Von Nordheim David, Herrick Cynthia, Verdecias Niko, Garg Rachel, Kreuter Matthew W, McQueen Amy
Health Communication Research Lab, Brown School of Social Work, Washington University, St. Louis, MO.
Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St. Louis, MO.
Diabetes Spectr. 2024 Jul 10;37(4):369-378. doi: 10.2337/ds23-0067. eCollection 2024 Fall.
Executive function (EF) impairment is associated with poorer outcomes for individuals with type 2 diabetes. Previous research has identified risk factors for EF impairment, but many of these are also associated with type 2 diabetes. To address this issue, this study identified relevant variables from the literature and compared their association with EF in a sample of people with type 2 diabetes.
Adult members of a Medicaid health plan diagnosed with type 2 diabetes were enrolled in a social needs intervention trial. Using baseline data from the trial, bivariate and multivariable regression analyses examined associations between EF and demographic, health, and psychosocial factors.
When controlling for other factors, we identified six significant correlates of EF impairment: age (β = 0.10), education (college vs. no college; β = -0.38), depression symptoms (β = 0.18), comorbidity burden (β = 0.21), diabetes-related distress (β = 0.14), and future time orientation (β = -0.13).
Our analysis identified several factors associated with greater EF impairment, which may interfere with diabetes self-management. Providers should consider these factors when prescribing treatments and determine whether additional resources or accommodations are warranted.
执行功能（EF）受损与2型糖尿病患者的较差预后相关。先前的研究已经确定了EF受损的风险因素，但其中许多因素也与2型糖尿病有关。为了解决这个问题，本研究从文献中确定了相关变量，并在2型糖尿病患者样本中比较了它们与EF的关联。
参加医疗补助健康计划且被诊断为2型糖尿病的成年成员参与了一项社会需求干预试验。利用该试验的基线数据，双变量和多变量回归分析检验了EF与人口统计学、健康和心理社会因素之间的关联。
在控制其他因素时，我们确定了EF受损的六个显著相关因素：年龄（β = 0.10）、教育程度（大学学历与非大学学历；β = -0.38）、抑郁症状（β = 0.18）、合并症负担（β = 0.21）、糖尿病相关困扰（β = 0.14）和未来时间取向（β = -0.13）。
我们的分析确定了几个与更严重的EF受损相关的因素，这些因素可能会干扰糖尿病自我管理。医疗服务提供者在开处方时应考虑这些因素，并确定是否需要额外的资源或调整。
