Abstract
Non-insulin-dependent diabetes mellitus (NIDDM) is a major health problem among Latinos, yet the quality of diabetes treatment among them has not been fully examined.Goals: A pilot study was conducted with adult diabetic patients for the purposes of describing their diabetes-related knowledge and behaviors and evaluating whether these patients were receiving effective outpatient care.
Methods: Demographic data, health knowledge, and behavioral information was collected using face-to-face interviews with 101 patients diagnosed for at least 1 year at three primary care clinics. The medical record of each interviewee was abstracted for evidence that medical follow-up was being conducted with the recommended frequency.
Results: Most respondents spoke only or mostly Spanish, yet 14% of these patients reported that they had received instruction about diabetes in English alone. A majority of patients exhibited a basic understanding of their disease, and more than half reported positive health behaviors within the past year. Nonetheless, 54% of Puerto Rican Americans and 26% of Mexican-Americans had been admitted to the hospital or had used the emergency room for diabetes-related conditions. Recommended medical procedures were infrequently documented in clinic records
Conclusions: Diabetes education was available in Spanish, and patients appeared to have a basic knowledge of the disease process. However, recommended clinical follow-up was not uniformly provided. The large number of diabetes-related hospitalizations may be related to sub-optimal management among at least some of these patients.
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References
Flegal, K., Ezzati, T.M., Harris, M.I., et al. Prevalence of diabetes in Mexican-Americans, Cubans, and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey, 1982–1984.Diabetes Care 14(suppl. 3):628–38, 1991.
Harris, M.I. Epidemiologic Correlates of NIDDM in Hispanics, Whites and Blacks in the US Population.Diabetes Care 14(suppl. 3):639–48, 1991.
Harris, M.I. Undiagnosed NIDDM: Clinical and Public Health Issues.Diabetes Care 16:642–52, 1993.
Marshall, J.A., Hamman, R.F., Baxter, J., Mayer, E.J., Fulton, D.L., Orleans, M., Rewers, M., and Jones, R.H. Ethnic differences in risk factors associated with the prevalence of non-insulin-dependent diabetes mellitus: The San Luis Valley Study.Am. J. Epidemiol. 137:706–18, 1993.
Joslin, E.P.A Diabetic Manual of the Mutual Use of Doctor and Patient, 3rd ed., Lea & Febinger, Philadelphia, PA, 1924, p. 24.
Raymond, N.R., and D'Eramo-Melkus, G. Non-insulin-dependent diabetes and obesity in the Black and Hispanic population: Culturally-sensitive management.Diabetes Educator 19:313–17, 1993.
Puente, S., Norkewicz, M., and Paral, R. Demographic profile of Latinos in the Midwest. Presented at the Surgeon General's Regional Health Meeting on Latino Health. Latino Institute, Chicago. IL, March 11, 1993.
Project Alivio Needs Assessment. Hispanic Health Alliance, Chicago, IL, 1986.
Weir, G. C., Nathan, D.M., and Singer, D.E. Standards of Care for Diabetes.Diabetes Care 17: 1514–22, 1994.
Greenfield, S., Kaplan, S.H., Silliman, R.A., Sullivan, L., Manning, W., D'Agostino, R., Singer, D.E., and Nathan, D.M. The use of outcomes research for medical effectiveness, quality of care, and reimbursement in Type II Diabetes.Diabetes Care 17(suppl. 1):32–39, 1994.
Marín, G., Sabogal, F., Marín, B., Otero-Sabogal, R., and Perez-stable, E.J. Development of a Short Acculturation Scale for Hispanics.Hisp. J. Behav. Sci. 9:183–205, 1987.
Songer, T.J., LaPorte, R.E., Dorman, J.S., Orchard, T.J., Becker, D.J., and Drash, A.L. Health, life and insurance characteristics in adults with IDDM.Diabetes Care 14:318–24, 1991.
Norusis, M.J. SPSS Base Manual, SPSS Inc., Chicago, IL, 1990.
Miller, K.L., and Hirsch, I.B. Physicians' Practices in Screening for the Development of Diabetic Nephropathy and the Use of Glycosylated Hemoglobin Levels.Diabetes Care 17:1495–97, 1994.
Fain, J.A. and D'Eramo-Melkus, G. Nurse practitioner practice patterns based on standards of medical care for patients with diabetes.Diabetes Care 17:879–81, 1994.
Anderson, R.M., Hess, G.E., Davis, W.K., and Hiss, R.G. Community diabetes care in the 1980s.Diabetes Care 11:519–26, 1988.
United States Public Health Service, Centers for Disease Control. Diabetes Surveillance 1991. US Government Printing Office Document #635-150; p. 90, 1992.
Zaremba, M.M., Wilhoite, B., and Ra, K. Self-reported data: Reliability and role in determining program effectiveness.Diabetes Care 8:486–90, 1985.
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Lipton, R., Losey, L., Giachello, A.L. et al. Factors affecting diabetes treatment and patient education among latinos: Results of a preliminary study in Chicago. J Med Syst 20, 267–276 (1996). https://doi.org/10.1007/BF02257040
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DOI: https://doi.org/10.1007/BF02257040