Prediction of Glycated Hemoglobin (HbA1c) Using Physical Activity, Eating Behavior and Medication Adherence in Bhutanese Patients with Type 2 Diabetes

Abstract

Objective: To examine the prediction of glycated hemoglobin (HbA1c) based on physical activity, eating behavior and medication adherence in Bhutanese patients with type 2 diabetes. Method: A descriptive study with the correlational method was conducted in March 2017. A sample with simple random sampling was 88 adult patients with type 2 diabetes visiting the diabetic outpatient clinic of Phuntsholing General Hospital in Western Bhutan. Data were collected using the structured questionnaires that included a demographic questionnaire, global physical activity questionnaire, self-management diabetic behavioral questionnaire, and short medication adherence questionnaire. Descriptive statistics was performed for the demographic data and a multiple regression analysis for the prediction of HbA1c. Results: The participants had a mean HbA1c level of 7.33% (SD = 1.53). HbA1c was significantly associated with patients’ medication adherence (r = 0.24, P-value < 0.05), i.e. higher scores indicating lower adherence, and inversely associated with patients’ physical activity (r = -0.37, P-value < 0.01) and eating behavior (r = -0.83, P-value < 0.01). The three factors could explain 38.2% of HbA1c variance (R2 = 0.382, P-value < 0.001). Patients’ eating behavior was the strongest predictor of HbA1c in this sample (b = -0.426, P-value = 0.001), followed by physical activity (b= -0.277, P-value = 0.003) and medication adherence (b = 0.229, P-value = 0.01). Conclusion: The findings of this study shed additional light on the roles of eating behavior, physical activity, and medication adherence in HbA1c of adult patients with type 2 diabetes. To promote a better HbA1c control, the improvement of the three health behaviors should be emphasized. Keywords: glycated hemoglobin, physical activity, eating behavior, medication adherence, type 2 diabetes