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已发表论文
中国 2 型糖尿病患者心理性胰岛素抵抗的影响因素：结构方程模型分析
Authors Wu R, Luo X, Cui J, Huang G, Wang Z, Hong J
Received 11 November 2024
Accepted for publication 23 September 2025
Published 1 December 2025 Volume 2025:18 Pages 4385—4397
DOI https://doi.org/10.2147/DMSO.S501031
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Rebecca Baqiyyah Conway
Rongrong Wu,1,2,* Xin Luo,1,* Junling Cui,1 Guohong Huang,1 Zhuzhu Wang,1 Jingfang Hong1
1School of Nursing, Anhui Medical University, Hefei, Anhui, People’s Republic of China; 2The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jingfang Hong, School of Nursing, Anhui Medical University, No. 81 Mei Shan Road, Shushan District, Hefei City, Anhui Province, 230032, People’s Republic of China, Tel +86 15955179337, Email 13739273006@163.com
Purpose: Psychological insulin resistance (PIR) seriously impairs compliance and satisfaction with insulin therapy in patients with type 2 diabetes (T2D). This study aimed to build a structural equation model (SEM) to investigate factors influencing PIR in patients with T2D and the interactions between them.
Patients and Methods: A cross-sectional study was conducted with 289 patients with T2D at the endocrinology department of the First Affiliated Hospital of Anhui Medical University in China between March and September 2023. Demographic characteristics, self-efficacy (SE), social support (SS), diabetes distress (DD), diabetes stigma (DS), and PIR were evaluated using questionnaires, and the pathways were validated by SEM.
Results: The participants had an average PIR score of 56.74 (standard deviation: 11.44). The final model fit well (CMIN/DF = 1.564, GFI = 0.960, AGFI = 0.933, RMSEA = 0.044, NFI = 0.948, TLI = 0.972, IFI = 0.981, CFI = 0.980). In patients with T2D, SE (β = − 0.610, P < 0.001), DD (β = 0.613, P < 0.01), SS (β = − 0.386, P = 0.001), and DS (β = 0.284, P = 0.001) were significantly associated with PIR.
Conclusion: The PIR scores of patients with T2D were moderate in this study. PIR was linked to SE, SS, DD, and DS in patients with T2D. Among T2D patients, greater SE and lower DD were linked to lower PIR. The direct and indirect correlations between the structural variables in this study offer a good basis for the creation of focused interventions that lower PIR levels.
Keywords: psychological insulin resistance, self-efficacy, structural equation model, social support, diabetes distress, diabetes stigma
1School of Nursing, Anhui Medical University, Hefei, Anhui, People’s Republic of China; 2The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jingfang Hong, School of Nursing, Anhui Medical University, No. 81 Mei Shan Road, Shushan District, Hefei City, Anhui Province, 230032, People’s Republic of China, Tel +86 15955179337, Email 13739273006@163.com
Purpose: Psychological insulin resistance (PIR) seriously impairs compliance and satisfaction with insulin therapy in patients with type 2 diabetes (T2D). This study aimed to build a structural equation model (SEM) to investigate factors influencing PIR in patients with T2D and the interactions between them.
Patients and Methods: A cross-sectional study was conducted with 289 patients with T2D at the endocrinology department of the First Affiliated Hospital of Anhui Medical University in China between March and September 2023. Demographic characteristics, self-efficacy (SE), social support (SS), diabetes distress (DD), diabetes stigma (DS), and PIR were evaluated using questionnaires, and the pathways were validated by SEM.
Results: The participants had an average PIR score of 56.74 (standard deviation: 11.44). The final model fit well (CMIN/DF = 1.564, GFI = 0.960, AGFI = 0.933, RMSEA = 0.044, NFI = 0.948, TLI = 0.972, IFI = 0.981, CFI = 0.980). In patients with T2D, SE (β = − 0.610, P < 0.001), DD (β = 0.613, P < 0.01), SS (β = − 0.386, P = 0.001), and DS (β = 0.284, P = 0.001) were significantly associated with PIR.
Conclusion: The PIR scores of patients with T2D were moderate in this study. PIR was linked to SE, SS, DD, and DS in patients with T2D. Among T2D patients, greater SE and lower DD were linked to lower PIR. The direct and indirect correlations between the structural variables in this study offer a good basis for the creation of focused interventions that lower PIR levels.
Keywords: psychological insulin resistance, self-efficacy, structural equation model, social support, diabetes distress, diabetes stigma