Modeling predictors of changes in glycemic control and diabetes-specific quality of life amongst adults with type 1 diabetes, one year after structured education in flexible, intensive insulin therapy

Background: Few studies have identified determinants of glycemic control (HbA1c) and diabetes-specific quality of life (DSQoL) in adults with type 1 diabetes.
Purpose: To identify factors predicting outcomes following structured diabetes
education.
Methods: 262 participants completed biomedical and questionnaire assessments before, and throughout one year of follow-up.
Results: The proportion of variance explained ranged from 28-62% (DSQoLS) and 14-20% (HbA1c). When change in psychosocial variables were examined, reduced hypoglycemia fear, lower 'perceived diabetes seriousness', greater self-efficacy and well-being predicted QoL improvements from baseline to 3-months. Increased frequency of blood glucose testing predicted improvements in HbA1c from baseline to 6-months.
Conclusions: Greater benefits may be achieved if programs focus explicitly on psychosocial factors. Self-care behaviours did not predict HbA1c suggesting existing assessment tools need refinement. Evaluation of treatment mechanisms in self-management programs is recommended.