Effect of Family support and Education in

Diabetes Self-Management in Cuban Americans

Deva Gundupalli1 , Joan Vaccaro, Fatma G Huffman, 1 1

1
Florida International University , Miami, FL 33199
BACKGROUND RESULTS CONCLUSIONS
ABSTRACT#
Objectives: Effect of family support and education level on  Type 2 diabetes, constituting approximately 95% of the cases of diabetes, has Table 1: Reduced Model Predictors of Glycemic Control  Family Support was associated with better DSM skills . Patients with
diabetes self management in Cuban Americans (CA) with type 2 been established as a major health threat in developing and developed better family and friends support felt they were better equipped to
diabetes was studied (n=183) (Females=110, Males=72) with nations. handle the disease and had better DSM skills.
type 2 diabetes (T2D). Type 2 diabetes has increased among the general population (NIDDK, 2008)
Methods: Participants were recruited from a randomized and disproportionately among minorities (particularly African Americans and  Education was also an important factor predicting DSM. Better education
mailing list in two counties of South Florida. Participants were Regression Models Model 1 Model 2
Hispanics) (NDSS, 2005). translates to better understanding of the disease state and concepts
screened by trained interviewers for heritage and diabetes Outcomes DSM HbA1c about health and Diabetes management. We believe that this translates
status and signed an informed consent form. Statistical analyses Understanding the role social support plays with self-care behavior is vital to Predictors: to better DSM skills as has been shown by our study.
used SPSS. the development of medical standards of care practices. Family Support t=-2.01, p=0.046
Results: DSM was regressed with family support score and Cuban Americans had the highest proportion of diabetes as the underlying
educational levels.  Family support (standardized β=.153, cause of death (44%) as compared to Puerto Ricans (39%) and Mexican Education Level
p=0.052) and educational levels (standardized β=.265, p=0.000) t= -2.13, p=0.036
Americans (37%) (CDC, 2008);
were significant in the model and explained 9.6% of the variation LIMITATIONS
in DSM scores (Adjusted =9.6)
Conclusions: The better the family support and higher the  The sample cannot be assumed to represent all Cuban Americans in
education level of the patient, the better the diabetes South Florida with type 2 diabetes.
management skills and hence outcomes. Overall model F= 10.2. p<.001 F=7.4, p=.001
Supported by a grant from NIH/SCORE Parameters: R2 = 0.16 R2 = .078
  IMPLICATIONS
Promulgation of federal standards of care in managing type 2
r2
DM by involving families in welfare programs.
Table 2: Multiple Linear Regression predictors of Composite  Local agencies involved in type 2 DM care should be advised
DSM Score (Best Model) to educate the families of the patients to provide care and support
to the patients in managing type 2 DM.

Predictors Family Support .153

standardized coefficients Education Factor .265
(ßeta)
.
Introduction . REFERENCES
Model Parameters: F = 5.45, p =.0001
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[1]. STUDY POPULATION: Cuban Americans from Broward and Miami-Dade Counties Importance of Race and Ethnic Background in Biomedical Research and
Study approved by Florida International University Institutional Review Board Clinical Practice. New England Journal of Medicine, 348, 1170-1175.
There are contradictory findings concerning assimilation to the (IRB) Regression Models Model 1 Model 2 Model 3 4.Centers for Disease Control and Prevention (CDC, 2007). National
United States with quality of diet and diabetes self- STUDY DESIGN: Study Design: A data set of Cuban Americans with type 2 Predictors Family Support diabetes fact sheet: General information and national estimates on diabetes
management (DSM). Acculturation may be a factor in DSM. diabetes (N=182) from the parent cross-sectional study of Cuban Americans Education in the United States, 2007. Atlanta, GA: U.S. Department of Health and Human
and cardiovascular risk factors (N=367) was analyzed for associations among Services, Centers for Disease Control and Prevention.
Type 2 diabetes if improperly managed leads to morbidities in predictor, outcome, mediator and confounding variables with respect to 5.Centers for Disease Control and Prevention (CDC, 2008). National
renal, eye, and peripheral nervous system and possible acculturation factors, dietary intake, diabetes self management skills and Diabetes Fact Sheet: General Information and National Estimates on Diabetes
mortality. Diabetes is an underreported cause of death, yet the beliefs (DSM). The recruitment, selection and data collection were discussed in the United States, 2007. Atlanta, GA: U.S. Department of Health and Human
overall risk of mortality for persons with diabetes is twice that previously [7]. R2-change .151 .112 .040 Services, Centers for Disease Control and Prevention.
of persons without diabetes [2]. Methods: Participants were recruited from a randomized mailing list in two Adjusted R2 .145 .254 .290
counties of South Florida. Participants were screened by trained interviewers F-change 29.2 25.0 9.5
for heritage and diabetes status and signed an informed consent form. P-value (F-change) <.001 <.001 .002
Statistical analyses used SPSS.
Variable Construction: A composite variable Family Support was made from the
questionnaire using questions based on how supportive the family and
friends were in DSM
ACKNOWLEDGEMENTS

The study was funded by a grant from NIH/SCORE