Predictors of diabetes self-management among Mexican Americans

Background:  Diabetes education increases knowledge and self-management behaviors, improves clinical outcomes, and prevents or delays diabetes associated morbidity.  Multiple variables including self-efficacy, health literacy and diabetes distress also affect diabetes self-management behaviors.

 Methods: Baseline data from 100 adults of Mexican origin with Type 2 diabetes were used. Hierarchical regression assessed the additional effects diabetes distress (step 2) and diabetes self-efficacy (step 3) had on diabetes self-management after controlling for health literacy and diabetes knowledge in step 1. A second regression assessed the four diabetes distress subscales in step 2.  

Results:  In the first regression diabetes distress and self-efficacy were both significant in step 3 accounting for 20% of the variance in diabetes self-management. In the second regression only the regimen distress subscale was significant in step 2. The diabetes distress subscales and self-efficacy accounted for 25% of the variance in diabetes self-management. Diabetes knowledge and health literacy were not significant predictors of diabetes self-management.

Conclusions: Unexpected findings were that three of the diabetes distress subscales, health literacy and diabetes knowledge were not significant predictors of diabetes self-management. One possible explanation is that the diabetes knowledge scale addresses general knowledge with limited items related to self-management behaviors. Based on these findings interventions with a greater emphasis on diabetes self-efficacy and diabetes distress may be required with this population.