Nutr Res Pract.  2020 Jun;14(3):218-229. 10.4162/nrp.2020.14.3.218.

Analysis of the relationship between lifestyle habits and glycosylated hemoglobin control based on data from a Health Management Plan

• Wang YC
• Wang C
• Shih PW
• Tang PL

• KMID: 2502482
• DOI: http://doi.org/10.4162/nrp.2020.14.3.218

Abstract

BACKGROUND/OBJECTIVES
Type 2 Diabetes mellitus (T2DM) is a hereditary disease that is also strongly dependent on environmental factors, lifestyles, and dietary habits. This study explored the relationship between lifestyle habits and glycosylated hemoglobin management in T2DM patients to provide empirical outcomes to improve T2DM management and patient health literacy.
SUBJECTS/METHODS
This study enrolled 349 diabetic patients with more than 5 care visits to a Diabetes Mellitus care network under the Health Management Plan led by Taiwan Department of Health (DOH). Based on relevant literature, an Outpatient Record Form of Diabetes Mellitus Care was designed and lipid profile tests were conducted for data collection and analysis.
RESULTS
When modeling the data, the results showed that the odds for HbA1c > 7.5% in T2DM patients duration over 10 years was 3.785 (P = 0.002) times that in patients with disease duration of fewer than 3 years. The odds of HbA1c > 7.5% in illiterate patients was 3.128 (P = 0.039) times that in patients with senior high school education or above. The odds of HbA1c > 7.5% in patients with other chronic illness was 2.207 (P = 0.019) times that in participants without chronic illness. Among 5 beneficial lifestyle habits, the odds of HbA1c > 7.5% in patients with 2 or 3 good habits were 3.243 (P = 0.003) and 3.424 (P = 0.001) times that in patients with more than 3 good habits, respectively.
CONCLUSION
This empirical outcome shows that maintaining a good lifestyle improves T2DM management and patients' knowledge, motivation, and ability to use health information. Patients with longer disease duration, education, or good lifestyle habits had optimal HbA1c management than those in patients who did not. Thus, effective selfmanagement and precaution in daily life and improved health literacy of diabetic patients are necessary to increase the quality of T2DM care.

Keyword

Type 2 diabetes mellitus; glycosylated hemoglobin A1c; lipids; smoking; health management plan

Reference

1. World Health Organization. The top 10 causes of death [Internet]. Geneva: World Health Organization;2018. cited 2019 December 17. Available from: https://www.who.int/en/news-room/fact-sheets/detail/the-top-10-causes-of-death.

2. Health Promotion Administration. World diabetes day [Internet]. Taipei: Ministry of Health and Welfare;2018. cited 2019 December 17. Available from: https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=1405&pid=9855.

3. Alam F, Islam MA, Mohamed M, Ahmad I, Kamal MA, Donnelly R, Idris I, Gan SH. Efficacy and safety of pioglitazone monotherapy in type 2 diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials. Sci Rep. 2019; 9:5389. PMID: 30926892.

4. International Diabetes Federation. IDF Diabetes Atlas, 8th ed [Internet]. Brussels: International Diabetes Federation;2017. cited 2019 October 10. Available from: http://www.diabetesatlas.org.

5. Health Promotion Administration. Diabetes mellitus [Internet]. Taipei: Ministry of Health and Welfare;2018. cited 2010 August 10. Available from: https://www.hpa.gov.tw/Pages/List.aspx?nodeid=359.

6. Hameed I, Masoodi SR, Mir SA, Nabi M, Ghazanfar K, Ganai BA. Type 2 diabetes mellitus: from a metabolic disorder to an inflammatory condition. World J Diabetes. 2015; 6:598–612. PMID: 25987957.

7. Hernandez L, Leutwyler H, Cataldo J, Kanaya A, Swislocki A, Chesla C. Symptom experience of older adults with type 2 diabetes and diabetes-related distress. Nurs Res. 2019; 68:374–382. PMID: 31465305.

8. Khardori R. Type 2 diabetes mellitus [Internet]. place unknown: Medscape Diabetes & Endocrinology;2018. cited 2019 December 17. Available from: https://emedicine.medscape.com/article/117853-overview#showall.

9. Bhowmik B, Siddiquee T, Mujumder A, Afsana F, Ahmed T, Mdala IA, do V Moreira NC, Khan AK, Hussain A, Holmboe-Ottesen G, Omsland TK. do V Moreira NC, Khan AKA, Hussain A, Holmboe-Ottesen G, Omsland TK. Serum lipid profile and its association with diabetes and prediabetes in a rural Bangladeshi population. Int J Environ Res Public Health. 2018; 15:E1944. PMID: 30200612.

10. Schmitt A, Reimer A, Hermanns N, Huber J, Ehrmann D, Schall S, Kulzer B. Assessing diabetes self-management with the Diabetes Self-Management Questionnaire (DSMQ) can help analyse behavioural problems related to reduced glycaemic control. PLoS One. 2016; 11:e0150774. PMID: 26938980.

