Psychosocial factors associated with poor diabetes self-care management in a specialized Center in Mexico City

• Published in: Biomedicine & pharmacotherapy Vol. 58; no. 10; pp. 566 - 570
• Main Authors: Lerman, Israel, Lozano, Liliana, Villa, Antonio R., Hernández-Jiménez, Sergio, Weinger, Katie, Enrique Caballero, A., Salinas, Carlos Aguilar, Velasco, Maria Luisa, Gómez-Pérez, Francisco Javier, Rull, Juan A.
• Format: Journal Article
• Language: English
• Published: Paris Elsevier SAS 01-12-2004; Elsevier
• Subjects: Adherence to treatment; Adult; Aged; Ambulatory Care Facilities; Biological and medical sciences; Blood Glucose Self-Monitoring - psychology; Cross-Sectional Studies; Depression; Diabetes Mellitus, Type 2 - psychology; Diabetes Mellitus, Type 2 - therapy; Female; Humans; Male; Medical sciences; Mexico; Middle Aged; Patient Compliance - psychology; Pharmacology. Drug treatments; Self Care - methods; Self Care - psychology; Social Support; Surveys and Questionnaires; Type 2 diabetes; Central America; Mexico; America; Type 2 diabetes; Depression; Adherence to treatment; Endocrinopathy; Mood disorder; Metabolic diseases; Treatment compliance; Public health
• ISSN: 0753-3322; 1950-6007
• DOI: 10.1016/j.biopha.2004.09.003

To examine the relationship between demographic, clinical and psychosocial variables and diabetes self-care management in Mexican type 2 diabetic patients. Cross-sectional study of 176 consecutive patients with type 2 diabetes aged 30–75 years, attending a tertiary health-care center in Mexico City. A brief medical history and previously validated questionnaires were completed. The study group consisted of 64 males/112 females, aged 55 ± 11 years, mean diabetes duration of 12 ± 8 years and HbA1c of 9.0 ± 2.0%, 78.4% reported following the correct dose of diabetes pills or insulin, 58% ate the recommended food portions, and 44.3% did exercise three or more times per week. A good adherence to these three recommendations was observed in only 26.1% of the patients. These patients considered as a group were characterized by a greater knowledge about the disease (
P < 0.00001), regular home blood glucose monitoring (
P < 0.01), an inner perception of better diabetes control (
P = 0.007), good health (
P = 0.004) and better communication with their physician (
P < 0.02). A poor adherence to two or the three main diabetes care recommendations was associated with a depressive state (OR 2.38, 95% CI 1.1–4.9,
P < 0.01) and a history of excessive alcohol intake (OR 4.03, 95% CI 1.1–21.0,
P = 0.03). Poor adherence to standard diabetes care recommendations is frequently observed in patients with type 2 diabetes attending a specialized health care center in Mexico City. Depression must be identified and treated effectively.