title: Psychosocial factors associated with poor diabetes self-care management in a specialized center in Mexico City.
abstract: 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.
authors.affiliation: Departmento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Tlalpan, 14000 Mexico City, Mexico. lerman@netservice.com.mx
authors.forename: Israel
authors.initials: I
authors.lastname: Lerman
authors.forename: Liliana
authors.initials: L
authors.lastname: Lozano
authors.forename: Antonio R
authors.initials: AR
authors.lastname: Villa
authors.forename: Sergio
authors.initials: S
authors.lastname: Hernández-Jiménez
authors.forename: Katie
authors.initials: K
authors.lastname: Weinger
authors.forename: A Enrique
authors.initials: AE
authors.lastname: Caballero
authors.forename: Carlos Aguilar
authors.initials: CA
authors.lastname: Salinas
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Velasco
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Gómez-Pérez
authors.forename: Juan A
authors.initials: JA
authors.lastname: Rull
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D015190:Blood Glucose Self-Monitoring / Q000523:psychology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D012648:Self Care / Q000379:methods / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires