scholarly journals Managing Type 2 Diabetes: Beliefs and Daily Practices in First Generation Asian Indians in the United States

2022 ◽  
Vol 8 ◽  
pp. 237796082110548
Author(s):  
Rupinder M Deol ◽  
Lisa M Thompson ◽  
Kevin M Chun ◽  
Catherine Chesla
Keyword(s):  
Type 2 Diabetes ◽  
Gender Roles ◽  
Asian Indians ◽  
First Generation ◽  
Diabetes Management ◽  
The United States ◽  
Self Management ◽  
Dietary Practices ◽  
Beliefs And Practices

Introduction Diabetes management and control remain poor in Asian Indians (AI) and is influenced by personal beliefs and cultural practices. Since AIs have a high prevalence of diabetes and are more likely develop complications earlier than any other ethnic group, understanding their beliefs and practices of diabetes management is essential. The purpose of this study was to examine and understand beliefs and practices about diabetes self-management in first-generation AI Hindus and Sikhs. Method Interpretative phenomenology was used to interview 12 first generation AI participants with type 2 diabetes to elicit beliefs and daily self-management practices of diabetes. Interpretative and thematic analysis were completed. Results Diabetes self-management was a balancing act influenced by Ayurvedic principles, allopathy and dietary practices; gender roles, insufficient knowledge and culturally inappropriate diabetes education. Discussion Culturally appropriate strategies that incorporate Ayurvedic principles, dietary practices, gender roles should be developed to improve diabetes management.

Beliefs About the Causes of Type 2 Diabetes Among First-Generation Asian Indians in the United States

2021 ◽  
pp. 104365962110165
Author(s):  
Rupinder M. Deol ◽  
Lisa M. Thompson ◽  
Kevin M Chun ◽  
Catherine Chesla
Keyword(s):  
United States ◽  
Type 2 Diabetes ◽  
Health Beliefs ◽  
Asian Indians ◽  
First Generation ◽  
Minority Group ◽  
The United States ◽  
Causal Beliefs ◽  
And Gender

Introduction Asian Indians (AIs) have the highest prevalence rates (18.3%-29%) of diabetes in any minority group in the United States, yet little is known about their beliefs about what causes type 2 diabetes. The purpose of this study was to examine first generation AIs causal beliefs about type 2 diabetes. Method Interpretative phenomenology was used to interview 12 first-generation AI participants with type 2 diabetes to elicit causal beliefs of their disease. Interpretative and thematic analysis were completed. Results Beliefs about the causes of diabetes in AIs were influenced by a general familiarity with the disease, limited knowledge about causal and preventative factors of the disease, and gender specific roles and norms. Discussion Health programs that aim to incorporate AI’s cultural and health beliefs about the causes of diabetes are warranted.

Type 2 diabetes self-management: spirituality, coping and responsibility

2021 ◽  
Vol 26 (8) ◽  
pp. 743-760
Author(s):  
Natasha Duke
Keyword(s):  
Type 2 Diabetes ◽  
Health Beliefs ◽  
Diabetes Management ◽  
Coping Styles ◽  
Glycated Haemoglobin ◽  
Self Management ◽  
Living Situation ◽  
Care Plans ◽  
Interpretive Method

Background In England, although The National Institute of Health and Care Excellence recommends that patients’ religious beliefs should be incorporated into individual healthcare plans, these components are often neglected in diabetes management care plans. A literature review identified a paucity of research regarding how the spirituality of British people may influence their approach to their self-management of type 2 diabetes (T2D). Aims To explore how the spirituality of a small group of adults with T2D, living in England, influenced their coping strategies and self-management of diet and exercise. Methods Biographic Narrative Interpretive Method of two interviews per participant and thematic analysis for data interrogation ( n = 8). Data as glycated haemoglobin, living situation, age, length of time since T2D diagnosis, body mass index and diabetic medicines contextualised the interview data. Results Participants’ spirituality, health beliefs, coping and sense of responsibility for T2D self-management overlapped in complex layers. Three themes were generated: (a) spirituality influences expectations in life; (b) beliefs influence coping styles of diabetes self-management; and (c) responsibility influences diabetes self-management. A model was created to assist nurses in addressing these components. Conclusion Nurses should consider how patients’ self-management of T2D may be influenced by their spirituality, health beliefs, coping and sense of responsibility.

