title: Associations between economic hardship and markers of self-management in adults with type 2 diabetes: results from Diabetes MILES - Australia.
abstract: OBJECTIVE
  A socioeconomic gradient exists in Australia for type 2 diabetes mellitus (T2DM). It remains unclear whether economic hardship is associated with T2DM self-management behaviours.
  
  
  METHODS
  Cross-sectional data from a subset of the Diabetes MILES - Australia study were used (n=915). The Economic Hardship Questionnaire was used to assess hardship. Outcomes included: healthy eating and physical activity (Diabetes Self-Care Inventory - Revised), medication-taking behaviour (Medication Adherence Rating Scales) and frequency of self-monitoring of blood glucose (SMBG). Regression modelling was used to explore the respective relationships.
  
  
  RESULTS
  Greater economic hardship was significantly associated with sub-optimal medication-taking (Coefficient: -0.86, 95%CI -1.54, -0.18), and decreased likelihood of regular physical activity (Odds Ratio: 0.47, 0.29, 0.77). However, after adjustments for a range of variables, these relationships did not hold. Being employed and higher depression levels were significantly associated with less-frequent SMBG, sub-optimal medication-taking and less-regular healthy eating. Engaging in physical activity was strongly associated with healthy eating.
  
  
  CONCLUSIONS
  Employment, older age and depressive symptoms, not economic hardship, were commonly associated with diabetes self-management.
  
  
  CONCLUSIONS
  Work-based interventions that promote T2DM self-management in younger, working populations that focus on negative emotions may be beneficial.
authors.affiliation: IMPACT Strategic Research Centre, Deakin University, Victoria; School of Public Health and Preventive Medicine, Monash University, Victoria.
authors.forename: Adrienne
authors.initials: A
authors.lastname: O'Neil
authors.forename: Emily D
authors.initials: ED
authors.lastname: Williams
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Browne
authors.forename: Rob
authors.initials: R
authors.lastname: Horne
authors.forename: Frans
authors.initials: F
authors.lastname: Pouwer
authors.forename: Jane
authors.initials: J
authors.lastname: Speight
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D015190:Blood Glucose Self-Monitoring / Q000191:economics* / Q000379:methods / Q000523:psychology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D011203:Poverty; D012648:Self Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents
keywords: blood glucose monitoring; economic hardship; medication taking; self-management; type 2 diabetes mellitus