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    ABSTRACT: This study examines the prevalence and correlates of poor glycemic control in Mexican Americans aged 75 years and older with diabetes. Data are from the 5(th) wave (2004-05) of the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE). A total of 2,069 Mexican Americans aged 75 and over were interviewed. Six hundred eighty nine subjects (33.5%) reported having been diagnosed with diabetes and 209 (30.3%) subjects agreed to a blood test of their HbA(1)c level. Of the 209 diabetic subjects with an HbA(1)c test, 73 (34.9%) had good glycemic control (HbA(1)c <7%) and 136 (65.1%) had poor glycemic control (HbA(1)c >7%). Bivariate analysis revealed that subjects with poor control had longer disease duration, had lower education, used the glucometer more frequently, and had more diabetes-complications when compared to those in the good glycemic control group. Multivariable logistic regression analysis found the following factors associated with poor glycemic control: <8 years of education, foreign-born, smoking, obesity, longer disease duration, daily glucometer use, and having macro-complications. Prevalence of poor glycemic control is very high in this population with very high and rising prevalence of diabetes. Further studies are needed to explore the effect of these and other characteristics on glycemic control among older Mexican Americans and to develop appropriate interventions to improve diabetes outcomes and increase life-expectancy.
    Journal of diabetes and its complications 04/2012; 26(3):181-6. · 2.11 Impact Factor
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    ABSTRACT: OBJECTIVE: The aim of this study was to explore the associations between inadequate glycemic control of diabetes and psychological, anthropometric and life style variables in a population based cohort of type 1 diabetes patients. DESIGN: Cross-sectional study. METHODS: In this study 292 patients with type 1 diabetes participated, age 18-59 years. Psychological data were assessed by self-report instruments, Hospital Anxiety and Depression Scale and Toronto Alexithymia Scale-20. Anthropometrics, blood analyses, data from medical records and data from the Swedish National Diabetes Registry were collected. RESULTS: Self-reported depression (Adjusted Odds Ratio (AOR) 4.8), obesity (AOR 4.3) and smoking (AOR 3.0) were independently associated with inadequate glycemic control of diabetes (HbA1c >8.6%). Gender stratified analyses showed that self-reported depression (AOR 19.8) and obesity (AOR 7.0) in women; and smoking in men (AOR 4.2) were associated with HbA1c >8.6%. Alexithymia, antidepressant medication and physical inactivity were associated with HbA1c >8.6% only in bivariate analyses. Alexithymia, self-rated anxiety, physical inactivity and absence of abdominal obesity were associated with self-reported depression. CONCLUSIONS: Depression was the only psychological factor independently associated with HbA1c >8.6%. The association was of comparable importance as obesity and smoking, well known risk factors for inadequate glycemic control and diabetes complications. The association between depression and HbA1c >8.6% was particularly strong for women. Alexithymia, which is a relatively stable personality trait, was associated with depression. In the future care of patients with diabetes, psychological aspects should be considered alongside anthropometrics and life style factors in order to achieve the goals for HbA1c.
    European Journal of Endocrinology 03/2013; · 3.14 Impact Factor
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    ABSTRACT: Background and Objectives: Saudi Arabia has one of the highest prevalence of diabetes. This study was conducted with the following objectives: (1) To study the socio-demographic profile of diabetic patients in Abha. (2) To find the socio-demographic determinants of compliance among diabetic patients in Abha. Material and Methods: A self administered questionnaire which had detailed the socio-demographic features and various aspects of compliance was used on a random sample of registered diabetics at two primary health care centres of Abha. Results: Most of the patients (70.4 percent) were between 40-60 years age. Most of the patients were men (about 60 percent) and Saudis. Majority of patients did not have a university education. Young patients (age<40) were more compliant with all aspects of management, except medication (23.8 percent). Women were significantly more compliant with exercise (49.7 percent), while men were significantly more compliant with follow up (81.1 percent). Saudi patients were significantly compliant with medication (79.2 percent), while non Saudis were compliant with exercise (62.9 percent). All single patients were diet compliant. Smokers were significantly less compliant with exercise. Patients with normal BMI were significantly more compliant with diet and exercise. Conclusion: Patients were found to be generally less compliant towards the regimen. Socio-demographic factors which were significantly associated with non compliance were age, gender, nationality, educational status, marital status, smoking status and BMI.
    Journal of clinical and diagnostic research : JCDR. 12/2013; 7(12):2810-3.

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Aug 12, 2014