Biobehavioral determinants of glycemic control in type 2 diabetes: A systematic review and meta-analysis

Brown, Sharon A.; García, Alexandra; Brown, Adama; Becker, Betsy Jane; Conn, Vicki S.; Ramı́rez, Gilbert; Winter, Mary A.; Sumlin, Lisa L.; Garcia, Alexandra A.; Cuevas, Heather

doi:10.1016/j.pec.2016.03.020

Cited by 94 publications

(77 citation statements)

References 23 publications

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“…Based on the common ground hypothesis, several biological mechanisms have been associated with poor diabetes outcomes in people with diabetes and depression [31][32][33][34][35][36][37]. This hypothesis assumes that diabetes and depression have common denominators, including genetic factors, overactivation of the innate immune system or dysregulation of the HPA axis.…”

Section: Mechanisms Linking Depression and Diabetesmentioning

confidence: 99%

How 25 years of psychosocial research has contributed to a better understanding of the links between depression and diabetes

et al. 2020

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This narrative review of the literature provides a summary and discussion of 25 years of research into the complex links between depression and diabetes. Systematic reviews have shown that depression occurs more frequently in people with type 1 or type 2 diabetes compared with people without diabetes. Currently, it remains unclear whether depression is also more common in people with impaired glucose metabolism or undiagnosed type 2 diabetes compared with people without diabetes. More prospective epidemiological research into the course of depression and an exploration of mechanisms in individuals with diabetes are needed. Depression in diabetes is associated with less optimal self‐care behaviours, suboptimal glycaemic control, impaired quality of life, incident micro‐ and macrovascular diseases, and elevated mortality rates. Randomized controlled trails concluded that depression in diabetes can be treated with antidepressant medication, cognitive–behavioural therapy (individual, group‐based or web‐based), mindfulness‐based cognitive therapy and stepped care. Although big strides forward have been made in the past 25 years, scientific evidence about depression in diabetes remains incomplete. Future studies should investigate mechanisms that link both conditions and test new diabetes‐specific web‐ or app‐based interventions for depression in diabetes. It is important to determine whether treatment or prevention of depression prevents future diabetes complications and lowers mortality rates.

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Section: Mechanisms Linking Depression and Diabetesmentioning

confidence: 99%

How 25 years of psychosocial research has contributed to a better understanding of the links between depression and diabetes

et al. 2020

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“…Latinos with diabetes have lower levels of glycemic control than non-Hispanic Whites (11) and they are twice as likely to be hospitalized for diabetes related complications (12). Compared to their non-Latino White counterparts with diabetes, they also have higher rates of emotional distress (13,14) and although data vary by sampling strategy and the specific sub-ethnicity under investigation, Latinos as a group have been shown to have lower levels of the diabetes self-care behaviors (15,16) that are powerful determinants of glucose control (17). …”

Section: Introductionmentioning

confidence: 99%

Mean Levels and Variability in Affect, Diabetes Self-Care Behaviors, and Continuously Monitored Glucose: A Daily Study of Latinos With Type 2 Diabetes

Wagner¹,

Armeli

Tennen

et al. 2017

Psychosom Med

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Objective This study investigated between-person and within-person associations among mean levels and variability in affect, diabetes self-care behaviors, and continuously monitored glucose in Latinos with type 2 diabetes. Methods Fifty participants (mean age=57.8 [SD=11.7] years, 74% women, mean A1c=8.3% [SD=1.5%]) wore a “blinded” continuous glucose monitor for 7 days, and they responded to twice-daily automated phone surveys regarding positive affect (PA), negative affect (NA) and self-care behaviors. Results Higher mean levels of NA were associated with higher mean glucose (r=.30), greater % hyperglycemia (r = .34) and greater % out of range glucose (r = .34). Higher NA variability was also related to higher mean glucose (r = .34), greater % hyperglycemia (r = .44) and greater % out-of-range glucose (r = .43). Higher PA variability was related to lower % hypoglycemia (r = −.33). Higher mean levels of self-care behaviors were related to lower glucose variability (r = −.35). Finally, higher self-care behavior variability was related to greater % hyperglycemia (r =.31) and greater % out-of-range glucose (r =−.28). In multilevel regression models, within-person increases from mean levels of self-care were associated with lower mean levels of glucose (b = −7.4, 95% CI: −12.8 to -1.9), lower % hyperglycemia (b = −.04, 95% CI: −.07 to −.01), and higher % hypoglycemia (b = .02, 95% CI: .01 to .03) in the subsequent 10-hour period. Conclusions Near-to-real time sampling documented associations of glucose with affect and diabetes self-care that are not detectable with traditional measures.

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“…For comparison, oral medications are expected to improve HbA 1c by ~11 mmol/mol (1.0%) . A recent systematic review of the behavioural determinants of good glycaemic control found that dietary adherence was the most important determinate (the other behavioural factors included were adherence to physical activity, medications, glucose self‐monitoring and appointment keeping).…”

Section: What Can Diet and Physical Activity Achieve?mentioning

confidence: 99%

James Lind Alliance research priorities: should diet and exercise be used as an alternative to drugs for the management of type 2 diabetes or alongside them?

England

2020

Diabet. Med.

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Aim To review evidence on whether diet and exercise should be used as an alternative to drug therapy for the management of type 2 diabetes or alongside. Method We present a narrative review that draws on evidence from other systematic reviews and meta‐analyses, narrative reviews, trials and cohort studies. We focused mainly on glycaemic control rather than control of blood pressure or cholesterol. Results Good‐quality dietary advice that results in weight loss of >5% and physical activity interventions of >150 min/week of moderate to vigorous physical activity, combined with resistance exercise, can produce improvements in HbA1c similar to those produced by the addition of glucose‐lowering drugs. These improvements can be seen at all stages of the disease. There are recognized interactions between glucose‐lowering drugs and physical activity which may not be synergistic, but these are not well understood, and it is not clear if they are considered in clinical practice. Studies that explicitly compare drugs with diet or physical activity or control for drug use found that lifestyle could delay or reduce medication use, but most people eventually needed to progress to drug treatment. There are few studies, however, that provide strategies for the long‐term maintenance of weight loss or physical activity. Conclusion Diet and physical activity are of key importance in type 2 diabetes management, and attention to them improves glycaemic control and cardiovascular disease risk, but it is not yet known whether maintained lifestyle changes provide an alternative to drug therapy in the long term.

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Biobehavioral determinants of glycemic control in type 2 diabetes: A systematic review and meta-analysis

Cited by 94 publications

References 23 publications

How 25 years of psychosocial research has contributed to a better understanding of the links between depression and diabetes

How 25 years of psychosocial research has contributed to a better understanding of the links between depression and diabetes

Mean Levels and Variability in Affect, Diabetes Self-Care Behaviors, and Continuously Monitored Glucose: A Daily Study of Latinos With Type 2 Diabetes

James Lind Alliance research priorities: should diet and exercise be used as an alternative to drugs for the management of type 2 diabetes or alongside them?

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