Gender Differences in Type 2 Diabetes Self-Management Among Spanish-Speaking, Mexican Immigrants

Wednesday, 24 July 2013: 2:10 PM

Cheryl A. Smith-Miller, PhD, RN-BC
Nursing Quality and Research, University of North Carolina Hospitals, Chapel Hill, NC
Diane C. Berry, PhD, CANP
School of Nursing, University of North Carolina - Chapel Hill, Chapel Hill, NC

Learning Objective 1: The learner will be able to verbalize the challenges of type 2 diabetes self-management among Spanish-speaking Latinas.

Learning Objective 2: The learner will be able to describe how the challenges Latinas face differ from those faced by Latino men.

Persons of Mexican heritage had the highest age-adjusted increase in diagnosed diabetes from 1997 to 2007 of any Latino subgroup. However, the lack of knowledge about the T2DM self-management practices of recent Mexican immigrants impedes the provision of culturally appropriate health care and interventions to effectively address their unique needs in the United States.

Purpose: The purpose of the study was twofold; one, to describe Spanish-speaking, Mexican immigrants’ type 2 diabetes (T2DM) self-management using social cognitive theory as a framework; and, two, to examine the influence of health literacy, diabetes knowledge, self-efficacy on diet practices and physical activity.

Methods: Mixed-methods were used to achieve the study aims.

Results: Gender, culture, and social environment informed and influenced nutritional practices and exercise behaviors among the 19 female and 11 male (N = 30) Spanish-speaking Latino participants. These differences were manifest in glycemic control and weight, and reported in physical activity and family support. Although its affect was uncertain, literacy indirectly influenced type 2 diabetes self-management and women reported lower academic achievement levels than men. Women were more likely to attribute being depressed because of their diabetes than men were, but men were more likely to report difficulty with excessive alcohol consumption. Improved T2DM self-management was associated with increased self-efficacy related to diabetes, especially among the women. Finally, women had lower level of eating and exercise self-efficacy and less physical activity compared to men.

Conclusion: Spanish-speaking, Mexican immigrant women and men face unique T2DM self-management challenges related to language and culture. This study revealed that gender is also a factor in T2DM. Gender sensitive interventions can improve self-management outcomes and enhance self-efficacy. A nursing delivered, patient-centered, multi-faceted approach to patient education and support could improve individual’s understanding about T2DM self-management and mitigate the challenges associated with low literacy and inadequate diabetes knowledge.