Preferences, beliefs and self-management of diabetes

People with diabetes who feel they have better control over life events are more likely to take good care of themselves and to believe they have the condition under control, but these factors do not translate to improved blood sugar levels, according to a new study of 1,034 adults.

Participants' responses to survey items on their risk tolerance, concern about their future and beliefs about their longevity had no correlation to clinical measures of their hemoglobin A1c levels, which reflect average blood glucose (or blood sugar) during the previous two to three months.

The study, which appears online in the journal Health Services Research , also found no differences by race or Hispanic ethnicity in how people took charge of their self-care.

People are not always adherent in managing their diabetes care, which affects overall health and the risk of diabetic complications, said lead study author Frank Sloan, Ph.D.

"What we are able to do here is bring some new measures to bear," said Sloan, a professor of health policy and management at the Center for Health Policy at Duke University.

Some people believe that whatever they do, they have no control over their diabetes; others are very tolerant of the risks of diabetes; and, some have a philosophy that they will live for today and not care about the future, Sloan said. "One result that comes through is that people who have self-control over life in general are more likely to adhere," he said.

"This area of study is valuable as we attempt to better understand the relationship between how people from all ethnic and cultural backgrounds perceive their destinies with diabetes," said Sue McLaughlin, a registered dietitian and president of health care and education with the American Diabetes Association.

"This study illustrates the insidious nature of hyperglycemia: it is a silent and deadly killer," added Miller, who had no affiliation with the study. Many people with diabetes assume they are in good health because they do not feel bad, she said.

Health Services Research is the official journal of the AcademyHealth and is published by John Wiley & Sons, Inc. on behalf of the Health Research and Educational Trust. For information, contact Jennifer Shaw, HSR Business Manager at (312) 422-2646 or [email protected]. HSR is available online at www.blackwell-synergy.com/loi/hesr.

Sloan FA, Padrón NA, Platt AC. Preferences, beliefs and self-management of diabetes. Health Services Research online, 2009.