TY - JOUR T1 - Socioeconomic status and glycemic control in adult patients with type 2 diabetes: a mediation analysis JF - BMJ Open Diabetes Research & Care JO - BMJ Open Diab Res Care DO - 10.1136/bmjdrc-2015-000184 VL - 4 IS - 1 SP - e000184 AU - Janie Houle AU - François Lauzier-Jobin AU - Marie-Dominique Beaulieu AU - Sophie Meunier AU - Simon Coulombe AU - José Côté AU - François Lespérance AU - Jean-Louis Chiasson AU - Louis Bherer AU - Jean Lambert Y1 - 2016/05/01 UR - http://drc.bmj.com/content/4/1/e000184.abstract N2 - Objective The purpose of this study is to examine the contribution of health behaviors (self-management and coping), quality of care, and individual characteristics (depressive symptoms, self-efficacy, illness representations) as mediators in the relationship between socioeconomic status (SES) and glycemic control.Methods A sample of 295 adult patients with type 2 diabetes was recruited at the end of a diabetes education course. Glycemic control was evaluated through glycosylated hemoglobin (HbA1c). Living in poverty and education level were used as indicators of SES.Results Bootstrapping analysis showed that the significant effects of poverty and education level on HbA1c were mediated by avoidance coping and depressive symptoms. The representation that diabetes is unpredictable significantly mediated the relationship between living in poverty and HbA1c, while healthy diet mediated the relationship between education level and HbA1c.Conclusions To improve glycemic control among patients with low SES, professionals should regularly screen for depression, offering treatment when needed, and pay attention to patients' illness representations and coping strategies for handling stress related to their chronic disease. They should also support patients in improving their self-management skills for a healthy diet. ER -