Effects of depression, diabetes distress, diabetes self-efficacy, and diabetes self-management on glycemic control among Chinese population with type 2 diabetes mellitus

Aim To examine the direct and indirect effects of depression, diabetes distress, diabetes self-efficacy and diabetes self-management on glycemic control among a group of T2DM patients in China. Method A convenience sample of 254 participants were selected from three outpatient departments in Beijing, China. They were surveyed using a self-administered questionnaire. Diabetes-related information was retrieved from their medical records. Descriptive statistics, independent student t tests, Chi-square tests, correlation analyses and Generalized Structural Equation Modeling were used. Results Only 91 (35.82%) participants achieved optimal glycemic control of HbA1c < 7.0% (53 mmol/mol). Only diabetes self-management had a direct effect on glycemic control (OR = 0.95, P < 0.001). Depression and diabetes distress had only indirect effects on glycemic control through both diabetes self-efficacy and diabetes self-management. Diabetes self-efficacy only had an indirect effect on glycemic control through diabetes self-management. Conclusions Glycemic control among Chinese population with T2DM was suboptimal. Future interventions should focus on decreasing depressive symptoms and diabetes distress levels, and, therefore, improve diabetes self-efficacy and self-management practices and, ultimately, reach the optimal goal of glycemic control. © 2017 Elsevier B.V.