Communal Coping Manifested in Daily Life: A Focus on Gender

Communal coping consists of a shared appraisal of a stressor and collaborative efforts to manage it. There has been a wealth of literature linking communal coping to relationship and health outcomes, but there is little research on the context in which communal coping occurs or how communal coping is manifested in daily life. The first and second study goals were to examine the implications of gender for the components of communal coping (shared appraisal, collaboration) and for potential manifestations of communal coping in daily life (e.g., shared meals). Our third study goal was to examine whether shared appraisal and collaboration in the context of diabetes generalized to another domain—household chore distribution—and whether these relations were moderated by gender. As an exploratory goal, we examined intersections of gender with race. Participants were 203 couples in which one person had been recently diagnosed with type 2 diabetes. Shared appraisal and collaboration were assessed with multiple methods. Results showed greater shared appraisal and collaboration when patients were male than when they were female. This finding extended to some, but not all, of the daily life behaviors. Actor–partner interdependence models showed that the relations of actor and partner shared appraisal to household labor depended on both role (patient, spouse) and gender; relations of actor and partner collaboration depended only on role. Findings were not moderated by race. These results highlight the need to consider gender in the context of communal coping.

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Correlates of Self-Care Behaviors in Adults With Type 2 Diabetes and Comorbid Heart Failure

The Diabetes Educator ◽

10.1177/0145721719855752 ◽

2019 ◽

Vol 45 (4) ◽

pp. 380-396 ◽

Cited By ~ 2

Author(s):

Fekadu B. Aga ◽

Sandra B. Dunbar ◽

Tedla Kebede ◽

Melinda Kay Higgins ◽

Rebecca A. Gary

Keyword(s):

Heart Failure ◽

Type 2 Diabetes ◽

African American ◽

Health Outcomes ◽

African American Men ◽

Self Care ◽

Multiple Chronic Conditions ◽

Foot Care ◽

And Gender

Purpose The purpose of this study was to describe sociodemographic, clinical, and psychosocial correlates of diabetes self-care behaviors in adults with type 2 diabetes mellitus (T2D) and comorbid heart failure (HF). Method Baseline data of 180 participants from a clinical trial that tested a 6-month integrated self-care intervention for persons with comorbid HF and T2D were analyzed. Correlational bivariate and multiple logistic regression analyses were performed to examine correlates of diabetes self-care behaviors. Result Participants had a mean age of 58 ± 11years; the majority were male (n = 118, 66%) and African American (n = 119, 66%). Number of comorbidities >2 ( P < .001), having more than a high school education ( P < .05), and African American ethnicity ( P < .05) predicted better exercise, self-monitoring blood glucose (SMBG), and foot care behaviors, respectively. The use of an aldosterone inhibitor ( P < .05) predicted worse exercise performance, higher Charlson Comorbidity Index scores ( P < .01) predicted worse SMBG, and treatment with diet plus medication ( P < .05) and dyslipidemia ( P < .001) predicted worse foot care. Conclusion Findings from this study provide new insights into the complex self-care requirements for T2D patients with comorbid HF. Integrated self-care interventions are clearly warranted in persons living with multiple chronic conditions for optimal health outcomes and the prevention of complications. Our sample of predominately African American men showed they had better T2D self-care behaviors than whites than previously reported. Additional research is needed to determine racial and gender differences on health outcomes in persons with T2D and comorbid HF.

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Outcomes of a digitally delivered, culturally-sensitive behaviour change platform for BAME adults with type 2 diabetes: 1 year health and engagement outcomes (Preprint)

10.2196/preprints.18674 ◽

2020 ◽

Author(s):

Charlotte Summers

Keyword(s):

