the scope of psychological information by reporting on previously unpublished factors.
To investigate if intolerance of uncertainty, emotion regulation, or purpose in life differentiate T2DM adults with sustained high HbA(1c) (HH) vs. sustained acceptable HbA(1c) (AH).
Cross-sectional observational study. Adult patients with diagnosed T2DM meeting inclusionary criteria for AH, HH, or a nondiabetic reference group (NDR) were randomly selected and invited to participate. Patients who consented and participated resulted in a final sample of 312 subgrouped as follows: HH (n = 108); AH (n = 98); and NDR (n = 106). Data sources included a survey, self-report questionnaires, and electronic medical record (EMR).
HH individuals with T2DM reported lower purpose in life satisfaction (p = 0.005) compared to the NDR group. The effect size for this finding is in the small-to-medium range using Cohen's guidelines for estimating clinical relevance. The HH-AH comparison on purpose in life was nonsignificant. The emotion regulation and intolerance of uncertainty comparisons across the three groups were not significant.
The present study determined that lower purpose in life satisfaction is associated with higher HbA(1c). In a T2DM patient with sustained high HbA(1c), the primary care clinician is encouraged to consider screening for purpose in life satisfaction by asking a single question such as "Do the things you do in your life seem important and worthwhile?" The patient's response will assist the clinician in determining if meaning or purpose in life distress may be interferring with diabetes self-care. If this is the case, the clinician can shift the conversation to the value of behavioral and emotional health counseling. The extant literature lacks breadth on psychological variables associated with health outcome for type 2 diabetes mellitus (T2DM). This investigation extends the scope of psychological information by reporting on previously unpublished factors. To investigate if intolerance of uncertainty, emotion regulation, or purpose in life differentiate T2DM adults with sustained high HbA1c (HH) vs. sustained acceptable HbA1c (AH). Cross-sectional observational study. Adult patients with diagnosed T2DM meeting inclusionary criteria for AH, HH, or a nondiabetic reference group (NDR) were randomly selected and invited to participate. Patients who consented and participated resulted in a final sample of 312 subgrouped as follows: HH (n=108); AH (n=98); and NDR (n=106). Data sources included a survey, self-report questionnaires, and electronic medical record (EMR). HH individuals with T2DM reported lower purpose in life satisfaction (p=0.005) compared to the NDR group. The effect size for this finding is in the small-to-medium range using Cohen's guidelines for estimating clinical relevance. The HH–AH comparison on purpose in life was nonsignificant. The emotion regulation and intolerance of uncertainty comparisons across the three groups were not significant. The present study determined that lower purpose in life satisfaction is associated with higher HbA1c. In a T2DM patient with sustained high HbA1c, the primary care clinician is encouraged to consider screening for purpose in life satisfaction by asking a single question such as “Do the things you do in your life seem important and worthwhile?” The patient's response will assist the clinician in determining if meaning or purpose in life distress may be interferring with diabetes self-care. If this is the case, the clinician can shift the conversation to the value of behavioral and emotional health counseling. The extant literature lacks breadth on psychological variables associated with health outcome for type 2 diabetes mellitus (T2DM). This investigation extends the scope of psychological information by reporting on previously unpublished factors.BACKGROUNDThe extant literature lacks breadth on psychological variables associated with health outcome for type 2 diabetes mellitus (T2DM). This investigation extends the scope of psychological information by reporting on previously unpublished factors.To investigate if intolerance of uncertainty, emotion regulation, or purpose in life differentiate T2DM adults with sustained high HbA(1c) (HH) vs. sustained acceptable HbA(1c) (AH).OBJECTIVETo investigate if intolerance of uncertainty, emotion regulation, or purpose in life differentiate T2DM adults with sustained high HbA(1c) (HH) vs. sustained acceptable HbA(1c) (AH).Cross-sectional observational study. Adult patients with diagnosed T2DM meeting inclusionary criteria for AH, HH, or a nondiabetic reference group (NDR) were randomly selected and invited to participate. Patients who consented and participated resulted in a final sample of 312 subgrouped as follows: HH (n = 108); AH (n = 98); and NDR (n = 106). Data sources included a survey, self-report questionnaires, and electronic medical record (EMR).SUBJECTS AND METHODSCross-sectional