Determinants of Fasting Plasma Glucose and Glycosylated Hemoglobin Among Low Income Latinos with Poorly Controlled Type 2 Diabetes
The objective of this study was to identify demographic, socio-economic, acculturation, lifestyle, sleeping pattern, and biomedical determinants of fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c), among Latinos with type 2 diabetes (T2D). Latino adults (N = 211) with T2D enrolled in the DIALBEST trial were interviewed in their homes. Fasting blood samples were also collected in the participants’ homes. Because all participants had poor glucose control, above-median values for FPG (173 mg/dl) and HbA1c (9.2%) were considered to be indicative of poorer glycemic control. Multivariate analyses showed that receiving heating assistance (OR: 2.20; 95% CI: 0.96–4.96), and having a radio (3.11, 1.16–8.35), were risk factors for higher FPG levels, and lower income (10.4, 1.54–69.30) was a risk factor for higher HbA1c levels. Lower carbohydrate intake during the previous day (0.04; 0.005–0.37), as well as regular physical activity (0.30; 0.13–0.69), breakfast (2.78; 1.10–6.99) and dinner skipping (3.9; 1.03–14.9) during previous week were significantly associated with FPG concentrations. Being middle aged (2.24, 1.12–4.47), 30–60 min of sleep during the day time (0.07, 0.01–0.74) and having medical insurance (0.31, 0.10–0.96) were predictors of HbA1c. Results suggest that contemporaneous lifestyle behaviors were associated with FPG and contextual biomedical factors such as health care access with HbA1c. Lower socio-economic status indicators were associated with poorer FPG and HbA1c glycemic control.
KeywordsFasting plasma glucose Glycosylated hemoglobin Type 2 diabetes Low income Latinos Hispanics
This study was funded and supported by Connecticut NIH Export Center for Eliminating Health Disparities among Latinos (NIH- NCMHD grant # P20MD001765). Special thanks to all who participated in the study and to community health care workers at the Hispanic Health Council. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center on Minority Health and Health Disparities or the National Institutes of Health.
- 1.National Diabetes Information Clearinghouse (NDIC). National diabetes statistics. Available at http://diabetes.niddk.nih.gov/dm/pubs/statistics/#allages (2007). Accessed on 16 Nov 2008.
- 2.American Diabetes Association. Economic costs of diabetes in the US in 2007. Diabetes Care; 2008. p. 1–20.Google Scholar
- 4.Standards of medical care in diabetes–2008. Diabetes Care 2008;31(Suppl 1):S12–54.Google Scholar
- 6.United States Department of Health and Human Services. Administration for children and families. Low income home energy assistance program: fiscal year 2006. Avaiable at http://www.acf.hhs.gov/programs/ocs/liheap/report/part3.html (2006). Accessed on Oct 2010; 2006.
- 8.United states Census Bureau. Income, poverty, and health insurance coverage in the United States: 2008. Available at http://www.census.gov/prod/2009pubs/p60-236.pdf. Accessed on 19 May 2009.
- 9.The Office of Minority Health. Diabetes and hispanic americans. Available at http://www.omhrc.gov/templates/content.aspx?ID=3324. The Office of Minority Health (2008). Accessed on 29 Dec 2008.
- 10.OMH. Diabetes and Hispanic Americans. The office of minority health; 2008.Google Scholar
- 11.Center for Disease Control and Prevention: Behavioral risk factor surveillance system. Available at http://apps.nccd.cdc.gov/brfss/ (2008). Accessed on 10 Sep 2009.
- 12.Perez-Escamilla RV-LS, Damio G, Segura-Pérez S, Fernandez ML, Calle MC, Kollannoor-Samue G, Chhabra J, D’Agostino D. Short and long term impacts of diabetes peer counseling on HbA1c among Latinos: przeliminary results. FASEB J. 2009;23:336–8.Google Scholar
- 13.Therrien M, Ramirez RR.The Hispanic population in the United States: population characteristics. Available at http://www.hawaii.edu/hivandaids/The%20Hispanic%20Population%20in%20the%20US%20%20%20March%202000.pdf (2000). Accessed on 20 June 2009.
- 17.United States Department of Health and Human Services. Physical activity and health: a report of the surgeon General. Atlanta, Georgia: US department of health and human services, public health service, CDC, national center for chronic disease prevention and health promotion. Available at http://www.cdc.gov/nccdphp/sgr/pdf/execsumm.pdf (1996). Accessed on 12 Feb 2009.
- 29.Lesser C, Cunningham P. Access to care: is it improving or declining? Data Bull (Cent Stud Health Syst Change). 1997;1:1–2.Google Scholar
- 32.Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism. 4th ed. Belmont, CA: Thompson Wadsworth; 2005.Google Scholar
- 35.Gardner DG, Shoback, D. Treatment of diabetes mellitus greenspan’s basic & clinical endocrinology. 8th ed; 2009.Google Scholar