Abstract
The prevalence of type 2 diabetes is disproportionately high among Asian Indians (AI), one of the fastest growing immigrant
groups in the United States (US). Poorly controlled diabetes associated with inadequate self-management increases complications
and thus medical costs. Acculturation may be an important determinant of diabetes self-management and hence control. This
study examined the association between the degree of acculturation and glycemic control as measured by Hemoglobin A1c in AI
adults with type 2 diabetes. A mixed method (quantitative and qualitative) study was conducted among 30 AI adults with type
2 diabetes. Acculturation assessment using the Suinn-Lew Asian Self-identity Instrument was followed by socio-demographic
questions, self-reported anthropometric measures, and open ended diabetes self-care questions. A two-step multiple regression
analysis and content analysis of verbatim interview transcriptions were conducted. Interactions of acculturation with body
mass index (interaction b = 1.11; p = 0.01), annual household income (interaction b = 7.19; p = .01), and diabetes duration (interaction b = .30; p = .02) significantly predicted higher HbA1c levels (R2 change = .368; F change = 4.21; p = .02). From the qualitative interviews, the following were regarded as US specific facilitators for glycemic control: excellent
health care system and facilities, availability of healthy food choices and self-monitoring devices, medical insurance benefits,
good quality medications, and improved health awareness. Cultural orientation might be important for patient tailored interventions
targeting AI with type 2 diabetes. Therefore, interventions targeted at Asian Indians with diabetes should include culture
specific adaptations to nutrition education and support.
groups in the United States (US). Poorly controlled diabetes associated with inadequate self-management increases complications
and thus medical costs. Acculturation may be an important determinant of diabetes self-management and hence control. This
study examined the association between the degree of acculturation and glycemic control as measured by Hemoglobin A1c in AI
adults with type 2 diabetes. A mixed method (quantitative and qualitative) study was conducted among 30 AI adults with type
2 diabetes. Acculturation assessment using the Suinn-Lew Asian Self-identity Instrument was followed by socio-demographic
questions, self-reported anthropometric measures, and open ended diabetes self-care questions. A two-step multiple regression
analysis and content analysis of verbatim interview transcriptions were conducted. Interactions of acculturation with body
mass index (interaction b = 1.11; p = 0.01), annual household income (interaction b = 7.19; p = .01), and diabetes duration (interaction b = .30; p = .02) significantly predicted higher HbA1c levels (R2 change = .368; F change = 4.21; p = .02). From the qualitative interviews, the following were regarded as US specific facilitators for glycemic control: excellent
health care system and facilities, availability of healthy food choices and self-monitoring devices, medical insurance benefits,
good quality medications, and improved health awareness. Cultural orientation might be important for patient tailored interventions
targeting AI with type 2 diabetes. Therefore, interventions targeted at Asian Indians with diabetes should include culture
specific adaptations to nutrition education and support.
- Content Type Journal Article
- Category Original Paper
- Pages 1-8
- DOI 10.1007/s10900-012-9584-6
- Authors
- Sumathi Venkatesh, Department of Food Science and Human Nutrition, Michigan State University, 332 G.M. Trout Building, 469 Wilson Road room 332, East Lansing, MI 48824-1224, USA
- Lorraine J. Weatherspoon, Department of Food Science and Human Nutrition, Michigan State University, 334C G.M. Trout Building, 469 Wilson Road room 332, East Lansing, MI 48824, USA
- Stan A. Kaplowitz, Department of Sociology, Michigan State University, 457C Berkey Hall, East Lansing, MI 48824, USA
- Won O. Song, Department of Food Science and Human Nutrition, Michigan State University, 135A G.M. Trout Building, 469 Wilson Road room 332, East Lansing, MI 48824, USA
- Journal Journal of Community Health
- Online ISSN 1573-3610
- Print ISSN 0094-5145