Type 2 Diabetes ◽

Body Weight ◽

Health Outcomes ◽

Behavioural Change ◽

Culturally Sensitive ◽

Lifestyle Changes ◽

Haemoglobin A1c ◽

Central Asian ◽

Increased Risk

BACKGROUND People from Black, Asian and Minority Ethnic (BAME) groups are known to have an increased risk of developing type 2 diabetes and face greater barriers to accessing healthcare resources compared to their “white British” counterparts. The main mediators of lifestyle behavioural change are gender, generation, geography, genes, God/religion, and gaps in knowledge and economic resources. Dietary and cultural practices of these individuals significantly vary according to gender, generation, geographical origin and religion. Recognition of these factors and implementing culturally sensitive interventions for type 2 diabetes prevention and management is essential in increasing knowledge of healthy eating, engagement in physical activity and improving health outcomes in BAME communities. Few health apps are tailored for BAME populations, and BAME communities are considered hard-to-reach. OBJECTIVE Our objective was to establish whether the Low Carb Program is a viable scalable solution that can be used as an effective tailored type 2 diabetes intervention for BAME communities. We hypothesized that by taking into account cultural sensitivities, providing the platform in native languages and personalising the platform in accordance with known barriers to health disparities including gender, generation, dietary preferences and religion, the app would engage BAME communities and improve type 2 diabetes related health outcomes. METHODS The study used a quasi-experimental research design comprised of an open-label, single-arm, pre-post intervention using a sample of convenience. All 705 adults with type 2 diabetes who had activated their referral to the Low Carb Program as a result of an NHS consultation between September 2018 and March 2019 were followed for a period of 12 months; mean age 54.61 (SD 16.69) years; 58.2% (410/705) women; 45.1% (318/705) white, 28.5% (201/705) Indian/Pakistani/Bangladeshi/Other Central Asian, 10.8% (76/705) Arab, 6.2% (44/705) Mixed/Multiple ethnic groups, 6% (43/705) black, 1.8% (13/705) other, (7/705) 1% Chinese/Japanese/Other East Asian. Mean starting glycated haemoglobin A1c (HbA1c) 7.99% (SD 2.05%); mean body weight 88.96kg (SD 23.25kg). RESULTS Of the 705 study participants, 513 (72.76%) had completed the Low Carb Program at 12 months. There were statistically significant reductions in body weight and HbA1c in white, Indian/Pakistani/Bangladeshi/Other Central Asian, Arabic and black participants with the most significant differences in the Indian/Pakistani/Bangladeshi/Other Central Asian population HbA1c -1.18% (SD 1.49%) and weight 8.03kg (SD 10.65kg). 82.9% of all participants (419/705) of all participants lost at least 5% of their body weight. CONCLUSIONS Offering the culturally tailored Low Carb Program that empowers members to make dietary and lifestyle changes to different BAME groups is an effective and engaging tool in the management of type 2 diabetes. Most importantly, BAME populations in particular people from Indian/Pakistani/Bangladeshi and Arabic groups who achieve better health outcomes than their white counterparts.

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Examining the impact of mental disease on type 2 diabetes outcomes: results from the EpiChron Cohort

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.819 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

I Guerrero Fernández de Alba ◽

A Gimeno-Miguel ◽

B Poblador Plou ◽

K Bliek Bueno ◽

J Carmona Pirez ◽

...

Keyword(s):

Type 2 Diabetes ◽

Substance Abuse ◽

Early Detection ◽

Health Outcomes ◽

Emergency Room ◽

Mental Disease ◽

Emergency Room Visits ◽

Mental Diseases ◽

The Impact

Abstract Background Type 2 diabetes mellitus (T2D) is often accompanied by other chronic diseases, including mental diseases (MD). This work aimed at studying MD prevalence in T2D patients and analyse its impact on T2D health outcomes. Methods Retrospective, observational study of individuals of the EpiChron Cohort aged 18 and over with prevalent T2D at baseline (2011) in Aragón, Spain (n = 63,365). Participants were categorized by the existence or absence of MD, defined as the presence of depression, anxiety, schizophrenia or substance abuse. MD prevalence was calculated, and a logistic regression model was performed to analyse the likelihood of the four studied health outcomes (4-year all-cause mortality, all-cause hospitalization, T2D-hospitalization, and emergency room visits) based on the presence of each type of MD, after adjusting by age, sex and number of comorbidities. Results Mental diseases were observed in 19% of T2D patients, with depression being the most frequent condition, especially in women (20.7% vs. 7.57%). Mortality risk was significantly higher in patients with MD (odds ratio -OR- 1.24; 95% confidence interval -CI- 1.16-1.31), especially in those with substance abuse (OR 2.18; 95% CI 1.84-2.57) and schizophrenia (OR 1.82; 95% CI 1.50-2.21). The presence of MD also increased the risk of T2D-hospitalization (OR 1.51; 95% CI 1.18-1.93), emergency room visits (OR 1.26; 95% CI 1.21-1.32) and all-cause hospitalization (OR 1.16; 95% CI 1.10-1.23). Conclusions The high prevalence of MD among T2D patients, and its association with health outcomes, underscores the importance of providing integrated, person-centred care and early detection of comorbid mental diseases in T2D patients to improve disease management and health outcomes. Key messages Comprehensive care of T2D should include specific strategies for prevention, early detection, and management of comorbidities, especially mental disorders, in order to reduce their impact on health. Substance abuse was the mental disease with the highest risk of T2D-hospitalization, emergency room visits and all-cause hospitalization.

