Work

Pathways to Glycemic Control: Diabetes Distress as a Mediator of the Impact of the EPICC Intervention in Veterans with Type 2 Diabetes

Year: 2025

Type: article

Abstract: Empowering Patients in Chronic Care (EPICC) is a patient-centered intervention that leverages a group-based approach, collaborative goal-setting, and motivational interviewing techniques to improve diabetes outcomes. However, the process by which EPICC’s collaborative goal-setting results in improved diabetes outcomes differs from traditional self-management and may be related to emotion regulation rather than disease centric goals. This study examines the role of diabetes distress in reduction of HbA1c following the EPICC intervention. A cohort of 224 participants with treated but uncontrolled type 2 diabetes were randomized to receive either EPICC or enhanced usual care (EUC). Examination of direct and indirect effects of the relationship between treatment group and improvements in HbA1c revealed that relative to EUC, Veterans in the EPICC group had lower HbA1c post-intervention indirectly through reduction in diabetes distress. These findings underscore the role of psychosocial well-being in diabetes management.

Source: Health Behavior Research

DOI: 10.4148/2572-1836.1323

Authors: Amber B Amspoker, Ryan Wong, Nipa Kamdar, Aanand D. Naik, LeChauncy Woodard, Omolola Adepoju

Institutions: Michael E. DeBakey VA Medical Center, University of Houston, The University of Texas Health Science Center at Houston, Baylor College of Medicine

Language: English

Topic: Diabetes Management and Education

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funders: U.S. Department of Veterans Affairs, Health Services Research and Development