11. García AA, Brown SA, Horner SD, Zuñiga J, Arheart KL. Home-based diabetes symptom self-management education for Mexican Americans with type 2 diabetes. Health Educ Res. 2015; 30:484–496. PMID: 25953971.

12. Caruso R, Magon A, Baroni I, Dellafiore F, Arrigoni C, Pittella F, Ausili D. Health literacy in type 2 diabetes patients: a systematic review of systematic reviews. Acta Diabetol. 2018; 55:1–12. PMID: 29129000.

13. Poureslami I, Nimmon L, Rootman I, Fitzgerald MJ. Health literacy and chronic disease management: drawing from expert knowledge to set an agenda. Health Promot Int. 2017; 32:743–754. PMID: 26873913.

14. Maneze D, Everett B, Astorga C, Yogendran D, Salamonson Y. The influence of health literacy and depression on diabetes mellitus self-management: a cross-sectional study. J Diabetes Res. 2016; 2016:3458969. PMID: 27595113.

15. Gunggu A, Thon CC, Whye Lian C. Predictors of diabetes self-management among type 2 diabetes patients. J Diabetes Res. 2016; 2016:9158943. PMID: 27563681.

16. Smith ML, Towne SD, Herrera-Venson A, Cameron K, Kulinski KP, Lorig K, Horel SA, Ory MG. Dissemination of chronic disease self-management education (CDSME) programs in the United States: intervention delivery by rurality. Int J Environ Res Public Health. 2017; 14:E638. PMID: 28613257.

17. American Diabetes Association. Introduction: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019; 42:S1–S2. PMID: 30559224.

18. Raebel MA, Schmittdiel J, Karter AJ, Konieczny JL, Steiner JF. Standardizing terminology and definitions of medication adherence and persistence in research employing electronic databases. Med Care. 2013; 51:S11–21. PMID: 23774515.

19. Munukutla S, Pan G, Deshpande M, Thandavarayan RA, Krishnamurthy P, Palaniyandi SS. Alcohol toxicity in diabetes and its complications: a double trouble? Alcohol Clin Exp Res. 2016; 40:686–697. PMID: 27013182.

20. Knott C, Bell S, Britton A. Alcohol consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of more than 1.9 million individuals from 38 observational studies. Diabetes Care. 2015; 38:1804–1812. PMID: 26294775.

21. He X, Rebholz CM, Daya N, Lazo M, Selvin E. Alcohol consumption and incident diabetes: the Atherosclerosis Risk in Communities (ARIC) study. Diabetologia. 2019; 62:770–778. PMID: 30820594.

22. Jia W, Weng J, Zhu D, Ji L, Lu J, Zhou Z, Zou D, Guo L, Ji Q, Chen L, Chen L, Dou J, Guo X, Kuang H, Li L, Li Q, Li X, Liu J, Ran X, Shi L, Song G, Xiao X, Yang L, Zhao Z. Chinese Diabetes Society. Standards of medical care for type 2 diabetes in China 2019. Diabetes Metab Res Rev. 2019; 35:e3158. PMID: 30908791.

23. Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, Alter DA. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med. 2015; 162:123–132. PMID: 25599350.

24. Li N, Fu J, Koonen DP, Kuivenhoven JA, Snieder H, Hofker MH. Are hypertriglyceridemia and low HDL causal factors in the development of insulin resistance? Atherosclerosis. 2014; 233:130–138. PMID: 24529133.

25. Houle J, Beaulieu MD, Chiasson JL, Lespérance F, Côté J, Strychar I, Bherer L, Meunier S, Lambert J. Glycaemic control and self-management behaviours in Type 2 diabetes: results from a 1-year longitudinal cohort study. Diabet Med. 2015; 32:1247–1254. PMID: 25581545.

26. Gonzalez-Zacarias AA, Mavarez-Martinez A, Arias-Morales CE, Stoicea N, Rogers B. Impact of demographic, socioeconomic, and psychological factors on glycemic self-management in adults with type 2 diabetes mellitus. Front Public Health. 2016; 4:195. PMID: 27672634.

27. Chuang LM, Tsai ST, Huang BY, Tai TY. DIABCARE (Taiwan) Study Group. The current state of diabetes management in Taiwan. Diabetes Res Clin Pract. 2001; 54(Suppl 1):S55–65. PMID: 11580970.

28. Wang QX, Dan GZ, He NT, Xin XZ, Li YJ, Lin RX, Lin HD, Qiu ZH, Guo QH, Zhuang JH, Zhuang LM, Xu HH, Chen JZ, Zhang M, Fu MZ, Zeng QX, Pei D, Tsai ST, Tsai SY, Pan WH, Zheng QY, Xiao SZ, Long JX, Dai DY, Su XY. Diabetes Mellitus Prevention Handbook - Guidelines for Diabetes Mellitus Prevention, Diagnosis and Control Process. Taipei: Health Promotion Administration, Ministry of Health and Welfare;2003. p. 1–238.

