Abstract

BackgroundThe study purpose examines diabetes self-care management practices among individuals diagnosed with diabetes with and without mental health stress. MethodsPooled cross-sectional data (2011–2016) from the Household Component of the Medical Expenditure Panel Survey (HC-MEPS) were used. The sample consisted of individuals ages 25–85 years (n = 13,193; weighted n = 23,559,975). Dependent variables were engagement in moderate/vigorous physical exercise five times weekly, receiving dilated eye exams, foot checks, treating diabetes with diet modification or insulin injections, and eating fewer high fat/cholesterol foods. The independent variable was diabetes with and without mental health stress. The study controlled for predisposing, enabling, and need factors. ResultsCompared with individuals with diabetes without mental health stress, findings indicate individuals with diabetes and low or mild/moderate mental health stress were more likely to treat diabetes with diet modification and to restrict high fat/cholesterol food. Individuals with diabetes and severe mental health stress were more likely to restrict high fat/cholesterol. Additionally, individuals with mild/moderate to severe mental health stress were less likely to engage in diabetes care behavior. LimitationsMental health stress is represented as a non-specific psychological distress index summary during the past 30 days and may not be an actual representation of overall distress in a person's life. There were no variables distinguishing diabetes type or severity. The study uses self-reported data and is cross-sectional. ConclusionsMental health stress may contribute to individuals not engaging in self-management practices. It would be beneficial to incorporate psychosocial services for individuals with diabetes and mental health stress.

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