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Age- and Gender-Related Differences in LDL-Cholesterol Management in Outpatients with Type 2 Diabetes Mellitus

International Journal of Endocrinology ◽

10.1155/2015/957105 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 10

Author(s):

Giuseppina Russo ◽

Basilio Pintaudi ◽

Carlo Giorda ◽

Giuseppe Lucisano ◽

Antonio Nicolucci ◽

...

Keyword(s):

Type 2 Diabetes ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Serum Levels ◽

Diabetes Duration ◽

Lipid Lowering ◽

Age And Gender ◽

Chd Risk ◽

And Gender

Background. Dyslipidemia contribute to the excess of coronary heart disease (CHD) risk observed in women with type 2 diabetes (T2DM). Low density lipoprotein-cholesterol (LDL-C) is the major target for CHD prevention, and T2DM women seem to reach LDL-C targets less frequently than men.Aim. To explore age- and gender-related differences in LDL-C management in a large sample of outpatients with T2DM.Results. Overall, 415.294 patients (45.3% women) from 236 diabetes centers in Italy were included. Women were older and more obese, with longer diabetes duration, higher total-cholesterol, LDL-C, and HDL-C serum levels compared to men (P<0.0001). Lipid profile was monitored in ~75% of subjects, women being monitored less frequently than men, irrespective of age. More women did not reach the LDL-C target as compared to men, particularly in the subgroup treated with lipid-lowering medications. The between-genders gap in reaching LDL-C targets increased with age and diabetes duration, favouring men in all groups.Conclusions. LDL-C management is worst in women with T2DM, who are monitored and reach targets less frequently than T2DM men. Similarly to men, they do not receive medications despite high LDL-C. These gender discrepancies increase with age and diabetes duration, exposing older women to higher CHD risk.

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I am a rock; I am an island: Implications of avoidant attachment for communal coping in adults with type 2 diabetes

Journal of Social and Personal Relationships ◽

10.1177/0265407519832671 ◽

2019 ◽

Vol 36 (11-12) ◽

pp. 3711-3732

Author(s):

Meredith Van Vleet ◽

Vicki S. Helgeson

Keyword(s):

Type 2 Diabetes ◽

Chronic Illness ◽

Boundary Conditions ◽

Relationship Quality ◽

Current Investigation ◽

Heterosexual Couples ◽

Communal Coping ◽

Diabetes Outcomes ◽

Avoidant Attachment

Accumulating evidence indicates that communal coping is beneficial for individuals with chronic illness. The current investigation examined attachment as a moderator of the effects of communal coping in a sample of persons with type 2 diabetes. We hypothesized that patient communal coping would be associated with higher relationship quality, lower distress, and better diabetes outcomes for patients low in avoidant attachment, but it would not be beneficial for patients high in avoidant attachment. Patient communal coping was coded from videotaped interactions in which 86 heterosexual couples discussed difficulties managing diabetes. The results indicated that patient communal coping was beneficial when avoidant attachment was low. When avoidant attachment was high, patient communal coping was related to lower relationship quality and higher distress and was unrelated to diabetes outcomes. This work sheds light on potential boundary conditions of communal coping’s benefits, which will be important to consider in future communal coping interventions.

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Abstract 3555: Increased Fatness and Reduced Fitness are Associated with Aortic Stiffness in Persons with Type 2 Diabetes and Hypertension

Circulation ◽

10.1161/circ.116.suppl_16.ii_804-c ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Kerry J Stewart ◽

Brian H George ◽

Kristina Potrekus ◽

Anita C Bacher ◽

Harry A Silber ◽

...

