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Alcohol consumption and compliance among inner-city minority patients with type 2 diabetes mellitus
K H Johnson1, M Bazargan, E G Bing
1Department of Family Medicine, Charles R. Drew University of Science and Medicine, Los Angeles, CA, USA. khjohn@pacbell.net
Objective:
To examine the relation between alcohol consumption and self-reported compliance with prescribed therapies for type 2 diabetes mellitus among underserved minority patients.
Design:
Cross-sectional sampling of consecutive patients with diabetes was performed following routine visits to their primary care physicians. Interviewers measured compliance using the Summary of Diabetes Self-Care Questionnaire and alcohol use using the timeline followback method and the Alcohol Use Disorders Identification Test.
Setting:
Seven inner-city medical clinics that provide primary care services to low-income residents of South Central Los Angeles, Calif.
Participants:
A total of 392 ethnic minority patients (61% Hispanic, 29% African American) with type 2 diabetes mellitus.
Main Outcome Measures:
Self-report compliance with prescribed diet, exercise, home glucose monitoring, medications, and outpatient follow-up.
Results:
Drinking any alcohol-containing beverage within 30 days was associated with poorer adherence to prescribed dietary recommendations for the consumption of fiber (t = 2.4; P<.05), fat (t = 4.2; P<.01), sweets (t = 2.7; P<.01), and energy (calories) (t = 2.0; P<.05). Drinkers were also less likely to exercise for at least 20 minutes per day (t = 2.2; P<.05), comply with oral medication regimens (t = 4.6; P<.01), or attend outpatient follow-up visits (r = -0.11; P<.05). Alcohol use did not significantly alter compliance with home glucose monitoring, insulin use, or hemoglobin A(1c) levels, although there was a trend toward higher hemoglobin A(1c) levels among drinkers (11.0 vs 10.4). Multivariate analysis of the data demonstrates that when demographic characteristics, health care utilization, and other diabetes-related variables are held constant, the relation between alcohol use and dietary compliance remained significant.
Conclusion:
Alcohol consumption may be associated with poorer compliance with recommendations for some self-care behaviors among inner-city minority patients with diabetes. Arch Fam Med. 2000;9:964-970
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