TY - JOUR
T1 - Factors predicting glycemic control in middle-aged and older adults with type 2 diabetes
AU - Chiu, Ching Ju
AU - Wray, Linda A.
N1 - Funding Information:
This research was supported by a level 2 grant from the Social Science Research Institute at The Pennsylvania State University for “Marriage and Diabetes Management in Middle-Aged and Older Couples” (L. A. Wray, principal investigator) and National Institute of Diabetes and Digestive and Kidney Diseases grant no. DK078894-01
Funding Information:
This research was supported by a level 2 grant from the Social Science Research Institute at The Pennsylvania State University for "Marriage and Diabetes Management in Middle-Aged and Older Couples" (L. A. Wray, principal investigator) and National Institute of Diabetes and Digestive and Kidney Diseases grant no. DK078894-01 (L. A. Wray, principal investigator). We also acknowledge the valuable comments provided by Warner K. Schaie and Jeffrey B. Halter on a symposium presentation of this study at the 60th Annual Meeting of the Gerontological Society of America, San Diego, California, November 2007.
PY - 2010
Y1 - 2010
N2 - Introduction: Few studies have prospectively assessed the explanatory effects of demographics, clinical conditions, treatment modality, and general lifestyle behaviors on glycemic control in large heterogeneous samples of middle-aged and older adults with type 2 diabetes. We hierarchically examined these factors, focused especially on the effects of modifiable factors (ie, general lifestyle behaviors), and compared predictive patterns between middle-aged and older adults. Methods: We used nationally representative data from the 1998 and 2000 Health and Retirement Study (HRS) and the HRS 2003 Diabetes Study. We analyzed data from 379 middle-aged adults (aged 51-64 y) and 430 older adults (aged ≥65 y) who self-reported having type 2 diabetes at baseline. Results: Among middle-aged adults, demographic factors and clinical conditions were the strongest predictors of hemoglobin A1c (HbA1c) levels. However, among older adults, treatment modality (diet only, oral medication, or insulin only or in combination with other regimens) significantly affected HbA1c levels. Lifestyle (physical activity, smoking, drinking, and body weight control), independent of the effects of demographics, clinical conditions, and treatment modality, significantly affected HbA1c levels. An increase of 1 healthy behavior was associated with a decrease in HbA1c levels of more than 1 percentage point. Conclusion Our findings provide support for current diabetes guidelines that recommend a lifestyle regimen across the entire span of diabetes care and highlight the need to help both sociodemographically and clinically disadvantaged middle-aged adults with type 2 diabetes as well as older adults who exhibit poor adherence to medication recommendations to achieve better glycemic control.
AB - Introduction: Few studies have prospectively assessed the explanatory effects of demographics, clinical conditions, treatment modality, and general lifestyle behaviors on glycemic control in large heterogeneous samples of middle-aged and older adults with type 2 diabetes. We hierarchically examined these factors, focused especially on the effects of modifiable factors (ie, general lifestyle behaviors), and compared predictive patterns between middle-aged and older adults. Methods: We used nationally representative data from the 1998 and 2000 Health and Retirement Study (HRS) and the HRS 2003 Diabetes Study. We analyzed data from 379 middle-aged adults (aged 51-64 y) and 430 older adults (aged ≥65 y) who self-reported having type 2 diabetes at baseline. Results: Among middle-aged adults, demographic factors and clinical conditions were the strongest predictors of hemoglobin A1c (HbA1c) levels. However, among older adults, treatment modality (diet only, oral medication, or insulin only or in combination with other regimens) significantly affected HbA1c levels. Lifestyle (physical activity, smoking, drinking, and body weight control), independent of the effects of demographics, clinical conditions, and treatment modality, significantly affected HbA1c levels. An increase of 1 healthy behavior was associated with a decrease in HbA1c levels of more than 1 percentage point. Conclusion Our findings provide support for current diabetes guidelines that recommend a lifestyle regimen across the entire span of diabetes care and highlight the need to help both sociodemographically and clinically disadvantaged middle-aged adults with type 2 diabetes as well as older adults who exhibit poor adherence to medication recommendations to achieve better glycemic control.
UR - http://www.scopus.com/inward/record.url?scp=77949324254&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77949324254&partnerID=8YFLogxK
M3 - Article
C2 - 20040223
AN - SCOPUS:77949324254
SN - 1545-1151
VL - 7
JO - Preventing Chronic Disease
JF - Preventing Chronic Disease
IS - 1
M1 - A08
ER -
