Profiles of people with type 2 diabetes mellitus

The Extremes of Glycemic Control

Bibliographic Data

ID4589031
AuthorsMargaret R Savoca (Prevention Institute), Carla K Miller (0000-0002-1002-7288, Pennsylvania State University), A Quandt (0000-0002-2968-5459, Wake Forest University), Sara A Quandt
Year2004
Volume58
Issue12
Pages2655-2666
Publication date2004-06-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2003.09.031
PMID15081213
OpenAlexW2025613088
LanguageEN
Citations received7
References cited39

For people with diabetes, hemoglobin A1c (HbA1c) is a measure of blood glucose control and an indication of the risk of developing diabetes complications. However, a given HbA1c value does not provide information about the diabetes self-management practices or philosophies of individuals in poor (HbA1c > 8.0%) or excellent (HbA1c < 6.5%) control. To contrast the experiences and attitudes of people at the extremes of glycemic control, interviews were conducted among 44 individuals (40-65 years old) diagnosed with diabetes for over 1 year. The participants were identified based upon their HbA1c value from a larger sample of people with type 2 diabetes that included African Americans, women, and persons with low income. Narratives were analyzed using a case-based and conceptually clustered matrix approach. The life course concept (life histories and natural transitions in roles and responsibilities across the life span) and the explanatory model of illness (individuals' beliefs about the causes, consequences, and treatment of a disease) provided the framework for the interview guide and the analysis of the narratives. Two self-management philosophy groups emerged from participants with excellent control (Committed [n = 15] and Tentative [ n = 7]) and three groups were identified among the poorly controlled group (Hopeful [n = 8], Hassled [n = 6 ], and Overwhelmed [n = 8]). Perseverance, coping skills, and age at diagnosis were life course concepts that distinguished participants within these groups. From the explanatory model of illness, beliefs about the cause of the disease, physical changes, and accepting the consequence of the disease influenced differences in these self-management philosophies. The profiles of people at the extremes of glycemic control can help those treating people with diabetes or seeking to improve self-management interventions understand differences in self-management philosophies and concentrate on specific issues hindering self-care control

Coping (psychology · Diabetes mellitus · Disease · Glycemic · Narrative · Chronic Disease Management Strategies · Clinical Psychology · Diabetes Management and Education · Diabetes Management and Research · Medicine · Psychology · Gerontology · Internal Medicine