Nuccitelli C, et al. – The aim of this study was to explore the correlation between disease–related emotional and cognitive aspects and metabolic control in subjects with Type 1 diabetes mellitus. The results validated that patients who fail to reach a satisfactory metabolic control tend to rely on significant others, trusting in the physicians’ skills or on the adequacy of the health–care system. Strategies aimed at increasing self–efficacy and sense of coherence, based on personal ability, are eagerly awaited to help patients improve diabetes care.

Methods

• Clinicians examined health locus of control (HLOC), sense of coherence (SOC), and self-esteem in T1DM subjects applying validated questionnaires.
• In this study, 67 consecutive subjects who did not attain the desired HbA1c target (mean HbA1c, 8.3% [67 mmol/mol]) were compared with 30 cases in satisfactory metabolic control (HbA1c levels <7%–53 mmol/mol).

Results

• They found that SOC was negatively correlated with BMI and average HbA1c, as was the correlation of self-esteem with HbA1c in the overall population.
• They defined subjects attaining the desired metabolic target by higher SOC scores, higher Internal HLOC and prevalent Internal vs. Powerful-others HLOC.
• Furthermore, compared to subjects in good metabolic control, subjects with unsatisfactory control had lower scores of SOC, Internal HLOC and Self-esteem, with no difference in Powerful others, or Chance HLOC.
• In the same group, they observed that SOC in the upper tertile was significantly correlated with self-esteem (OR 1.35; 95% CI 1.08-1.69) and PHLOC (OR 1.24; 95% CI 1.03-1.49), after adjustment for age, sex, educational level, and comorbidities.