Patient age: A neglected factor when considering disease management in adults with type 2 diabetes

PATIENT EDUCATION AND COUNSELING

卷:85

Article

Hessler, Danielle M.¹  Fisher, Lawrence¹  Mullan, Joseph T.²  Glasgow, Russell E.³  Masharani, Umesh⁴ 

[1] Univ Calif San Francisco, Dept Family & Community Med, San Francisco, CA 94143 USA

[2] Univ Calif San Francisco, Dept Social & Behav Sci, Sch Nursing, San Francisco, CA 94143 USA

[3] Kaiser Permanente, Inst Hlth Res, Denver, CO USA

[4] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA

关键词: Age;    Type 2 diabetes;    HbA1c;    Psychosocial stressors;   

DOI  :  10.1016/j.pec.2010.10.030

来源: Elsevier

【 摘 要 】

Objective: The average age at diagnosis for type 2 diabetes is decreasing. However, because age is most often controlled for in clinical research, little is known regarding how adult age is associated with diabetes disease-related variables. Methods: In a community based study with type 2 diabetes patients (N = 506), after adjusting for potentially confounding variables, we examined associations between patients' age and: stress, depression, diabetes-related distress, self-efficacy, diet, exercise, and glycemic control. We then explored to what extent age interacts with these variables in their association with glycemic control. Results: Younger age was independently associated with: greater chronic stress and negative life events, higher levels of diabetes-related distress, higher depressed affect, eating healthier foods and exercising less frequently, lower diabetes self-efficacy, and higher HbA1c. Interactions showed that younger patients with high stress and/or low self-efficacy were more likely to have higher HbA1c levels than older patients. Conclusions: Results suggest younger adult patients with type 2 diabetes represent a unique patient subgroup with specific needs and health risks based on their developmental stage and life context. Practice implications: Treatment programs need to target younger adult patients and may need to utilize different Media or modalities (e.g., social media) to reach this group. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

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