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Biobehavioral determinants of glycemic control in type 2 diabetes

Title: Biobehavioral determinants of glycemic control in type 2 diabetes: A systematic review and meta-analysis.
Name(s): Brown, Sharon A, author
García, Alexandra A, author
Brown, Adama, author
Becker, Betsy J, author
Conn, Vicki S, author
Ramírez, Gilbert, author
Winter, Mary A, author
Sumlin, Lisa L, author
Garcia, Theresa J, author
Cuevas, Heather E, author
Type of Resource: text
Genre: Journal Article
Date Issued: 2016-10-01
Physical Form: computer
online resource
Extent: 1 online resource
Language(s): English
Abstract/Description: To conduct a model-driven meta-analysis of correlational research on psychological and motivational predictors of diabetes outcomes, with adherence factors as mediators. A comprehensive literature search of published and unpublished studies located a sample of 775 individual correlational or predictive studies reported across 739 research reports. Results varied according to the outcome variable included in the regression models. Depression had a larger negative effect on adherence to physical activity than on dietary adherence. Coping and self-efficacy were strongly related to dietary adherence, which was strongly related to improved glycemic control. Medication adherence was related to glycosylated hemoglobin, whereas medications and self-monitoring were related to fasting blood glucose. Adding appointment keeping to the models did not significantly alter the results. Self-efficacy was the most consistent predictor of all adherence behaviors and dietary adherence was the most significant predictor of HbA1c. Physical activity was the most predictive factor of BMI and glucose self-monitoring the most predictive of FBG. Metabolic control is a primary goal in T2DM, so the best pathway to attaining that goal appears to be an emphasis on self-efficacy and dietary adherence.
Identifier: FSU_pmch_27036083 (IID), 10.1016/j.pec.2016.03.020 (DOI), PMC5028237 (PMCID), 27036083 (RID), 27036083 (EID), S0738-3991(16)30142-2 (PII)
Keywords: Depression, Explanatory models, HbA1c, Meta-analysis, Self-efficacy, Type 2 diabetes
Grant Number: R01 NR011450
Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at
Subject(s): Blood Glucose/analysis
Blood Glucose Self-Monitoring
Diabetes Mellitus, Type 2/psychology
Diabetes Mellitus, Type 2/therapy
Glycated Hemoglobin A/analysis
Patient Compliance/psychology
Self Care/psychology
Self Efficacy
Stress, Psychological/psychology
Persistent Link to This Record:
Host Institution: FSU
Is Part Of: Patient education and counseling.
Issue: iss. 10, vol. 99

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Brown, S. A., García, A. A., Brown, A., Becker, B. J., Conn, V. S., Ramírez, G., … Cuevas, H. E. (2016). Biobehavioral determinants of glycemic control in type 2 diabetes: A systematic review and meta-analysis. Patient Education And Counseling. Retrieved from