Investigation of the relationship between patient empowerment and glycaemic control in patients with type 2 diabetes: a cross-sectional analysis

OBJECTIVE: To determine whether there is an association between patient empowerment and diabetes management in terms of the primary outcomes of metabolic control as measured by glycaemic control (glycated haemoglobin, HbA1c), high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC) and triglycerides. DESIGN: Retrospective cross-sectional analysis conducted in 2012. SETTING: Data from Diabetes Federation of Ireland from participants enrolled in the Community Orientated Diabetes Education (CODE) Programme. PARTICIPANTS: 569 patients diagnosed with type 2 diabetes. EXPOSURES: Patient empowerment levels, as measured by the Diabetes Empowerment Scale-Short Form. Additional information collected included patients’ gender, age, body mass index (BMI), smoking status and number of years with diabetes. OUTCOME MEASURES: HbA1c, HDL, LDL, TC and triglycerides values. RESULTS: Partial correlation analyses failed to show any statistically significant relationship between patient empowerment and glycaemic control or other diabetes management variables (HbA1c, p=0.32; HDL, p=0.95; LDL, p=0.77; TC, p=0.49; triglycerides, p=0.77). Logistic regression analysis confirmed that patient empowerment score was not a significant predictor of level of glycaemic control. Time since diagnosis of diabetes was associated with increased HbA1c levels. Age and gender were significant predictors of HDL and LDL levels, while gender and age were associated with changes in TC and triglycerides levels, respectively. CONCLUSIONS: No significant association was found between patient empowerment levels and other measures of diabetes control in this study. Further research into the short-term and long-term outcomes of the empowerment model, at different levels of disease management, and across different settings, is required to evaluate its value in the management of patients with diabetes.