Keyword(s):

Type 2 Diabetes ◽

Oxygen Uptake ◽

Body Fat ◽

Visceral Fat ◽

Maximal Oxygen Uptake ◽

Aortic Stiffness ◽

Percent Body Fat ◽

Large Artery ◽

And Gender

Background: Large artery stiffness, thought to be a marker of cardiovascular disease, is accelerated in persons with diabetes and hypertension. While reduced fatness and increased fitness are associated with lower BP, we tested the hypothesis that increased fatness and reduced fitness are each independently associated with greater aortic stiffness. Methods: Sedentary subjects (M=60; F=29), mean (SD) age 57.1 (5.8) years, were examined at baseline as part of an exercise training study to reduce BP in persons with type 2 diabetes. Subjects were taking their usual medical therapy. For BP eligibility, subjects were required to have SBP between 120–159 and/or DBP between 80–99 mm Hg during 2 consecutive weekly visits. BP was the mean of the screening visits and a visit after qualification for the study. Aortic stiffness was assessed by carotid-to-femoral pulse wave velocity (PWV), using ultrasound probes simultaneously at each of these sites. General fatness was assessed by dual-energy x-ray absorptiometry (DEXA) and expressed as percent body fat. Abdominal fatness was assessed by magnetic resonance imaging at the level of the umbilicus and the areas for total, subcutaneous, and visceral fat were measured. Maximal oxygen uptake was obtained on a treadmill. The associations of PWV with BP, oxygen uptake, and abdominal fat were determined by stepwise regression analysis with adjustment for age and gender. Results: PWV was 922.9 (300.0) msec, SBP was 126.9 (13.2) mm Hg, DBP was 71.8 (8.8) mm Hg, pulse pressure (PP) was 55.0 (10.4) mm Hg, percent body fat was 35.0 (6.5) %, and maximal oxygen uptake was 21.7 (5.0) ml/kg/min. In the final model, the variance in PWV was accounted for by increased PP, 8.9%; increased abdominal visceral fat accounted for an additional 6.2%; increased percent body fat, an additional 3%; and decreased maximal oxygen uptake, an additional 5.6%. Conclusions: These data bring to light an independent relationship of aortic stiffness with increased fatness and reduced fitness. Though further work is needed to elucidate the mechanisms linking aortic stiffness, fatness, and fitness, these findings support the need for a therapeutic approach for reducing aortic stiffness that considers the potential benefits of weight reduction and exercise.

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584-P: Diabetes Distress, Depressive Symptoms, and Gender Disparities in Glycemic Control among African Americans with Type 2 Diabetes

Diabetes ◽

10.2337/db21-584-p ◽

2021 ◽

Vol 70 (Supplement 1) ◽

pp. 584-P

Author(s):

JACLYNN M. HAWKINS ◽

NIKOLAS J. KOSCIELNIAK ◽

ROBIN NWANKWO ◽

MARTHA M. FUNNELL ◽

KATHERINE A. KLOSS ◽

...

Keyword(s):

Type 2 Diabetes ◽

Depressive Symptoms ◽

African Americans ◽

Glycemic Control ◽

Gender Disparities ◽

Diabetes Distress ◽

And Gender

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Impact on Diabetes Mellitus on the Epicardial Coronary Flow Velocity Assessed by the Thrombolysis in Myocardial Infarction Frame Count

Angiology ◽

10.1177/0003319708321187 ◽

2008 ◽

Vol 60 (4) ◽

pp. 431-440 ◽

Cited By ~ 1

Author(s):

Ahmet Soylu ◽

Kurtulus Ozdemir ◽

Mehmet Akif Duzenli ◽

Mehmet Yazici ◽

Mehmet Tokac

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Flow Velocity ◽

Coronary Arteries ◽

Coronary Flow ◽

Coronary Flow Velocity ◽

And Gender

The aim of this study is to evaluate the effect of type 2 diabetes mellitus on epicardial coronary flow velocity assessed by the thrombolysis in myocardial infarction frame count. The thrombolysis in myocardial infarction frame count was measured in 272 coronary arteries from 101 patients with type 2 diabetes mellitus and in 271 coronary arteries from 104 age- and gender-matched patients without type 2 diabetes mellitus referred for coronary angiography. The thrombolysis in myocardial infarction frame count was measured only in normal arteries or in arteries without significant lesion. By both univariate and multivariate analysis, the thrombolysis in myocardial infarction frame count was not related with either type 2 diabetes mellitus or the duration and glycated hemoglobin levels in the patients with type 2 diabetes mellitus. The thrombolysis in myocardial infarction frame count was significantly associated with body surface area, heart rate, and proximal coronary artery diameter. Type 2 diabetes mellitus did not affect epicardial coronary flow velocity assessed by the thrombolysis in myocardial infarction frame count.

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