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Coping skills and glycaemic control: the mediating role of diabetes distress

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Abstract

Aims

The present study examined the mediating role of diabetes distress on the relationship between coping and glycaemic control, and evaluated if the afore-mentioned mediation was moderated by insulin treatment in people with type 2 diabetes.

Methods

A total of 473 adults with type 2 diabetes were recruited from an outpatient clinic in Hong Kong and invited to take part in a survey that measured adaptive coping, maladaptive coping, and diabetes stress. Glycaemic control was measured by glycated haemoglobin values extracted from medical records. PROCESS v3.4 macro was used to test the moderated mediation model.

Results

Adaptive coping was negatively associated with diabetes distress (−0.29, 95% CI: −0.53, −0.06), whereas maladaptive coping was positively associated with diabetes distress (1.82, 95% CI: 1.12, 2.51). Diabetes distress had a positive relationship with glycated haemoglobin (0.04, 95% CI: 0.02, 0.05), but no correlations were found between glycated haemoglobin and adaptive coping or maladaptive coping. Insulin treatment not only weakened the diabetes distress-glycaemic control relationship (−0.04, 95% CI: −0.06, −0.01), but also weakened the mediation effect of maladaptive coping-glycaemic control relationship via diabetes distress (−0.07, 95% CI: −0.12, −0.02).

Conclusions

The study findings revealed the role of diabetes distress and insulin treatment in the link between coping skills and glycaemic control. Interventions to help boost confidence and autonomy in people with diabetes could help them lessen diabetes distress.

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Data availability

The datasets analysed during the current study are not publicly available because of ethical restrictions (e.g. data contain potentially identifying patient information), but are available from the corresponding author on reasonable request.

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Funding

This study was supported by Health and Medical Research Fund, Food and Health Bureau, The Government of Hong Kong SAR, China (Reference number 12130751). The funder did not take part in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR

    Christine Y. K. Lau, Joseph T. F. Lau, Virginia Chan & Phoenix K. H. Mo

  2. Division of Endocrinology and Diabetes, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR

    Alice P. S. Kong

Authors
  1. Christine Y. K. Lau
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  2. Alice P. S. Kong
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  3. Joseph T. F. Lau
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  4. Virginia Chan
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  5. Phoenix K. H. Mo
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by VC. Data analysis was performed by CYKL. The first draft of the manuscript was written by CYKL, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Phoenix K. H. Mo.

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Conflict of interest

The authors have no conflicts of interests to declare.

Ethical approval

The study was approved by the joint Chinese University of Hong Kong- New Territories East Cluster Clinical Research Ethics Committee, and was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments.

Consent to participate

Written informed consent forms were obtained from all participants included the study.

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This article belongs to the topical collection Health Education and Psycho-Social Aspects, managed by Massimo Porta and Marina Trento.

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Lau, C.Y.K., Kong, A.P.S., Lau, J.T.F. et al. Coping skills and glycaemic control: the mediating role of diabetes distress. Acta Diabetol 58, 1071–1079 (2021). https://doi.org/10.1007/s00592-021-01679-w

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  • DOI: https://doi.org/10.1007/s00592-021-01679-w

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