29. Health Promotion Administration. Diabetes Mellitus Prevention Manual (Guidelines for Diabetes Mellitus Prevention, Diagnosis and Control Process) - Medical Staff Reference [Internet]. Taipei: Ministry of Health and Welfare;2018. cited 2019 October 10. Available from: https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=359&pid=1235.

30. The Diabetes Mellitus Association of the Republic of China (Taiwan). Elderly Diabetes Mellitus Clinical Care Handbook in 2019. Taipei: The Diabetes Mellitus Association of the Republic of China (Taiwan);2019. p. 1–53.

31. Kaohsiung Veterans General Hospital. General inspection room [Internet]. Kaohsiung: Department of Pathology and Examination, Kaohsiung Veterans General Hospital;2019. cited 2019 October 10. Available from: https://org.vghks.gov.tw/path/cp.aspx?n=6197EB6B4A0562E1&s=C95A6597404888CE.

32. Hayashino Y, Izumi K, Okamura S, Nishimura R, Origasa H, Tajima N. JDCP study group. Duration of diabetes and types of diabetes therapy in Japanese patients with type 2 diabetes: the Japan Diabetes Complication and its Prevention prospective study 3 (JDCP study 3). J Diabetes Investig. 2017; 8:243–249.

33. Liu YT, Lin LY, Tuan CW, Yang CY, Tang PL. Analyzing the association HbA1c control by depression, social participation and utilizing self-management questionnaire. Diabetes Res Clin Pract. 2019; 153:103–110. PMID: 31175913.

34. Bachkati KH, Mortensen EL, Brønnum-Hansen H, Holm-Pedersen P. Midlife cognitive ability, education, and tooth loss in older Danes. J Am Geriatr Soc. 2017; 65:194–199. PMID: 28111753.

35. Kautzky-Willer A, Harreiter J, Pacini G. Sex and gender differences in risk, pathophysiology and complications of type 2 diabetes mellitus. Endocr Rev. 2016; 37:278–316. PMID: 27159875.

36. Herrington WG, Alegre-Díaz J, Wade R, Gnatiuc L, Ramirez-Reyes R, Hill M, Solano-Sánchez M, Baigent C, Lewington S, Collins R, Tapia-Conyer R, Peto R, Kuri-Morales P, Emberson JR. Effect of diabetes duration and glycaemic control on 14-year cause-specific mortality in Mexican adults: a blood-based prospective cohort study. Lancet Diabetes Endocrinol. 2018; 6:455–463. PMID: 29567074.

37. World Health Organization. Global Report on Diabetes Mellitus. Geneva: World Health Organization;2016. p. 4–84.

38. Yi S, Ngin C, Tuot S, Chhoun P, Fleming T, Brody C. Utilization of traditional, complementary and alternative medicine and mental health among patients with chronic diseases in primary health care settings in Cambodia. Int J Ment Health Syst. 2017; 11:58. PMID: 29021821.

39. Brien SB, Stuart B, Dickens AP, Kendrick T, Jordan RE, Adab P, Thomas M. Independent determinants of disease-related quality of life in COPD - scope for nonpharmacologic interventions? Int J Chron Obstruct Pulmon Dis. 2018; 13:247–256. PMID: 29386893.

40. American Diabetes Association. Standards of Medical Care in Diabetes-2019 abridged for primary care providers. Clin Diabetes. 2019; 37:11–34. PMID: 30705493.

41. Akter S, Goto A, Mizoue T. Smoking and the risk of type 2 diabetes in Japan: A systematic review and meta-analysis. J Epidemiol. 2017; 27:553–561. PMID: 28716381.

42. Akter S, Okazaki H, Kuwahara K, Miyamoto T, Murakami T, Shimizu C, Shimizu M, Tomita K, Nagahama S, Eguchi M, Kochi T, Imai T, Nishihara A, Sasaki N, Nakagawa T, Yamamoto S, Honda T, Uehara A, Yamamoto M, Hori A, Sakamoto N, Nishiura C, Totsuzaki T, Kato N, Fukasawa K, Pham NM, Kurotani K, Nanri A, Kabe I, Mizoue T, Sone T, Dohi S. Japan Epidemiology Collaboration on Occupational Health Study Group. Smoking, smoking cessation, and the risk of type 2 diabetes among Japanese adults: Japan Epidemiology Collaboration on Occupational Health Study. PLoS One. 2015; 10:e0132166. PMID: 26200457.

43. Polsky S, Akturk HK. Alcohol consumption, diabetes risk, and cardiovascular disease within diabetes. Curr Diab Rep. 2017; 17:136. PMID: 29103170.

44. Franc A, Muselík J, Vetchý D. Beer with reduced carbohydrates and alcohol content suitable for diabetics. Ceska Slov Farm. 2018; 67:212–215. PMID: 30871327.

45. Schnell O, Alawi H, Battelino T, Ceriello A, Diem P, Felton AM, Grzeszczak W, Harno K, Kempler P, Satman I, Vergès B. Self-monitoring of blood glucose in type 2 diabetes: recent studies. J Diabetes Sci Technol. 2013; 7:478–488. PMID: 23567007.