Which of the following factors can lead to poor glycemic control in a patient with diabetes?

In the context of diabetes management, increased stress is recognized as a significant factor that can adversely affect glycemic control. When a person experiences stress, the body responds by releasing stress hormones such as cortisol and adrenaline. These hormones encourage the liver to release more glucose into the bloodstream as part of the "fight or flight" response. As a result, elevated blood sugar levels can occur, making it more difficult for individuals with diabetes to maintain stable glycemic control.

In contrast, consistent medication adherence, an active lifestyle, and following proper dietary guidelines are all strategies that help promote better blood sugar management. These factors are associated with improved glycemic control by ensuring that blood sugar levels are kept within the desired range. Thus, while stress can lead to challenges in managing diabetes effectively, the other factors support effective glycemic control.