Symptom-Related Self-Care of Mexican Americans With Type 2 Diabetes: Preliminary Findings of the Starr County Diabetes Education Study

Abstract

Starr County, Texas, a Texas-Mexico border community, was the site of a study involving culturally-appropriate education and group support for Mexican Americans with type 2 diabetes. Data were collected from 63 subjects on frequency of diabetes-related symptoms during the previous month and on self-care symptom treatments. On average, subjects were 57-year-old females, diagnosed with diabetes for 10 years, and exhibiting HbA1c levels of 12.5%. Almost 50% experienced excessive urination, excessive thirst, shakiness/nervousness, and numbness and/or tingling in their extremities. More than 50% of those who experienced symptoms did not view them as serious. Only one subject checked blood sugar levels when symptoms occurred. Significantly higher mean glycosylated hemoglobin levels were found for individuals who experienced dizziness and/or chest pain compared with those who did not. A variety of self-care treatments were employed, including over-the-counter medications and home remedies.

Culturally Competent Diabetes Self-Management Education for Mexican Americans

“…A total of ϳ25% of subjects were taking insulin alone or in combination with oral hypoglycemic agents. One third reported using home remedies, such as herbal teas (e.g., teas from the chaya plant), garlic, aloe vera, etc., to lower blood glucose levels (25). There were no statistically significant differences at baseline between the experimental and control groups on any of the outcome measures (Tables 3 and 4).…”

The Starr County Diabetes Education Study

“…The study site, Starr County, TX, one of 14 Texas counties bordering northern Mexico, has been described previously (13)(14)(15). Of the population residing in this area, 20% is foreign-born (16).…”

“…The sample was recruited as part of The Starr County Diabetes Education Study (13,14). The 4-year project (1994-1998) focused on delivery and evaluation of a culturally competent community-based intervention consistent with national standards for diabetes care and designed to improve the health of Mexican-Americans with type 2 diabetes and their families.…”

The Diabetes Symptom Self-Care Inventory: Development and Psychometric Testing with Mexican Americans

“…Symptoms are usually discussed in the context of diagnosing diabetes 6,7. However, long after the initial diagnosis, people with diabetes often have symptoms in response to hyper- and hypoglycemia, side effects of medication, and concurrent medical conditions 8,9…”

“…However, too many act without knowing the symptoms’ physiologic cause thus inviting potentially damaging consequences 8,9. Therefore, patients and their caregivers need an effective tool to identify symptoms, assess the perceived seriousness of those symptoms, and evaluate responses taken to alleviate symptoms.…”