179170 Patient-perceived barriers to diabetes control among Spanish-speaking migrant workers in northeast Colorado

Monday, October 27, 2008

Loretta V. Sullivan, MD, MPH , Department of Medicine, UCLA/VA Greater Los Angeles Healthcare System, Los Angeles, CA
Paul Hicks, MD , Salud Family Health Center, Fort Lupton, CO
Gilda Salazar, RN, CDE , Salud Family Health Center, Fort Lupton, CO
Kelet Robinson, MD , Salud Family Health Center, Fort Lupton, CO
Purpose: Latinos have higher diabetes prevalence and complication rates with lower use of self-management compared to Anglo patients. This study evaluated perceived barriers to diabetes control among Spanish-speaking only patients in the rural Colorado community of Fort Morgan.

Methods: Thirty-five patients Spanish-speaking patients with diabetes were randomly sampled and interviewed about their attitudes and beliefs concerning diabetes, self-management activities, and the care they received.

Results: Patients perceived a high level of control over their diabetes. A minority of patients were adherent to recommended dietary changes or levels of exercise. Use of herbal home remedies to maintain glycemic control was common. Almost half of respondents felt that susto played a role in the development of their diabetes. Three fourths of those testing their glucose felt their physician was not interested in reviewing their blood sugar log. Many respondents had seasonal-related migration between their home countries and the US, disrupting continuity of care.

Conclusions: Diabetes management programs should recognize the unique barriers that Latino migrant patients may have to self-management and help patients incorporate traditional beliefs into a workable treatment regimen. Improved communication between physicians and patients should be emphasized, and with the support of social workers and diabetes educators, may mitigate the unique challenges in providing diabetes care to migrant populations.

Learning Objectives:
1. Recognize three unique barriers to diabetes care in immigrant populations. 2. Identify three examples of the incorporation traditional beliefs in diabetes care. 3. Develop an action plan to improve the care of diabetes in immigrant populations.

Keywords: Diabetes, Migrant Workers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted the research and was the primary author of the paper.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.