Psychosocial and Biological Factors Associated with Glycemic Control for Patients with Type 2 Diabetes: An Application of Structural Equation Modeling Analysis

The purpose of this study is to identify the psychosocial and biologic factors associated with the effectiveness of glycemic control in a type 2 diabetes management program. The study group was comprised of 285 patients with type 2 diabetes mellitus who were enrolled for 12 months in the National Diabetes Pay-by-Quality Program. Structural equation modeling analysis was employed to determine the importance of various parameters to the effectiveness of glycemic control. The results showed that effectiveness of glycemic control was significantly associated with gender, number of complications, locus of control, stages of change and previous status of lycemic control. The final model proved to be valid (χ^2=32.18, df=29, p=.31), showing a sound fit (AGFI=0.96 and RMSEA=0.018). The model explained 49% of the variance of metabolic control at glycemic control. The findings obtained in this study offer an insight into the complexity of patient behavior in diabetes management. Health system specialists must understand the dilemmas of type 2 diabetic patients and their clinicians well as the limitations to successful treatments before expending substantial resources on disease management.