Patient Attachment Style Influences Self-care and Outcomes in Diabetes

With all the difficulties collaborating with providers and important others, it is often the way a patient attaches to others that has a great deal effect on outcomes. If a patient has high interpersonal self-reliance and a low trust of others, there is often poor self-management of diabetes.
In a mail survey sent to all patients with diabetes from nine primary care clinics of a health maintenance organization, data was collected on attachment style, self-care behaviors, patient-provider relationship and depression status. These were then matched against diagnostic, pharmacy, and laboratory data to measure diabetes treatment intensity, medical comorbidity, glycosylated hemoglobin levels, and diabetes complications.

Data was received from 4095 primary care patients with diabetes; these patients were broken down by attachments styles. The styles were labeled secure, dismissing, preoccupied, and fearful When compared with secure attachment style, dismissing attachment style was associated with significantly lower levels of exercise, foot care, diet, and adherence to oral hypoglycemic medications (p < .05), and with higher rates of smoking (p < .05), and these associations were mediated through the patient-provider relationship. Preoccupied attachment style, characterized by overreliance on others, was associated with a significantly lower risk of having glycosylated hemoglobin levels >8%, compared with secure attachment style. Fearful styles had a higher A1c than others, possibly because of a sense of failure and depression.

Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA

To have your own A1c Analyzer in your office www.a1ctest.com

Learn about the new Steps-To-Health Program. A program like no other. It will motivate your patients to increasing their physical activity while they are having fun.