Type 1 and Type 2 Diabetes

2019 ◽  
pp. 343-360
Author(s):  
Katherine A. S. Gallagher ◽  
Marisa E. Hilliard
Keyword(s):  
Type 2 Diabetes ◽  
Medical Condition ◽  
School Personnel ◽  
The United States ◽  
Self Management ◽  
Chronic Medical Condition ◽  
School Based ◽  
Support Students

Diabetes is a chronic medical condition that affects many children in the United States. The chapter provides an overview of type 1 and type 2 diabetes and focuses on the roles of school-based providers in helping students with diabetes, in collaboration with families and medical providers. Specific strategies, such as educating school personnel and peers about the conditions and treatments and recognizing and responding to symptoms of the conditions, are discussed. Providing assistance with, and supervision of, self-management tasks, monitoring symptoms, and identifying and implementing appropriate school-based accommodations are some key activities school-based professionals adopt to support students with diabetes. Additionally, addressing any learning or psychological concerns and assessing for possible diabetes-related contributors are critical. Included in the chapter are handouts with helpful resources for professionals, lists of measures for assessing concerns common to children with diabetes, and a tool to support student engagement in self-management activities related to diabetes care.

scholarly journals The Relationship between Macronutrient Distribution and Type 2 Diabetes in Asian Indians

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4406
Author(s):  
Amisha Pandya ◽  
Mira Mehta ◽  
Kavitha Sankavaram
Keyword(s):  
Type 2 Diabetes ◽  
Asian Indians ◽  
Diabetes Management ◽  
Critical Role ◽  
Convenience Sample ◽  
Specific Distribution ◽  
Diabetes Status ◽  
Increased Risk ◽  
Macronutrient Distribution

Asian Indians (AIs) are at increased risk for type 2 diabetes mellitus than other ethnic groups. AIs also have lower body mass index (BMI) values than other populations, so can benefit from strategies other than weight reduction. Macronutrient distributions are associated with improved glycemic control; however, no specific distribution is generally recommended. This study looks at whether a macronutrient distribution of 50:30:20 (percent of total calories from carbohydrates, fats, and protein) is related to diabetes status in AIs. Diet and Hemoglobin A1c (HbA1c) were assessed from convenience sample of AI adults in Maryland. A ratio of actual to needed calories using the 50:30:20 macronutrient distribution was then tested against diabetes status to identify associations. All groups except non-diabetic females, were in negative energy balance. The non-diabetic group consumed larger actual to needed ratios of protein than pre-diabetics and diabetics. However, all groups consumed protein at the lower end of the Acceptable Macronutrient Distribution Range (AMDR), and the quality of all macronutrients consumed was low. Therefore, weight loss may not be the recommendation for diabetes management for AIs. Increasing protein and insoluble fiber consumption, could play a critical role.

scholarly journals Social Inequality and Type 2 Diabetes Management among Older Latinx Immigrants

2020 ◽  
pp. 1-3
Author(s):  
Jasmin Tahmaseb McConatha ◽  
Jasmin Tahmaseb McConatha ◽  
Frauke Schnell
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Management ◽  
Well Being ◽  
The United States ◽  
Negative Consequences ◽  
Older Immigrants ◽  
Immigrant Populations ◽  
Health And Well Being ◽  
The U.S

Being an immigrant in the contemporary U.S. is stressful. During the pandemic of 2020, these stressors are amplified for all populations. At the same time, Latinx immigrants are also disproportionately affected by the pandemic. They are more vulnerable, face greater economic challenges, and are more likely to die from the virus. In addition to these difficult realities, regardless of status, Latinx immigrants are often perceived as illegal and subjected to discriminatory treatment [1]. Type 2 diabetes is also an illness that disproportionately affects minorities and immigrant populations. In 2018, there were almost 60 million Latinos-18% of the U.S. population (more than one in six)-living in the United States [2]. In addition to the myriad of stressors that immigrants, particularly older immigrants experience, the stigma and vulnerability associated with the pandemic of 2020 are likely to have serious negative consequences on their health and well-being. This paper addresses some of the challenges Latinx immigrants face as they struggle to manage Type 2 diabetes during a pandemic.

scholarly journals Pilot Study of a Prototype Integrated Diabetes Management System and the Relationship of Use to Diabetes Management Behaviors and HbA1c Among Type 2 Diabetes Patients

Iproceedings ◽  
10.2196/16298 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e16298
Author(s):  
Connor Devoe ◽  
Nils Fischer ◽  
Tim Hale ◽  
Neda Derakhshani ◽  
Mursal Atif ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Pilot Study ◽  
Basal Insulin ◽  
Diabetes Management ◽  
The United States ◽  
Step Count ◽  
Management Behaviors ◽  
Hba1c Levels

