Characteristics of Low-Income African-American and Caucasian Adults That Are Important in Self-Management of Type 2 Diabetes

Abstract

Incidence of type 2 diabetes has greatly increased in the US, with over 90 percent having type 2. A cross-sectional, self-report survey was conducted for the purpose of assessing characteristics associated with self-management of type 2 diabetes (attitudes, certain behaviors, and perceived knowledge) among low-income Caucasian and African-American adults enrolled in the Food Stamp Nutrition Education Program (FSNEP). At the time of the study, almost 11 percent of FSNEP adult participants (457 individuals) throughout the state had type 2 diabetes. Among 196 subjects interviewed for the study, 86 were Caucasian (44%) and 100 (51%) were African-American. Results indicated that over three-fourths of subjects had been counseled on diet and exercise, but less that half were following dietary recommendations and only one-fourth were getting adequate exercise. No significant differences were found between the two race groups on assessed characteristics or among subjects grouped by place of residence (p < or = 0.01). Significant correlations were found among subjects' characteristics, including perceived health status, perceived knowledge of diabetes, attitudes towards diabetes, meal-plan adherence, perceived barriers to physical activity, and reported diabetes control (p < or = 0.0001). Findings imply that (a) self-management education for type 2 diabetes does not need to be different for African-Americans vs. Caucasians in southern states and (b) best disease control is achieved when those with type 2 diabetes have a high degree of knowledge of diabetes, positive attitudes, good meal plan adherence, and few perceived barriers to physical activity.

Needs and preferences for nutrition education of type 2 diabetic adults in a resource-limited setting in South Africa

“…This problem is particularly apparent in low-income groups (Cox et al 2004). There is therefore a need for effective NE that will assist diabetic individuals overcome barriers to dietary self-care.…”

“…Individuals of low socioeconomic status are amongst those noted to experience worse long-term diabetes management outcomes (Roper et al 2001;Levetan, Levitt & Bonnici 1997). This is attributed to more barriers to self-care, including limited access to continuous quality health care (Glazier et al 2006;Cox et al 2004). The complications of poorly controlled diabetes pose a serious social and financial burden, especially to those in resourcelimited settings.…”

Clinical critics in the management of diabetes mellitus

“…The majority sought to balance their dietary habits with some recommendations. This illustrates the widespread difficulty in adhering to dietary recommendations and the discrepancy between diabetes knowledge and self-care practices [64][65][66][67][68][69][70]. It also implies other factors influence dietary behavior.…”

“…Several other researchers also reported that age was inversely associated with poor dietary adherence with no cause inferred due to study design limitations [58,65,66,76]. Irregular meal patterns and lack of consistency of day-to-day carbohydrates intake in conventional diabetes regimens contribute to poor glycaemic control [56,78].…”

“…Subjects who were depressed had problems with acceptance of diabetes. They considered self-care to be a low priority resulting in little dietary adherence leading to poor metabolic control [59,66,71,[80][81][82].…”