Profiles of people with type 2 diabetes mellitus: the extremes of glycemic control

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Carla K. Miller (Creator)
Margaret R. Savoca, Assistant Professor (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:

Abstract: For people with diabetes, hemoglobin A1c (HbA1c) is a measure of blood glucose control and an indication of the risk of developing diabetes complications. However, a given HbA1c value does not provide information about the diabetes self-management practices or philosophies of individuals in poor (HbA1c >8.0%) or excellent (HbA1c<6.5%) control. To contrast the experiences and attitudes of people at the extremes of glycemic control, interviews were conducted among 44 individuals (40–65 years old) diagnosed with diabetes for over 1 year. The participants were identified based upon their HbA1c value from a larger sample of people with type 2 diabetes that included African Americans, women, and persons with low income. Narratives were analyzed using a case-based and conceptually clustered matrix approach. The life course concept (life histories and natural transitions in roles and responsibilities across the life span) and the explanatory model of illness (individuals‘ beliefs about the causes, consequences, and treatment of a disease) provided the framework for the interview guide and the analysis of the narratives. Two self-management philosophy groups emerged from participants with excellent control (Committed [n=15] and Tentative [n=7]) and three groups were identified among the poorly controlled group (Hopeful [n=8], Hassled [n=6], and Overwhelmed [n=8]). Perseverance, coping skills, and age at diagnosis were life course concepts that distinguished participants within these groups. From the explanatory model of illness, beliefs about the cause of the disease, physical changes, and accepting the consequence of the disease influenced differences in these self-management philosophies. The profiles of people at the extremes of glycemic control can help those treating people with diabetes or seeking to improve self-management interventions understand differences in self-management philosophies and concentrate on specific issues hindering self-care control.

Additional Information

Soc Sci & Med 2004;58(12): 2655-2666
Language: English
Date: 2004
Type 2 diabetes mellitus, Diabetes, Self-management, Health education, African American, USA

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