Background Type 2 diabetes (T2D) is the seventh leading cause of death (2017) in the United States, and by 2030 it is estimated that it will affect 439 million globally. Effective glycemic control can be challenging for patients. A tool to guide patients’ in their self-management behaviors and share this data with their physician may improve insulin adherence leading to lower HbA1c. We examined an integrated diabetes management (IDM) system that utilizes a Bluetooth-enabled insulin event capture device, a Bluetooth-enabled glucometer, and an Android smartphone app. IDM data can be viewed by clinicians in the electronic medical record (EMR). Objective The primary aim of this study is to describe how app use is related to insulin adherence, blood glucose measurements, meal snapshots, and step count. Secondarily, we assessed the impact on HbA1c levels over a 3- and 6-month period. Methods Thirty-five participants were enrolled from Boston-area hospitals in this single-arm pilot study. Use of the IDM system was defined as the number of days per week participants logged into the app and moved past the home screen. Three app use groups were created: low app use (0.33-2.46 days per week), medium app use (2.54-5.08 days per week), and high app use (>5.4 days per week). Adherence to insulin, blood glucose measurements, and meal snapshots were defined as a ratio of actual weekly events recorded by participants’ app use divided by their physician’s recommendation. Step count was defined as the total weekly steps for each participant. Daily app-generated data on app use and indicators of diabetes management were collected. HbA1c levels were assessed via blood test at enrollment, 3-months, and 6-months. Using a hierarchical linear mixed model, we examined changes in outcome measures while accounting for random intercepts and slopes to control for variation in individual outcomes over the study. Results Overall app use (average unique days using the app per week) declined from 6.19 days to 3.00 days (at 1 and 24 weeks, respectively). Participants with high app use had significant improvement in bolus and basal insulin adherence per week (0.009 P=.041 [95% CI 0.0004 to 0.018] and 0.016 P<.001 [95% CI 0.0079 to 0.023], respectively), but participants had no significant improvements in blood glucose and meal snapshot adherence or absolute step count. HbA1c significantly decreased per week (coefficient –0.025 [95% CI –0.044 to –0.007], P=.007) with an overall change of 0.6. Participants with high app use significantly improved their HbA1c per week (–0.037 P=.016 [–0.066 to –0.0067]) compared to participants with medium and low app use, yielding a total improvement of 0.88 over 24 weeks. Conclusions Results show that bolus and basal insulin may have increased with higher app use. HbA1c significantly improved over the course of the study, along with significantly greater improvement in HbA1c among participants with higher app use compared to participants in the middle or low app use groups. This study is not designed or intended to evaluate efficacy but provides results to guide the future design and development of this prototype IDM system.

scholarly journals Managing with Learning Disability and Diabetes: OK-Diabetes – a case-finding study and feasibility randomised controlled trial

2018 ◽  
Vol 22 (26) ◽  
pp. 1-328 ◽  
Author(s):  
Allan House ◽  
Louise Bryant ◽  
Amy M Russell ◽  
Alexandra Wright-Hughes ◽  
Liz Graham ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Observational Study ◽  
Learning Disability ◽  
Diabetes Management ◽  
Controlled Trial ◽  
Self Management ◽  
Feasibility Randomised Controlled Trial ◽  
The Mean ◽  
Randomised Controlled

BackgroundObesity and type 2 diabetes are common in adults with a learning disability. It is not known if the principles of self-management can be applied in this population.ObjectivesTo develop and evaluate a case-finding method and undertake an observational study of adults with a learning disability and type 2 diabetes, to develop a standardised supported self-management (SSM) intervention and measure of adherence and to undertake a feasibility randomised controlled trial (RCT) of SSM versus treatment as usual (TAU).DesignObservational study and an individually randomised feasibility RCT.SettingThree cities in West Yorkshire, UK.ParticipantsIn the observational study: adults aged > 18 years with a mild or moderate learning disability, who have type 2 diabetes that is not being treated with insulin and who are living in the community. Participants had mental capacity to consent to research and to the intervention. In the RCT participants had glycated haemoglobin (HbA1c) levels of > 6.5% (48 mmol/mol), a body mass index (BMI) of > 25 kg/m2or self-reported physical activity below national guideline levels.InterventionsStandardised SSM. TAU supported by an easy-read booklet.Main outcome measures(1) The number of eligible participants identified and sources of referral; (2) current living and support arrangements; (3) current health state, including level of HbA1c, BMI and waist circumference, blood pressure and lipids; (4) mood, preferences for change; (5) recruitment and retention in RCT; (6) implementation and adherence to the intervention; (7) completeness of data collection and values for candidate primary outcomes; and (8) qualitative data on participant experience of the research process and intervention.ResultsIn the observational study we identified 147 eligible consenting participants. The mean age was 54.4 years. In total, 130 out of 147 (88%) named a key supporter, with 113 supporters (77%) being involved in diabetes management. The mean HbA1clevel was 54.5 mmol/mol [standard deviation (SD) 14.8 mmol/mol; 7.1%, SD 1.4%]. The BMI of 65% of participants was > 30 kg/m2and of 21% was > 40 kg/m2. Many participants reported low mood, dissatisfaction with lifestyle and diabetes management and an interest in change. Non-response rates were high (45/147, 31%) for medical data requested from the primary care team. In the RCT, 82 participants were randomised. The mean baseline HbA1clevel was 56 mmol/mol (SD 16.5 mmol/mol; 7.3%, SD 1.5%) and the mean BMI was 34 kg/m2(SD 7.6 kg/m2). All SSM sessions were completed by 35 out of 41 participants. The adherence measure was obtained in 37 out of 41 participants. The follow-up HbA1clevel and BMI was obtained for 75 out of 82 (91%) and 77 out of 82 (94%) participants, respectively. Most participants reported a positive experience of the intervention. A low response rate and difficulty understanding the EuroQol-5 Dimensions were challenges in obtaining data for an economic analysis.LimitationsWe recruited from only 60% of eligible general practices, and 90% of participants were on a general practice learning disability register, which meant that we did not recruit many participants from the wider population with milder learning disability.ConclusionsA definitive RCT is feasible and would need to recruit 194 participants per arm. The main barrier is the resource-intensive nature of recruitment. Future research is needed into the effectiveness of obesity treatments in this population, particularly estimating the longer-term outcomes that are important for health benefit. Research is also needed into improving ways of assessing quality of life in adults with a learning disability.Trial registrationCurrent Controlled Trials ISRCTN41897033.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 22, No. 26. See the NIHR Journals Library website for further project information.

