Concepts of diabetes self-management in Mexican American and African American low-income patients with diabetes

The goal of the study was to explore low-income minority patients ’ concepts of diabetes self-management and assess the extent to which patient beliefs correspond to evidence-based rec-ommendations. African American and Mexican American patients with type 2 diabetes were recruited from safety net clinics that serve the un-insured and under-insured in Chicago and San Francisco to participate in focus group discus-sions. Grounded theory was used to identify themes related to diabetes self-management. Strategies participants mentioned for diabetes self-care were medication use, diet, weight loss and exercise. Eating more fruit and vegetables and consuming smaller portions were the most commonlymentioneddietarybehaviorstocontrol diabetes.AfricanAmericansexpressedskepticism about taking medications. Mexican Americans discussed barriers to acquiring medications and use of herbal remedies. Mexican Americans fre-quently mentioned intentional exercise of long duration as a management strategy, whereas African Americans more frequently described exercise as regular activities of daily living. Blood glucose self-monitoring and reducing risks of diabetes complications were rarely mentioned as diabetes self-management behaviors. African American and Mexican American patients have different concepts of diabetes self-management, especiallywithregardtomedicationuseandphys-ical activity. Consideration of these differences may facilitate designof effective self-management interventions for these high-risk populations