Effect of Medical Advice for Diet on Diabetes Self-Management and Glycemic Control for Haitian and African Americans with Type 2 Diabetes

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.

Integrative Review on Adherence in Haitians With Diabetes

“…Huffman, Exebio, Vaccaro, Zarini, and Dixon () conducted a quantitative descriptive study aimed at evaluating the relationship of dietary counseling on diabetes self‐management (DSM) and glucose control for Haitian and African American subjects with T2DM. The researchers recruited 254 Blacks with T2DM in community centers in Miami‐Dade and Broward counties, among them 129 Haitians and 125 African Americans.…”

Self-Management of Type 2 Diabetes in Adult Haitian Immigrants: A Qualitative Study

“…The studies related to Haitian immigrants and diabetes have primarily used descriptive, quantitative designs (Huffman, Exebio, Vaccaro, Zarini, & Dixon, 2013;Vaccaro, Exebio, Zarini, & Huffman, 2014;Vimalananda, Rosenzweig, Cabral, David, & Lasser, 2011). In one study, Haitian immigrants were more likely than AAs to follow dietary recommendations when they were provided with medical advice on a healthy dietary regimen (Huffman et al, 2013). In another study, resilient cultural values were perceived to be valuable in the prevention and management of T2D (Moise et al, 2017).…”

“…In another study, resilient cultural values were perceived to be valuable in the prevention and management of T2D (Moise et al, 2017). Diabetes self-management practices were higher in Haitian immigrants compared to AAs, yet Haitian immigrants had poorer glycemic control (Huffman et al, 2013). Family/friend support has been strongly associated with improved diabetes self-management in different ethnic groups, including Haitian immigrants (Vaccaro et al, 2014).…”

“…Family/friend support has been strongly associated with improved diabetes self-management in different ethnic groups, including Haitian immigrants (Vaccaro et al, 2014). Thus, varying levels of family/friend support and self-management strategies have been described, but no research is available on how family/friend support and self-management relationships developed over time and how culture may have led to the variations (Huffman et al, 2013;Vaccaro et al, 2014;Vimalananda et al, 2011).…”

“…In summary, strong family/friend support, self-monitoring, and effective dietary and medical advice are associated with improved self-management, metabolic control, and clinical health outcomes in Haitian immigrants (Huffman et al, 2013;Vaccaro et al, 2014). However, Haitian immigrants had poorer metabolic control than comparable ethnic groups (Vaccaro et al, 2014;Vimalananda et al, 2011).…”