title: Differences in diabetes self-care activities by race/ethnicity and insulin use.
abstract: The purpose of this study is to examine differences in diabetes self-care activities by race/ethnicity and insulin use.
  
  
  
  Data were from the 2011 Behavioral Risk Factor Surveillance System for adults with diabetes. Outcomes included 5 diabetes self-care activities (blood glucose monitoring, foot checks, nonsmoking, physical activity, healthy eating) and 3 levels of diabetes self-care (high, moderate, low). Logistic regression models stratified by insulin use were used to estimate the odds of each self-care activity by race/ethnicity.
  
  
  
  Only 20% of adults had high levels of diabetes self-care, while 64% had moderate and 16% had low self-care. Racial/ethnic differences were apparent for every self-care activity among non-insulin users but only for glucose monitoring and foot checks among insulin users. Overall, American Indian / Alaska Natives had higher odds of glucose monitoring; blacks had higher odds of foot checks; and Hispanics had higher odds of not smoking compared with non-Hispanic Whites. Non-insulin-using American Indian / Alaska Natives had higher odds of foot checks, and non-insulin-using Hispanics had higher odds of fruit/vegetable consumption.
  
  
  
  Participation in specific diabetes self-care behaviors differs by race/ethnicity and by insulin use. Yet, few adults with diabetes of any race/ethnicity engage in high levels of self-care. Findings suggest that culturally tailored messages about diabetes self-care may be needed, in addition to more effective population promotion of healthy lifestyles and risk reduction behaviors to improve diabetes control and overall health. Diabetes educators can be a catalyst for adopting a population approach to diabetes management, which requires addressing both prevention and management of diabetes for all patients.
authors.affiliation: Medica Research Institute, Minnetonka, MN, USA (Dr Johnson, Ms Ghildayal)|Center for Spirituality and Healing and the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA (Dr Johnson)
authors.forename: Pamela Jo
authors.initials: PJ
authors.lastname: Johnson
authors.affiliation: Medica Research Institute, Minnetonka, MN, USA (Dr Johnson, Ms Ghildayal)|Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA (Ms Ghildayal, Dr Rockwood)
authors.forename: Neha
authors.initials: N
authors.lastname: Ghildayal
authors.affiliation: Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA (Ms Ghildayal, Dr Rockwood)
authors.forename: Todd
authors.initials: T
authors.lastname: Rockwood
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, MN, USA (Dr Everson-Rose)
authors.forename: Susan A
authors.initials: SA
authors.lastname: Everson-Rose
mesh_terms: D040343:Behavioral Risk Factor Surveillance System; D015190:Blood Glucose Self-Monitoring; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D004032:Diet; D005006:Ethnicity; D015444:Exercise; D015438:Health Behavior / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D040242:Risk Reduction Behavior; D012648:Self Care / Q000523:psychology* / Q000706:statistics & numerical data; D016353:Self-Examination / Q000706:statistics & numerical data*; D016540:Smoking Cessation; D014481:United States / Q000453:epidemiology
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin