Blood glucose symptom recognition: perspectives of older rural adults

Diabetes symptoms and self-management behaviors in rural older adults

AIMS

To evaluate the demographic and health correlates of reporting diabetes symptoms, and the relationship between diabetes symptoms and self-management behaviors in rural older adults.

METHODS

Cross-sectional interviews were conducted with 489 African American, American Indian, and white female and male adults 60 years and older. Participants with diabetes were recruited from eight North Carolina counties. Participants completed the 34-item Diabetes Symptom Checklist (DSC). Associations of demographic and health characteristics with reported symptoms were evaluated. Multivariate linear regression models were used to examine the associations of DSC scores and diabetes self-management.

RESULTS

Participants had low scores on the DSC. They largely practiced appropriate diabetes self-management behaviors (self-foot checks, fruit and vegetable consumption, and self-monitoring blood glucose). Correlates of DSC included women having higher scores for hypoglycemia, psychological total, and fatigue dimensions. Neuropathic pain and vision dimensions were significantly associated with educational attainment. Most DSC dimensions were associated with ethnicity or economic status. Taking oral diabetes medicine was correlated with hyperglycemia; insulin use was associated with most DSC dimensions. HbA1c was not associated with any DSC dimension; diabetes duration >10 years was correlated with all dimensions except neuropathic pain and vision. Higher levels of psychological fatigue were significantly associated with fewer self-management behaviors.

DISCUSSION/CONCLUSIONS

Demographic and health characteristics are associated with reported symptoms. Fatigue is a symptom negatively associated with diabetes self-management behavior in older adults. Health care providers are uniquely positioned to assess patient symptoms and potential relationships with successful diabetes management.

Patterns and Stability over Time of Older Adults' Diabetes-related Beliefs

OBJECTIVES

We sought to identify coherent profiles of diabetes beliefs within discrete domains (ie causes, symptoms, consequences, self management, and medical management), and delineate consistency of belief profiles over one month.

METHODS

Diabetes beliefs of rural-dwelling older adults were assessed with the Common Sense Model of Diabetes Inventory at baseline (N = 593) and one month later (N = 563).

RESULTS

A discrete number of belief patterns were identified in each belief domain using latent class analysis. Belief patterns varied by the extent to which more popular or folk notions of diabetes encroached on biomedical understandings of the disease. Belief patterns were generally stable over time.

CONCLUSIONS

A manageable number of belief patterns can be identified and used to strengthen patient-centered care and, potentially, enhance diabetes management.