Self-Management of Type 2 Diabetes (T2DM) Among African Americans

Abstract

The World Health Organization (WHO) purports that over 422 million people around the world are diagnosed with diabetes mellitus, and in 2040, the number of people affected by diabetes will increase to 640 million people worldwide. African Americans represent 13.4% of the US population, yet are disproportionately affected by diabetes (13.2%) compared to non-Hispanic whites (7.4%). They are more likely to be diagnosed with diabetes and have two to four times the rate of type 2 diabetes mellitus (T2DM)-complications compared to other racial groups in the US, generally related poor self-management. The purpose of this study was to examine associations between depression, health literacy, working memory (WM), executive function (EF), illness representation and self-management among African Americans (18-65 years) with T2DM. The modified common-sense model of African American self-management of T2DM (CSM-AAST2DM) provided a framework for this study. A descriptive cross-sectional design was used to examine predictors and associated outcomes among participants who self-identify as African American with T2DM. Fifty-three African Americans, ranging from 26 to 65 years of age (M= 49.35, SD= 10.3 years of age) were recruited through a Facebook™ post (i.e., social media). After answering basic demographic and ‘insider’ knowledge, screening questions, participants completed measures of depression, diabetes self-management-care activities, illness perception, health literacy, medication adherence and working memory. Cognitive function (storage, attention, executive) were significantly associated with depression and illness perception. Cognitive function (storage, attention, executive) were inversely associated with medication adherence. It is important to note that there was missing data on the storage, attention and executive domains and hence, conclusions relationships are tentative. Depression was also inversely associated with health literacy and medication adherence. SDSCA (general diet) was significantly associated with storage, attention, depression and illness perception (R: .671, R2: 450, p=.039). In this study, storage domain, attention domain, depression and illness perception were significant predictors of SDSCA (general diet), a component of self-management. Preliminary findings suggest a need to examine these variables with interventions that may be used to improve self-management of type 2 diabetes among African Americans.