title: Association between alcohol screening scores and diabetic self-care behaviors.
abstract: OBJECTIVE
  Alcohol misuse is associated with poor adherence to recommended self-care behaviors, which are critical for diabetes management. This study investigated whether scores on a validated brief alcohol misuse screen are associated with diabetes self-care.
  
  
  METHODS
  Male outpatients (n=3,930) from seven Veterans Affairs sites returned the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) alcohol screen on mailed surveys and indicated they had diabetes. Patients were divided into five alcohol screening groups: no past year alcohol use (AUDIT-C 0), low-level alcohol use (AUDIT-C 1-3); and mild (AUDIT-C 4-5), moderate (AUDIT-C 6-7), and severe (AUDIT-C 8-12) misuse. Outcomes included self-report of monitoring blood glucose, maintaining normal blood glucose levels, inspecting feet, following a meal plan, not smoking, and laboratory data indicating that glycosylated hemoglobin A1c (HbA1c) had been tested in the past year. For each group, the proportion of patients adherent to each behavior were estimated from logistic regression models adjusted for demographics, comorbidity, and depressive symptoms.
  
  
  RESULTS
  Patients who did not drink were most likely to report adherence to self-care behaviors, except for past-year HbA1c testing. Compared to patients who did not drink, patients with AUDIT-C scores ?6 were significantly less likely to report maintaining normal blood glucose levels (eg, AUDIT-C 6-7 44% versus AUDIT-C 0 59%) or following a meal plan (48% versus 58%), and were more likely to smoke (71% abstained versus 85%) in adjusted analyses.
  
  
  CONCLUSIONS
  Results of this study indicate that higher alcohol screening scores are associated with poorer diabetes self-care.
authors.affiliation: Health Services Research and Development Northwest Center of Excellence, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA 98101, USA. rachel.thomas3@va.gov
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Thomas
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Francis Gerstel
authors.forename: Emily C
authors.initials: EC
authors.lastname: Williams
authors.forename: Haili
authors.initials: H
authors.lastname: Sun
authors.forename: Chris L
authors.initials: CL
authors.lastname: Bryson
authors.forename: David H
authors.initials: DH
authors.lastname: Au
authors.forename: Katharine A
authors.initials: KA
authors.lastname: Bradley
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000628:therapy*; D015438:Health Behavior; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012648:Self Care / Q000706:statistics & numerical data*; D057566:Self Report; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data*