title: Racial differences in glucose control among patients with type 2 diabetes: a survey on dietary temptations, coping, and trust in physicians.
abstract: OBJECTIVE
  A quantitative evaluation of self-care behaviors, psychosocial stressors, and patient relationships to health care to better understand racial disparities in these domains.
  
  
  METHODS
  A cross-sectional study of adult patients with type 2 diabetes in University of Pennsylvania Healthcare System who had a HbA1c test within one month of survey administration. The survey instrument included among other items, the Dieter's Inventory of Eating Temptations Self-Efficacy instrument (DIET-SE), the Jalowiec Coping Scale (JCS), and the Trust in Physician (TIP) scale.
  
  
  RESULTS
  332 individuals completed the survey. Poor glucose control was significantly associated with Black race, lower income level, other demographic variables, non-perfect medication adherence, and poorer diet quality. It was also associated with lower self-efficacy to resist social dietary temptations, and among White patients it was associated was decreased use of a confrontive coping style. However, these factors did not explain the racial differences in glucose control between Blacks and Whites.
  
  
  CONCLUSIONS
  Interventions aimed at dietary temptations, coping styles, or trust in physicians may not reduce racial disparities in glucose control. However, interventions that focus on dietary temptations may positively affect all diabetic patients.
authors.affiliation: University of California San Francisco Department of Family and Community Medicine, USA. betancourtr@fcm.ucsf.edu
authors.forename: Renée M
authors.initials: RM
authors.lastname: Betancourt
authors.affiliation: Perelman School of Medicine at the University of Pennsylvania, USA.
authors.forename: Kathleen O
authors.initials: KO
authors.lastname: Degnan
authors.affiliation: Philadelphia VA Center for Health Equity Research and Promotion, Division of General Internal Medicine, University of Pennsylvania Perelman School of Medicine, USA.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Long
mesh_terms: D000223:Adaptation, Psychological; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000628:therapy*; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010817:Physician-Patient Relations; D012307:Risk Factors; D012648:Self Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D035502:Trust
chemical_list: D001786:Blood Glucose