Abstract
Adequate care of type 2 diabetes is reflected by the individual’s adherence to dietary guidance; yet, few patients are engaged in diabetes self-care at the recommended level, regardless of race/ethnicity. Few studies on the effect of dietary medical advice on diabetes self-management (DSM) and glycemic control have been conducted on Haitian and African American adults with type 2 diabetes. These relationships were assessed in total of 254 Blacks with type 2 diabetes (Haitian Americans = 129; African Americans = 125) recruited from Miami-Dade and Broward Counties, Florida by community outreach methods. Although dietary advice received was not significantly different between the two Black ethnicities, given advice “to follow a diet” as a predictor of “using food groups” was significant for Haitian Americans, but not for African Americans. Haitian Americans who were advised to follow a diet were approximately 3 times more likely to sometimes or often use food groups (or exchange lists) in planning meals. Less than optimal glycemic control (A1C > 7.2) was inversely related to DSM for African Americans; but the relationship was not significant for Haitian Americans. A one unit increase in DSM score decreased the odds ratio point estimate of having less than optimal glycemic control (A1C > 7.2%) by a factor of 0.94 in African Americans. These results suggest that medical advice for diet plans may not be communicated effectively for DSM for some races/ethnicities. Research aimed at uncovering the enablers and barriers of diet management specific to Black ethnicities with type 2 diabetes is recommended.
Highlights
Type 2 diabetes, the most common form (90% - 95% of all cases) has increased among the general population [1] and disproportionately among minorities ( African-Americans and Hispanics) [2]
It is essential for persons with diabetes to acquire and practice adequate diabetes self-management (DSM) skills in order to reduce the risk factors that lead to morbidity and mortality associated with diabetes-related complications [3]
Khan and Egede [5] reported few patients are engaged in diabetes self-care at the recommended level, regardless of race/ethnicity using a US representative sample from the Behavioral Risk Factor Surveillance Survey (BRFSS)
Summary
Type 2 diabetes, the most common form (90% - 95% of all cases) has increased among the general population [1] and disproportionately among minorities ( African-Americans and Hispanics) [2]. Due to the many health consequences of diabetes and the nature of the disease, diabetes care is vital to quality of life and survival It is essential for persons with diabetes to acquire and practice adequate diabetes self-management (DSM) skills in order to reduce the risk factors that lead to morbidity and mortality associated with diabetes-related complications [3]. Even when adjusting for socioeconomic status, the effects of race and/or ethnicity predict poor health outcomes (such as micro- and macro-vascular complications) due to a lack of cultural competency and appropriate communication skills by health care providers [7] It is essential for persons with diabetes to acquire and practice adequate DSM skills in order to reduce the risk factors that lead to morbidity and mortality associated with
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