observational study. Adult patients with diagnosed T2DM meeting inclusionary criteria for AH, HH, or a nondiabetic reference group (NDR) were randomly selected and invited to participate. Patients who consented and participated resulted in a final sample of 312 subgrouped as follows: HH (n = 108); AH (n = 98); and NDR (n = 106). Data sources included a survey, self-report questionnaires, and electronic medical record (EMR).HH individuals with T2DM reported lower purpose in life satisfaction (p = 0.005) compared to the NDR group. The effect size for this finding is in the small-to-medium range using Cohen's guidelines for estimating clinical relevance. The HH-AH comparison on purpose in life was nonsignificant. The emotion regulation and intolerance of uncertainty comparisons across the three groups were not significant.RESULTSHH individuals with T2DM reported lower purpose in life satisfaction (p = 0.005) compared to the NDR group. The effect size for this finding is in the small-to-medium range using Cohen's guidelines for estimating clinical relevance. The HH-AH comparison on purpose in life was nonsignificant. The emotion regulation and intolerance of uncertainty comparisons across the three groups were not significant.The present study determined that lower purpose in life satisfaction is associated with higher HbA(1c). In a T2DM patient with sustained high HbA(1c), the primary care clinician is encouraged to consider screening for purpose in life satisfaction by asking a single question such as "Do the things you do in your life seem important and worthwhile?" The patient's response will assist the clinician in determining if meaning or purpose in life distress may be interferring with diabetes self-care. If this is the case, the clinician can shift the conversation to the value of behavioral and emotional health counseling.CONCLUSIONSThe present study determined that lower purpose in life satisfaction is associated with higher HbA(1c). In a T2DM patient with sustained high HbA(1c), the primary care clinician is encouraged to consider screening for purpose in life satisfaction by asking a single question such as "Do the things you do in your life seem important and worthwhile?" The patient's response will assist the clinician in determining if meaning or purpose in life distress may be interferring with diabetes self-care. If this is the case, the clinician can shift the conversation to the value of behavioral and emotional health counseling. BACKGROUND: The extant literature lacks breadth on psychological variables associated with health outcome for type 2 diabetes mellitus (T2DM). This investigation extends the scope of psychological information by reporting on previously unpublished factors. OBJECTIVE: To investigate if intolerance of uncertainty, emotion regulation, or purpose in life differentiate T2DM adults with sustained high HbA₁c (HH) vs. sustained acceptable HbA₁c (AH). SUBJECTS AND METHODS: Cross-sectional observational study. Adult patients with diagnosed T2DM meeting inclusionary criteria for AH, HH, or a nondiabetic reference group (NDR) were randomly selected and invited to participate. Patients who consented and participated resulted in a final sample of 312 subgrouped as follows: HH (n=108); AH (n=98); and NDR (n=106). Data sources included a survey, self-report questionnaires, and electronic medical record (EMR). RESULTS: HH individuals with T2DM reported lower purpose in life satisfaction (p=0.005) compared to the NDR group. The effect size for this finding is in the small-to-medium range using Cohen's guidelines for estimating clinical relevance. The HH–AH comparison on purpose in life was nonsignificant. The emotion regulation and intolerance of uncertainty comparisons across the three groups were not significant. CONCLUSIONS: The present study determined that lower purpose in life satisfaction is associated with higher HbA₁c. In a T2DM patient with sustained high HbA₁c, the primary care clinician is encouraged to consider screening for purpose in life satisfaction by asking a single question such as “Do the things you do in your life seem important and worthwhile?” The patient's response will assist the clinician in determining if meaning or purpose in life distress may be interferring with diabetes self-care. If this is the case, the clinician can shift the conversation to the value of behavioral and emotional health counseling. Abstract Background The extant literature lacks breadth on psychological variables associated with health outcome for type 2 diabetes mellitus (T2DM). This investigation extends the scope of psychological information by reporting on previously unpublished factors. Objective To investigate if intolerance of uncertainty, emotion regulation, or purpose in life differentiate T2DM adults with sustained high HbA1c (HH) vs. sustained acceptable HbA1c (AH). Subjects and methods Cross-sectional observational study. Adult