A growing body of research indicates that alcohol consumption may affect diabetes self-management and control, yet this association has not been examined in relation to ethnicity. This is an important area of study because there are significant ethnic differences in drinking practices between Whites, Blacks, and Hispanics which may impact diabetic management practices. Diabetes disproportionately affects Blacks and Hispanics relative to non-Hispanic Whites, in terms of its prevalence, and its associated morbidity and mortality. In order to prevent the morbidity and mortality associated with this disease, a thorough understanding of factors associated with its optimal management and control is required. Unfortunately, previous research on the association between alcohol consumption and poor adherence to self-care activities has not thoroughly characterized drinking. Consumption in these studies is limited to volume measures which are divided into drinking categories that vary between studies making the comparison of results challenging. This submission proposes in Aim 1 to describe and compare the drinking practices (abstention, volume (drinks/week), heavy drinking (>2 drinks/day for men and >1 drink/day for women), and binge drinking (e 5 drinks per occasion for men and e 4 drinks for women)) of those with diagnosed diabetes in relation to ethnicity and health status (insulin dependence, the duration of diabetes, co-occurring medical conditions, and perceived health status), while controlling for the effects of known correlates of drinking practices (age, sex, socioeconomic status, employment, and marital status). In addition, Aim 2 will characterize adherence to 7 diabetic self-care activities of Black, White, and Hispanic diabetics and to determine how these activities vary in relation to drinking practices, ethnicity, and other covariates. The practices to be examined include: 1) daily glucose self- monitoring;2) at least one hemoglobin A1c (HbA1c) test in the previous year;3) a dilated eye examination in the previous year;4) an examination of feet by a health professional in the previous year;5) at least weekly self-examination of feet;6) annual dyslipidemia screening;and 7) ever having visited a diabetes educator. Finally, Aim 3 will test a partial mediation model which proposes that optimal diabetes self-care results from several factors, including SES, health care access, social support, health status, and drinking practices. Importantly, the model postulates that self-care is not directly affected by ethnicity, but rather ethnicity affects other factors, namely alcohol consumption, which directly impact self-care activities.
The proposed study may identify a significant, but modifiable barrier to diabetes self-management and control. Our findings may impact clinical practice by alerting health professionals about the importance of assessing patients'drinking practices and addressing how these practices impact diabetes self-management activities and glucose control.
|Vaeth, Patrice A C; Caetano, Raul; Durazo, Eva M (2014) Ethnicity and alcohol consumption among US adults with diabetes. Ann Epidemiol 24:720-6|