Post-Diagnosis Family Adaptation Influences Glycemic Control in Women with Type 2 Diabetes Mellitus

Gerstle, Jinny Franze; Varenne, Hervé; Contento, Isobel R.

doi:10.1016/s0002-8223(01)00227-9

Cited by 19 publications

(16 citation statements)

References 28 publications

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“…Interventions designed to enhance family support may benefit from using ethnographic data to identify "naturally occurring" support dynamics, as such dynamics will likely be culturally relevant and already accommodate families' exigencies as they deal with diabetes (28,29). Consistent with an increasing number of scholars, we strongly recommend that culturally relevant, familybased approaches become a central element in the medical management of diabetes (5, 28,29,31).…”

Section: Study Participants' Characteristicsmentioning

confidence: 84%

“…Indeed, most of the study's respondents perceived their family members as being supportive, yet we found no relation between these perceptions and the diabetes control measures (data not shown). Because our active nutritional support variables were developed from detailed ethnographic findings, we assessed behaviors that were culturally valued, that were more likely to be incorporated into families' routines, and that were more likely to reflect several key family dynamics simultaneously (17,28,29). For example, behaviors beneficial to diabetes control, such as cooking or buying "light" foods, signal family accommodation to the disease.…”

Section: Study Participants' Characteristicsmentioning

confidence: 99%

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The Role of Active Family Nutritional Support in Navajos’ Type 2 Diabetes Metabolic Control

et al. 2003

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OBJECTIVE -We examined if active family nutritional support is associated with improved metabolic outcomes for Diné (Navajo) individuals living with type 2 diabetes.RESEARCH DESIGN AND METHODS -The presence of family support, using variables identified in earlier ethnographic research, was assessed via surveys in a convenience sample of 163 diabetic individuals. Diabetes outcome measures (HbA 1c , serum glucose, triglycerides, total cholesterol, creatinine, and systolic and diastolic blood pressure measures) were extracted from participants' medical records. Bivariate analyses and multiple logistic regressions were conducted.RESULTS -All measures of family support showed a relation with one or more indicators of metabolic control in bivariate analyses. In multivariate analyses, respondents were more likely to be in the best tertile for triglyceride (P Ͻ 0.05), cholesterol (P Ͻ 0.05), and HbA 1c (P Ͻ 0.05) if another person cooked most of the meals. Respondents in families who bought/cooked "light" foods were more likely to be in the best tertile for triglyceride (P Ͻ 0.005) and cholesterol levels (P Ͻ 0.005), and those in families whose members ate "light" foods with them were more likely to be in the best tertile for triglycerides (P Ͻ 0.005). When all three support variables were entered into a multivariate model, only the variable "other family members cook the majority of the meals" was significantly associated with being in the lowest triglyceride (P ϭ 0.05), HbA 1c (P Ͻ 0.05), or cholesterol tertiles (P Ͻ 0.05). These relationships were most evident for women with diabetes.CONCLUSIONS -Active family nutritional support, as measured by culturally relevant categories, is significantly associated with control of triglyceride, cholesterol, and HbA 1c levels. The findings suggest that the family is a more useful unit of intervention for Diné individuals than for the individual alone when designing diabetes care strategies. Diabetes Care 26:2829 -2834, 2003D iabetes has reached epidemic proportions among the Diné (Navajo): over one in five adults aged Ն20 years (22.9%) have diabetes, which is a prevalence rate five times higher than the age-standardized rate for the U.S. population as a whole (1). Among Diné individuals aged 45-64 years and Ն65 years, diabetes prevalence rates increase to 40.1 and 41.3%, respectively (1). Complications from the disease can also be devastating. Nearly one-third (30.9%) of those with the disease had cardiovascular disease, which is a rate 5.2 times greater than age-and sex-matched Diné without diabetes (2). Cerebrovascular disease, peripheral vascular disease, microalbuminuria, and hospital admissions occurred at rates 10.2, 6.8, 4, and 2 times greater, respectively, for Diné with diabetes than for those without the disease (2-4). Among Diné with diabetes, 30% reported problems with vision, 20% with feet, and 17% with kidneys (1). Thus, identification of factors that improve metabolic control in the disease is of paramount importance to the Diné.Fisher et al. (5) have identified f...

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Section: Study Participants' Characteristicsmentioning

confidence: 84%

Section: Study Participants' Characteristicsmentioning

confidence: 99%

The Role of Active Family Nutritional Support in Navajos’ Type 2 Diabetes Metabolic Control

et al. 2003

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“…High BMI (>30) was positively, whereas medium level of BMI (27)(28)(29)(30) was negatively correlated to having a perceived ''passive'' role in diabetes management (r = 0.182 and À0.159; both p < 0.05, respectively).…”

Section: Characteristics Of the Diseasementioning

confidence: 97%

“…Women often experience conflicting demands in their day-to-day diabetes management [25][26][27][28]. Therefore, it seems to be of special importance that women's social networks provide them diabetes-specific social support to improve metabolic outcomes [29].…”

Section: Characteristics Of the Social Network/context Of Disease Manmentioning

confidence: 99%

The influence of participant's self-perceived role on metabolic outcomes in a diabetes group education program

Sarkadi

Vég

Rosenqvist

2005

Patient Education and Counseling

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“…13 There are several psychosocial factors supported in the literature that appear to affect DSM in nonimmigrant populations, namely social support, 14,15 depressive symptomatology, 16 and illness perceptions. 17 Yet, the role of gender and ethnocultural barriers in DSM have received minimal research attention, 18,19 and diabetes associations have recognized the need to be more culturally relevant. Our objective in this study was to explore the relationship among gender and ethnocultural barriers, family support, depressive symptomatology, and illness perceptions on self-reported DSM in Italian women and men with type 2 diabetes living in Canada.…”

Section: Gender Ethnocultural and Psychosocial Barriers To Diabetesmentioning

confidence: 99%

Gender, Ethnocultural, and Psychosocial Barriers to Diabetes Self-Management in Italian Women and Men With Type 2 Diabetes

Ponzo

Gucciardi

Weiland

et al. 2006

Behavioral Medicine

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Although several ethnic groups experience a greater burden of diabetes, this has not been examined in first-generation Italians, who compose one of the largest ethnocultural groups in Canada. In this cross-sectional study, the authors examined the relationship among gender and ethnocultural factors, family support, depressive symptomatology, and illness perceptions on diabetes self-management (DSM) in 50 Italian women and men with type 2 diabetes. The authors first conducted a focus group to explore cultural barriers. They then assessed gender, ethnocultural, and psychosocial barriers quantitatively by an interviewer-administered questionnaire. Compared with Italian men, Italian women reported significantly greater depressive symptomatology and perceived disease seriousness. Greater depressive symptomatology was significantly associated with perceived family sabotage and DSM barriers. In univariate analyses, shorter duration of diabetes and greater perceived treatment effectiveness significantly predicted better DSM. In conclusion, certain illness perceptions and culturally relevant gender-specific barriers should be addressed by health care providers to maximize DSM in this population. Index Terms: diabetes, diet, gender, self-management

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Post-Diagnosis Family Adaptation Influences Glycemic Control in Women with Type 2 Diabetes Mellitus

Cited by 19 publications

References 28 publications

The Role of Active Family Nutritional Support in Navajos’ Type 2 Diabetes Metabolic Control

The Role of Active Family Nutritional Support in Navajos’ Type 2 Diabetes Metabolic Control

The influence of participant's self-perceived role on metabolic outcomes in a diabetes group education program

Gender, Ethnocultural, and Psychosocial Barriers to Diabetes Self-Management in Italian Women and Men With Type 2 Diabetes

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