Abstract 311: Facilitators and Barriers to Self-management of Patients with Type 2 Diabetes in Communities in China, a Qualitative Study

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Xiang Y Chen ◽  
Peng Yue ◽  
Yong L Wang ◽  
Shu Q Xiao ◽  
Xin W Feng ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Management Practices ◽  
Diabetes Management ◽  
Financial Burden ◽  
Chinese Patients ◽  
Self Management ◽  
Difficult Time ◽  
Facilitators And Barriers

Background: Self-management has become a key strategy for caring chronic patients in community. However, little is known about peoples’ self-management experiences and their perceived cues and barriers to engagement in self-management. Objective: To explore issues patients with type 2 diabetes experienced in their self-management practices,to understand cues and barriers to engagement in self-management. Design: Qualitative study (Semi-structured interviews) Setting: 11 communities in Beijing, China Participants: Type 2 diabetes patients in community, aged >18, no admission in past 90 days. Methods: 40 critical incident interviews were run during Apr to Sep in 2011 using purposive sampling (20 interviews with patients whose HbA1c well-controlled (<6.5%), while 20 badly-controlled (≥8%)).Themes from interviews were identified using content analysis, which revealed cues and barriers to self-modification for diabetes management. Results: Implications for self- management practice included objectively understanding on the severity and complications of diabetes. In addition to family support such as supervision in family and fully-use of family resource, desires/duties to be responsible for whole family life as a breadwinner was emerged as a key cue to engagement in self-control. Barriers to engagement in self-management stemmed from financial burden to monitor blood glucose daily, dissatisfaction of HbA1c level after efforts, and malignant life events. It is worth mentioning that starving experience of difficult time with natural disasters in1960s- 1970s in China was identified also as a key barrier to engagement in diet management. Discussion and Conclusion: There was a strong desire for Chinese patients to comply with Chinese cultural norms; particularly those relating to family value. It was the patients’ power to be involved in self-management that they could devote their healthy life to family duty. Everyone had his/her own history so experiences in past shaped patients’ behaviors now. The findings highlighted the importance of understanding the family value and the personal experiences as facilitators and barriers to self-management of Chinese patients with type 2 diabetes living in community.

The Impact of Partnership Status on Diabetes Control and Self-Management Behaviors

2018 ◽  
Vol 45 (5) ◽  
pp. 668-671 ◽  
Author(s):  
Lindsay Haines ◽  
Natalie Coppa ◽  
Yael Harris ◽  
Juan P. Wisnivesky ◽  
Jenny J. Lin
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Monitoring ◽  
The United States ◽  
Diabetes Control ◽  
Self Management ◽  
Partnership Status ◽  
The Impact ◽  
Management Behaviors

According to the Centers for Disease Control and Prevention, diabetes affects 29.1 million people in the United States. Marriage has been suggested to have a protective effect on overall health outcomes, but few studies have evaluated the role of partnership status on patients with type 2 diabetes. This study aimed to assess this role of partnership status on diabetes control and self-management behaviors. Patients with type 2 diabetes taking at least one oral hypoglycemic agent were assessed over a 3-month period to measure hemoglobin A1c (HbA1c) changes and adherence to medication, exercise, diet, and glucose monitoring. Partnered participants were more likely to adhere to their medications, but there was no significant difference in HbA1c changes over 3 months or exercise, diet, or glucose monitoring adherence. This study suggests that being partnered improves medication adherence; further analysis with a larger population is required to fully assess the role of partner support for patients with type 2 diabetes.

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