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Acculturation and Glycemic Control of Asian Indian Adults with Type 2 Diabetes

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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.

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Authors and Affiliations

  1. 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

    Sumathi Venkatesh

  2. 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

    Lorraine J. Weatherspoon

  3. Department of Sociology, Michigan State University, 457C Berkey Hall, East Lansing, MI, 48824, USA

    Stan A. Kaplowitz

  4. 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

    Won O. Song

Authors
  1. Sumathi Venkatesh
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  2. Lorraine J. Weatherspoon
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  3. Stan A. Kaplowitz
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  4. Won O. Song
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Correspondence to Sumathi Venkatesh.

Additional information

Approval for this study was obtained from the Institutional Review Board of Michigan State University. The research study was conducted to complete the M.S. degree requirements of Sumathi Venkatesh. The following Michigan State University Graduate School scholarship funds were used for data collection: Graduate Student Research Enhancement Award, 2009 and the Food, Nutrition, and Chronic Disease Fellowship, 2009.

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Venkatesh, S., Weatherspoon, L.J., Kaplowitz, S.A. et al. Acculturation and Glycemic Control of Asian Indian Adults with Type 2 Diabetes. J Community Health 38, 78–85 (2013). https://doi.org/10.1007/s10900-012-9584-6

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