Academic journal article Journal of Cultural Diversity

Relationship between Diabetes Self-Management Education and Self-Care Behaviors among African American Women with Type 2 Diabetes

Academic journal article Journal of Cultural Diversity

Relationship between Diabetes Self-Management Education and Self-Care Behaviors among African American Women with Type 2 Diabetes

Article excerpt

Abstract: The purpose of this study was to explore the extent to which African American women participate in diabetes self-management education (DSME) and the impact of participation on self-care behaviors. Results from the Behavioral Risk Factor Surveillance Survey (2007) revealed, approximately, 53.6% of participants reported having had DSME, less than the 62.5% participation rate suggested by Healthy People 2020. Those who received DSME were significantly more likely to check their own blood sugar and feet regularly; to participate in moderate physical activity; and to have received healthcare provider foot examinations, glycosolated hemoglobin measurements, and dilated eye examinations in the past year. These results indicate the importance of DSME and the need for health care providers to develop strategies and policies to improve participation among this ethnic group of women. Thereby,, decreasing complications related to Type 2 diabetes and improving the quality of life for these Women.

Key Words: Diabetes, Diabetes Complications, Diabetes Self-Management Education, African American Women.

According to the National Institutes of Health (as cited in National Cancer Institute, 2010), a disproportionate burden of illness contributes to general health disparities, "differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific populations groups in the United States" (para. 2). Such differences in burden of disease is evident in the racial disparity in Type 2 diabetes. Type 2 diabetes is one of four classifications of diabetes and is the focus of this study. This type of diabetes is characterized by (a) insulin resistance, which prevents the uptake of glucose by skeletal muscle; (b) a decrease in pancreatic beta cell function, which alters the release of insulin; and (c) an increase in glyconeogenesis by the liver.

African American women suffer more from diabetesrelated complications and disabilities when compared to Caucasian women. Complications among African Amencans include higher rates of diabetic retinopathy, lower extremity amputations, and kidney failure compared to Caucasians (Office of Minority Health, 2007). Diabetesrelated complications and associated hospitalizations cost this nation billions of dollars each year. According to the Centers for Disease Control (CDC; 2005a), cost estimates for direct care in 2002 totaled 92 billion dollars, and indirect costs related to disability, work loss, and premature mortality totaled 40 billion dollars.

With all chronic diseases, self-care is critical to the successful management of the disease, and there is convincing evidence that diabetes complications can be curtailed through adequate self-care behaviors. Glycémie control, defined by the American Diabetes Association (ADA; 2008) as glycosolated hemoglobin (HbAlC) levels of less than 7%, is an indicator of adequate self-care behaviors. Research consistently has found abnormally high HbAlC levels in African American women. Montague, Nichols, and Dutta (2005), for example, found HbAlC levels > 8% among African American women in their study. One reason for this may be that African American women find self-care challenging because they must follow a complex daily regimen that requires them to make lifestyle changes concerning diet, exercise, medication management, blood glucose level monitoring, and stress management (Montague, et., 2005).

To address this problem, it is critical to further clinical understanding of factors that positively or negatively affect self-care behaviors in African American women who have Type 2 diabetes. Such understanding may promote the development of appropriate policies and interventions, helping to narrowing the health disparities gap and promoting diabetes health and well-being in this group of women. The ADA (2008) has suggested that ongoing diabetes self-management education is required for those suffering from the disease. …

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