Prediction of Diabetes Outcomes in People from Mexico

Monday, 30 July 2012: 3:05 PM

Chris L. Latham, DNSc, RN
Nursing, California State University, Fullerton, Fullerton, CA

Learning Objective 1: Following the presentation, participants will be able to identify four key factors that predict Type 2 diabetes outcomes in people with a Mexican heritage.

Learning Objective 2: Following the presentation, the participant will identify the top five priorities to improve the care of Hispanic people from Mexico.

Purpose: A three-year partnership between the United States and Mexico was created to impact the high mortality rate of Type 2 diabetes in Mexico.  Two universities shared innovative, culturally appropriate methods to address lifestyle changes in newly diagnosed people with diabetes and conducted research together.  The purpose of the research was to use a theoretical, research-based model called the Hispanic Health Protection Model (HHPM) to compare the predictors of Type 2 diabetes outcomes n Tlaxcala residents and compare the findings to a U.S. study of Mexican-American residents.

Methods: A predictive, correlational replication study was performed in the State of Tlaxcala, Mexico due to the sudden upsurge in Type 2 diabetes morbidity and mortality (NIGSI, 2000; WHO, 2009).  The study involved 109 participants in rural clinics, who, following informed consent, participated in a three-phases of interviews following their initial diagnosis of Type 2 diabetes, after diabetes education, and at 4-6 months. 

Results: The Tlaxcala findings upheld the HHPM and U.S. findings, including the importance of assessing pre-morbid lifestyles, health beliefs, level of professional and social support, diabetes self-efficacy in patients with new diabetes, and comprehensive outcomes that include diabetes knowledge, quality of life (impact of diabetes and self-satisfaction while diabetic), and HbA1c and body weight changes from diagnosis to follow-up visits.  The research found that participants frequently followed good lifestyle practices while continuing to adhere to culturally-based treatment and attribution beliefs.  There were moderate perceptions of diabetes self-care efficacy, low ratings of support, poor understanding of diabetes, continued obesity, acceptable quality of life ratings, and near-normal HbA1c levels.

Conclusion: This study provides support for a culturally appropriate model that may serve as a comprehensive health protection framework for practice. Pre-morbid lifestyle and diabetes self-efficacy following education classes are important predictors of psychological and physiological outcomes in both studies, and need to be included when evaluating patient diabetes outcomes.