OBJECTIVE:To assess racial/ethnic differences in multiple diabetes self-care behaviors. DESIGN:Cross-sectional study.PARTICIPANTS: 21,459 participants with diabetes in the 2003 Behavioral Risk Factor Surveillance survey. MEASUREMENTS:The study assessed self-care behaviors including physical activity, fruits/vegetables consumption, glucose testing, and foot examination, as well as a composite of the 4 self-care behaviors across racial/ethnic groups. Multiple logistic regression was used to assess the independent association between race/ethnicity, the composite variable, and each self-care behavior controlling for covariates. STATA was used for statistical analysis. RESULTS:Overall, 6% engaged in all 4 self-care behaviors, with a range of 5% in non-insulin users to 8% in insulin users. Blacks were less likely to exercise (OR 0.63, 95% CI 0.51, 0.79), while Hispanics and "others" were not significantly different from whites. Hispanics (OR 0.64, 95% CI 0.49, 0.82) and others (OR 0.69, 95% CI 0.49, 0.96) were less likely to do home glucose testing, while blacks were not significantly different from whites. Blacks (OR 1.42, 95% CI 1.12, 1.80) were more likely to do home foot examinations, while Hispanics and others were not significantly different from whites. Blacks (OR 0.56, 95% CI 0.36, 0.87) were less likely to engage in all 4 behaviors, while Hispanics and others were not significantly different from whites. There were no significant racial/ethnic differences in fruit and vegetable consumption.CONCLUSIONS: Few patients engage in multiple selfcare behaviors at recommended levels, and there are significant racial/ethnic differences in physical activity, dietary, and foot care behaviors among adults with diabetes.

Background Little is known about the cardiovascular risk factors in the Bangladeshi population. We examined ‘classic’ risk factors, including central obesity, in a rural population. Methods Non-biochemical variables were examined in 238 men and 272 women aged 18 years or more (mean ± standard deviation 38.1 ± 10.7 years in men and 36.0 ± 9.8 in women). Fasting blood glucose and total cholesterol concentrations were determined in a sub-sample of 106 men and 135 women. Results Men and women had a similar body mass index (20.4 ± 3.1 vs 20.8 ± 3.4 kg/m2), waist circumference (72.8 ± 7.6 vs 71.4 ± 8.7 cm), systolic blood pressure (118.4 ± 13.7 vs 119.5 ± 17.7 mmHg), diastolic blood pressure (75.9 ± 9.9 vs 74.6 ± 11.5 mmHg), total cholesterol (155.7 ± 36.0 vs 162.0 ± 35.2 mg/dl) and blood glucose level (89.0 ± 14.9 vs 86.2 ± 9.6 mg/dl. After categorization of these variables, the prevalence of thinness (body mass index < 18.5; 30.0 vs 30.3%), obesity (body mass index ≥ 30; 0.8 vs 1.1%), hypertension (systolic blood pressure ≥ 140 and/or diastolic blood pressure ≥ 90 or medication; 9.8 vs 15.6%), hypercholesterolemia (total cholesterol ≥ 240; 2.8 vs 3.0%) and diabetes mellitus (blood glucose ≥ 126; 2.9 vs 0.7%) remained similar between the sexes. However, central obesity (waist circumference ≥ 94 cm in men and ≥ 80 cm in women) was less frequent (2.9 vs 16.8%; P =0.001) in men. Overall, tobacco consumption (57.1 vs 23.2%; P = 0.001) and smoking (50.3% vs 2.9%; P =0.001) were more frequent in men, but chewing tobacco consumption was similar (16.3 vs 21.4%; P=0.095). Conclusions Our sample size is small, and larger studies are necessary for a more accurate description of the risk factors.

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