patients with diagnosed T2DM meeting inclusionary criteria for AH, HH, or a nondiabetic reference group (NDR) were randomly selected and invited to participate. Patients who consented and participated resulted in a final sample of 312 subgrouped as follows: HH ( n = 108); AH ( n = 98); and NDR ( n = 106). Data sources included a survey, self-report questionnaires, and electronic medical record (EMR). Results HH individuals with T2DM reported lower purpose in life satisfaction ( p = 0.005) compared to the NDR group. The effect size for this finding is in the small-to-medium range using Cohen's guidelines for estimating clinical relevance. The HH–AH comparison on purpose in life was nonsignificant. The emotion regulation and intolerance of uncertainty comparisons across the three groups were not significant. Conclusions The present study determined that lower purpose in life satisfaction is associated with higher HbA1c . In a T2DM patient with sustained high HbA1c , the primary care clinician is encouraged to consider screening for purpose in life satisfaction by asking a single question such as “Do the things you do in your life seem important and worthwhile?” The patient's response will assist the clinician in determining if meaning or purpose in life distress may be interferring with diabetes self-care. If this is the case, the clinician can shift the conversation to the value of behavioral and emotional health counseling. |
| Author | Cha, Stephen S. Agerter, David C. Rasmussen, Norman H. Smith, Steven A. Bernard, Matthew E. Maxson, Julie A. Shah, Nilay D. |
| Author_xml | – sequence: 1 givenname: Norman H. surname: Rasmussen fullname: Rasmussen, Norman H. email: rasmussen.norman@mayo.edu organization: Department of Psychiatry and Psychology, Division of Integrated Behavioral Healthcare, Mayo Clinic, Rochester, MN, USA – sequence: 2 givenname: Steven A. surname: Smith fullname: Smith, Steven A. organization: Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA – sequence: 3 givenname: Julie A. surname: Maxson fullname: Maxson, Julie A. organization: Department of Family Medicine, Mayo Clinic, Rochester, MN, USA – sequence: 4 givenname: Matthew E. surname: Bernard fullname: Bernard, Matthew E. organization: Department of Family Medicine, Mayo Clinic, Rochester, MN, USA – sequence: 5 givenname: Stephen S. surname: Cha fullname: Cha, Stephen S. organization: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA – sequence: 6 givenname: David C. surname: Agerter fullname: Agerter, David C. organization: Department of Family Medicine, Mayo Clinic, Rochester, MN, USA – sequence: 7 givenname: Nilay D. surname: Shah fullname: Shah, Nilay D. organization: Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/23685023$$D View this record in MEDLINE/PubMed |
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| Copyright | 2013 Primary Care Diabetes Europe Primary Care Diabetes Europe Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved. |
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| Keywords | HH IUS-12 AH CCI Purpose in life satisfaction PHQ-9 Emotion regulation Primary care T2DMM ICD-9 Intolerance of uncertainty LET DERS NDR HbA1c International Classification of Diseases, ninth edition difficulties in emotion regulation scale life engagement test type 2 diabetes mellitus nondiabetic reference group high A 1c Charlson comorbidity index acceptable A1c HbA 1c intolerance of uncertainty scale, short form patient health questionnaire–depression scale HbA(1c) high A(1c) |
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| Snippet | The extant literature lacks breadth on psychological variables associated with health outcome for type 2 diabetes mellitus (T2DM). This investigation extends... Abstract Background The extant literature lacks breadth on psychological variables associated with health outcome for type 2 diabetes mellitus (T2DM). This... BACKGROUND: The extant literature lacks breadth on psychological variables associated with health outcome for type 2 diabetes mellitus (T2DM). This... |
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| SubjectTerms | adults Aged Biomarkers - blood Case-Control Studies Cost of Illness counseling Cross-Sectional Studies Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - psychology distress Electronic Health Records Emotion regulation Emotions Endocrinology & Metabolism Female Glycated Hemoglobin A - metabolism guidelines HbA1c Humans Internal Medicine Intolerance of uncertainty Male Mental Health Middle Aged noninsulin-dependent diabetes mellitus observational studies patients Personal Satisfaction Primary care Primary Health Care Purpose in life satisfaction Quality of Life questionnaires screening Self Report surveys Uncertainty |
| Title | Association of HbA1c with emotion regulation, intolerance of uncertainty, and purpose in life in type 2 diabetes mellitus |
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