title: Blood glucose symptom recognition: perspectives of older rural adults.
abstract: Blood glucose symptom recognition and the interpretation of how one feels with regard to low or high glucose can impact how diabetes is self-managed. Understanding interpretation of symptoms related to diabetes and ultimate glucose regulation can be challenging. Health care providers can develop strategies to improve care by listening to individuals describe their symptoms in the context of everyday life.
  
  
  
  The perspectives of older rural adults were assessed through individual in-depth interviews conducted among 75 African American, American Indian, and white individuals. The study design included a sample balanced with regard to sex, ethnicity, and educational attainment. The Self-Regulatory Model of Illness and the concept that people construct their own common sense models of health were utilized in this study.
  
  
  
  There were four dominant themes of symptoms described that were related to blood glucose. These categories included sensations, lightheadedness, energy level, and eyesight changes. Participants described symptoms they experienced at perceived levels of both high and low blood glucose. Results suggest that older adults were unable to distinguish whether their symptoms occurred because of high or low blood glucose.
  
  
  
  Education that incorporates methods to aid older individuals differentiate blood glucose levels related to diabetes symptoms could help improve self-management.
authors.affiliation: The Department of Family and Community Medicine, Wake Forest University School of
  Medicine, Winston Salem, North Carolina (Dr Kirk, Dr Grzywacz, Dr Arcury)
authors.forename: Julienne K
authors.initials: JK
authors.lastname: Kirk
authors.affiliation: The Department of Family and Community Medicine, Wake Forest University School of
  Medicine, Winston Salem, North Carolina (Dr Kirk, Dr Grzywacz, Dr Arcury)
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Grzywacz
authors.affiliation: The Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of
  Medicine, Winston Salem, North Carolina (Chapman, Dr Bell, Dr Quandt)
authors.forename: Christine
authors.initials: C
authors.lastname: Chapman
authors.affiliation: The Department of Family and Community Medicine, Wake Forest University School of
  Medicine, Winston Salem, North Carolina (Dr Kirk, Dr Grzywacz, Dr Arcury)
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Arcury
authors.affiliation: The Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of
  Medicine, Winston Salem, North Carolina (Chapman, Dr Bell, Dr Quandt)
authors.forename: Ronny A
authors.initials: RA
authors.lastname: Bell
authors.affiliation: The Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest University School of
  Medicine, Winston Salem, North Carolina (Dr Ip)
authors.forename: Edward H
authors.initials: EH
authors.lastname: Ip
authors.affiliation: The Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of
  Medicine, Winston Salem, North Carolina (Chapman, Dr Bell, Dr Quandt)
authors.forename: Sara A
authors.initials: SA
authors.lastname: Quandt
mesh_terms: D000368:Aged; D015190:Blood Glucose Self-Monitoring; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D033262:Narration; D009657:North Carolina; D010353:Patient Education as Topic; D012424:Rural Population