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Determinants of Fasting Plasma Glucose and Glycosylated Hemoglobin Among Low Income Latinos with Poorly Controlled Type 2 Diabetes

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Abstract

The objective of this study was to identify demographic, socio-economic, acculturation, lifestyle, sleeping pattern, and biomedical determinants of fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c), among Latinos with type 2 diabetes (T2D). Latino adults (N = 211) with T2D enrolled in the DIALBEST trial were interviewed in their homes. Fasting blood samples were also collected in the participants’ homes. Because all participants had poor glucose control, above-median values for FPG (173 mg/dl) and HbA1c (9.2%) were considered to be indicative of poorer glycemic control. Multivariate analyses showed that receiving heating assistance (OR: 2.20; 95% CI: 0.96–4.96), and having a radio (3.11, 1.16–8.35), were risk factors for higher FPG levels, and lower income (10.4, 1.54–69.30) was a risk factor for higher HbA1c levels. Lower carbohydrate intake during the previous day (0.04; 0.005–0.37), as well as regular physical activity (0.30; 0.13–0.69), breakfast (2.78; 1.10–6.99) and dinner skipping (3.9; 1.03–14.9) during previous week were significantly associated with FPG concentrations. Being middle aged (2.24, 1.12–4.47), 30–60 min of sleep during the day time (0.07, 0.01–0.74) and having medical insurance (0.31, 0.10–0.96) were predictors of HbA1c. Results suggest that contemporaneous lifestyle behaviors were associated with FPG and contextual biomedical factors such as health care access with HbA1c. Lower socio-economic status indicators were associated with poorer FPG and HbA1c glycemic control.

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References

  1. National Diabetes Information Clearinghouse (NDIC). National diabetes statistics. Available at http://diabetes.niddk.nih.gov/dm/pubs/statistics/#allages (2007). Accessed on 16 Nov 2008.

  2. American Diabetes Association. Economic costs of diabetes in the US in 2007. Diabetes Care; 2008. p. 1–20.

  3. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC. Holman RR: association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. Bmj. 2000;321:405–12.

    Article  PubMed  CAS  Google Scholar 

  4. Standards of medical care in diabetes–2008. Diabetes Care 2008;31(Suppl 1):S12–54.

  5. Connolly V, Unwin N, Sherriff P, Bilous R, Kelly W. Diabetes prevalence and socioeconomic status: a population based study showing increased prevalence of type 2 diabetes mellitus in deprived areas. J Epidemiol Community Health. 2000;54:173–7.

    Article  PubMed  CAS  Google Scholar 

  6. United States Department of Health and Human Services. Administration for children and families. Low income home energy assistance program: fiscal year 2006. Avaiable at http://www.acf.hhs.gov/programs/ocs/liheap/report/part3.html (2006). Accessed on Oct 2010; 2006.

  7. Burchfiel CM, Hamman RF, Marshall JA, Baxter J, Kahn LB, Amirani JJ. Cardiovascular risk factors and impaired glucose tolerance: the San Luis Valley Diabetes Study. Am J Epidemiol. 1990;131:57–70.

    PubMed  CAS  Google Scholar 

  8. United states Census Bureau. Income, poverty, and health insurance coverage in the United States: 2008. Available at http://www.census.gov/prod/2009pubs/p60-236.pdf. Accessed on 19 May 2009.

  9. The Office of Minority Health. Diabetes and hispanic americans. Available at http://www.omhrc.gov/templates/content.aspx?ID=3324. The Office of Minority Health (2008). Accessed on 29 Dec 2008.

  10. OMH. Diabetes and Hispanic Americans. The office of minority health; 2008.

  11. Center for Disease Control and Prevention: Behavioral risk factor surveillance system. Available at http://apps.nccd.cdc.gov/brfss/ (2008). Accessed on 10 Sep 2009.

  12. Perez-Escamilla RV-LS, Damio G, Segura-Pérez S, Fernandez ML, Calle MC, Kollannoor-Samue G, Chhabra J, D’Agostino D. Short and long term impacts of diabetes peer counseling on HbA1c among Latinos: przeliminary results. FASEB J. 2009;23:336–8.

    Google Scholar 

  13. Therrien M, Ramirez RR.The Hispanic population in the United States: population characteristics. Available at http://www.hawaii.edu/hivandaids/The%20Hispanic%20Population%20in%20the%20US%20%20%20March%202000.pdf (2000). Accessed on 20 June 2009.

  14. Blumberg SJ, Bialostosky K, Hamilton WL, Briefel RR. The effectiveness of a short form of the household food security scale. Am J Public Health. 1999;89:1231–4.

    Article  PubMed  CAS  Google Scholar 

  15. Cuellar A, Arnold B, Maldonado R. Acculturation rating scale for mexican Americans-II: a revision of the original ARSMA scale. Hisp J Behav Sci. 1995;17:275–304.

    Article  Google Scholar 

  16. American Diabetes Association. Standards of medical care in diabetes-2009. Diabetes Care. 2009;32(Suppl 1):S13–61.

    Article  Google Scholar 

  17. United States Department of Health and Human Services. Physical activity and health: a report of the surgeon General. Atlanta, Georgia: US department of health and human services, public health service, CDC, national center for chronic disease prevention and health promotion. Available at http://www.cdc.gov/nccdphp/sgr/pdf/execsumm.pdf (1996). Accessed on 12 Feb 2009.

  18. Dhand R, Sohal H. Good sleep, bad sleep! The role of daytime naps in healthy adults. Curr Opin Pulm Med. 2006;12:379–82.

    Article  PubMed  Google Scholar 

  19. Gillberg M, Kecklund G, Axelsson J, Akerstedt T. The effects of a short daytime nap after restricted night sleep. Sleep. 1996;19:570–5.

    PubMed  CAS  Google Scholar 

  20. Monk TH, Buysse DJ, Carrier J, Billy BD, Rose LR. Effects of afternoon “siesta” naps on sleep, alertness, performance, and circadian rhythms in the elderly. Sleep. 2001;24:680–7.

    PubMed  CAS  Google Scholar 

  21. Mullington J, Broughton R. Scheduled naps in the management of daytime sleepiness in narcolepsy-cataplexy. Sleep. 1993;16:444–56.

    PubMed  CAS  Google Scholar 

  22. Randolff LS. The CES-D scale. Appl Psychol Meas. 1977;1:385–401.

    Article  Google Scholar 

  23. Turk DC, Okifuji A. Detecting depression in chronic pain patients: adequacy of self-reports. Behav Res Ther. 1994;32:9–16.

    Article  PubMed  CAS  Google Scholar 

  24. de Groot M, Pinkerman B, Wagner J, Hockman E. Depression treatment and satisfaction in a multicultural sample of type 1 and type 2 diabetic patients. Diabetes Care. 2006;29:549–53.

    Article  PubMed  Google Scholar 

  25. Zich JM, Attkisson CC, Greenfield TK. Screening for depression in primary care clinics: the CES-D and the BDI. Int J Psychiatry Med. 1990;20:259–77.

    Article  PubMed  CAS  Google Scholar 

  26. Schulberg HC, Saul M, McClelland M, Ganguli M, Christy W, Frank R. Assessing depression in primary medical and psychiatric practices. Arch Gen Psychiatry. 1985;42:1164–70.

    PubMed  CAS  Google Scholar 

  27. Cho MJ, Moscicki EK, Narrow WE, Rae DS, Locke BZ, Regier DA. Concordance between two measures of depression in the Hispanic health and nutrition examination survey. Soc Psychiatry Psychiatr Epidemiol. 1993;28:156–63.

    Article  PubMed  CAS  Google Scholar 

  28. Darmon N, Ferguson EL, Briend A. A cost constraint alone has adverse effects on food selection and nutrient density: an analysis of human diets by linear programming. J Nutr. 2002;132:3764–71.

    PubMed  CAS  Google Scholar 

  29. Lesser C, Cunningham P. Access to care: is it improving or declining? Data Bull (Cent Stud Health Syst Change). 1997;1:1–2.

    Google Scholar 

  30. Marmot MG, Kogevinas M, Elston MA. Social/economic status and disease. Annu Rev Public Health. 1987;8:111–35.

    Article  PubMed  CAS  Google Scholar 

  31. Chin MH, Cook S, Jin L, Drum ML, Harrison JF, Koppert J, Thiel F, Harrand AG, Schaefer CT, Takashima HT, Chiu SC. Barriers to providing diabetes care in community health centers. Diabetes Care. 2001;24:268–74.

    Article  PubMed  CAS  Google Scholar 

  32. Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism. 4th ed. Belmont, CA: Thompson Wadsworth; 2005.

    Google Scholar 

  33. Schlundt DG, Hill JO, Sbrocco T, Pope-Cordle J, Sharp T. The role of breakfast in the treatment of obesity: a randomized clinical trial. Am J Clin Nutr. 1992;55:645–51.

    PubMed  CAS  Google Scholar 

  34. Alexander KE, Ventura EE, Spruijt-Metz D, Weigensberg MJ, Goran MI, Davis JN. Association of breakfast skipping with visceral fat and insulin indices in overweight Latino youth. Obesity (Silver Spring). 2009;17:1528–33.

    Article  Google Scholar 

  35. Gardner DG, Shoback, D. Treatment of diabetes mellitus greenspan’s basic & clinical endocrinology. 8th ed; 2009.

  36. Baldi JC, Snowling N. Resistance training improves glycaemic control in obese type 2 diabetic men. Int J Sports Med. 2003;24:419–23.

    Article  PubMed  CAS  Google Scholar 

  37. Lund S, Holman GD, Schmitz O, Pedersen O. Contraction stimulates translocation of glucose transporter GLUT4 in skeletal muscle through a mechanism distinct from that of insulin. Proc Natl Acad Sci U S A. 1995;92:5817–21.

    Article  PubMed  CAS  Google Scholar 

  38. Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C. Physical activity/exercise and type 2 diabetes. Diabetes Care. 2004;27:2518–39.

    Article  PubMed  Google Scholar 

  39. Songer TJ. The role of cost-effectiveness analysis and health insurance in diabetes care. Diabetes Res Clin Pract. 2001;54(Suppl 1):S7–11.

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was funded and supported by Connecticut NIH Export Center for Eliminating Health Disparities among Latinos (NIH- NCMHD grant # P20MD001765). Special thanks to all who participated in the study and to community health care workers at the Hispanic Health Council. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center on Minority Health and Health Disparities or the National Institutes of Health.

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Correspondence to Grace Kollannoor-Samuel.

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Kollannoor-Samuel, G., Chhabra, J., Fernandez, M.L. et al. Determinants of Fasting Plasma Glucose and Glycosylated Hemoglobin Among Low Income Latinos with Poorly Controlled Type 2 Diabetes. J Immigrant Minority Health 13, 809–817 (2011). https://doi.org/10.1007/s10903-010-9428-3

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