206569 Diabetes Self-Management and Outcomes: A Bi-National Comparison of Urban/Rural Mexicans and Mexican-Americans

Tuesday, November 10, 2009

Ranjita Misra, PhD , Medical Dietetics, Health and Wellness, Ohio State University, Columbus, OH
Roxana Valdes-Ramos, PhD , Dept of Medicine, UAEM, Toluca, Edo. Mex. 50000, Mexico
Ivonne Vizcarra-Bordi, PhD , Dept of Medicine, UAEM, Toluca, Edo. Mex. 50000, Mexico
Martha Kaufer-Horwitz, DSc , y Nutrición Salvador Zubirán, Obesity and Food Disorders Clinic, Instituto Nacional de Ciencias Médicas, Mexico, DF, Mexico
Sukho Lee, PhD , Fitness and Sports Program, Texas A&M International University, Laredo, TX
Steve Riechman, PhD , Health and Kinesiology, Texas A&M University, College Station, TX
Linda Castillo, PhD , Dept of Educational Psychology, Texas A&M University, College Station, TX
Anita Connelly-Nicholson, PhD , Texas, Houston TX, TX
Objective: To examine social, contextual, and individual factors that influence self-management and short/long-term diabetes outcomes in Mexicans and Mexican-Americans. Method: 151 Mexico rural/urban Mexicans in El Oro and Toluca City in Mexico (76% Females, 24% Males; mean age 55.1 ± 15.5 years) and 108 Texas Mexican-Americans in Laredo, McAllen, and Bryan/College Station Texas (78% Females, 22% Males; mean age 47.7 ± 10.7 years). Data was collected via face-to-face interviews by ethnically similar interviewers. Results: Mean age of onset was 42 and 49 years for Mexican-Americans and Mexicans respectively. The majority of Mexican-Americans was first generation, high school graduates, and indicated their diet has changed since coming to the US. Average number of years lived in the US was 21.5 ±12.6 years. Respondents in Mexico had a similar pattern of high illiteracy. 75% of the respondents were obese or morbidly obese (BMI ≥ 35.0). Biochemical markers indicated Mexican-Americans had high cholesterol and triglyceride levels (cholesterol 181±41 mg/dl, triglyceride 195 ± 129 mg/dl, HDL 42±9.6 mg/dl, LDL, 100±34 mg/dl, and A1C, 7.4±1.7). 47% of Mexican-Americans had poor diabetes control as per the ADA standards (A1C > 7.0); 57.3% Mexicans had abnormal A1C values. Significant differences were found in demographic, anthropometric, psychosocial, lifestyle, and clinical parameters between Mexicans and Mexican-Americans. Mexican Americans were significantly more obese, had higher systolic and diastolic hypertension then the Mexican respondents. However, Mexican with diabetes had significantly higher fasting blood glucose and poorer control of the disease and higher levels of depression as compared to Mexican-Americans (p<0.001). Mexicans had generally healthier nutrition behavior but lower levels of physical activity as compared to Mexican-Americans. Conclusion: Results indicate the need for self-management education programs in both groups.

Learning Objectives:
1. Describe the self-management behaviors and biochemical makers among Mexicans and Mexican-Americans. 2. List the differences in social, contextual, and individual factors that influence self-management in the two groups. 3. Discuss critical components of a culturally responsive management and education program for this ethnic group.

Keywords: Diabetes, Outcome Measures

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a health disparities researcher with cross-cultural studies in US, Mexico, and India.
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.