title: Acculturation and glycemic control of Asian Indian adults with type 2 diabetes.
abstract: The prevalence of type 2 diabetes is disproportionately high among Asian Indians (AI), one of the fastest growing immigrant groups in the United States (US). Poorly controlled diabetes associated with inadequate self-management increases complications and thus medical costs. Acculturation may be an important determinant of diabetes self-management and hence control. This study examined the association between the degree of acculturation and glycemic control as measured by Hemoglobin A1c in AI adults with type 2 diabetes. A mixed method (quantitative and qualitative) study was conducted among 30 AI adults with type 2 diabetes. Acculturation assessment using the Suinn-Lew Asian Self-identity Instrument was followed by socio-demographic questions, self-reported anthropometric measures, and open ended diabetes self-care questions. A two-step multiple regression analysis and content analysis of verbatim interview transcriptions were conducted. Interactions of acculturation with body mass index (interaction b = 1.11; p = 0.01), annual household income (interaction b = 7.19; p = .01), and diabetes duration (interaction b = .30; p = .02) significantly predicted higher HbA1c levels (R(2) change = .368; F change = 4.21; p = .02). From the qualitative interviews, the following were regarded as US specific facilitators for glycemic control: excellent health care system and facilities, availability of healthy food choices and self-monitoring devices, medical insurance benefits, good quality medications, and improved health awareness. Cultural orientation might be important for patient tailored interventions targeting AI with type 2 diabetes. Therefore, interventions targeted at Asian Indians with diabetes should include culture specific adaptations to nutrition education and support.
authors: Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824-1224, USA. venkate6@msu.edu
authors: Sumathi
authors: S
authors: Venkatesh
authors: Lorraine J
authors: LJ
authors: Weatherspoon
authors: Stan A
authors: SA
authors: Kaplowitz
authors: Won O
authors: WO
authors: Song
mesh_terms: D000069:Acculturation; D001213:Asian / Q000523:psychology / Q000706:statistics & numerical data*; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000628:therapy*; D004032:Diet / Q000706:statistics & numerical data; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007194:India / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D012648:Self Care / Q000706:statistics & numerical data; D014481:United States
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human