Diabetes Self Management: Are Cuban Americans Receiving Quality Health Care?

Objectives: We investigated the relationship among factors predicting inadequate glucose control among 182 Cuban-American adults (Females=110, Males=72) with type 2 diabetes mellitus (CAA). Study Design: Cross-sectional study of CAA from a randomized mailing list in two counties of South Florida Methods: Fasted blood parameters and anthropometric measures were collected during the study. BMI was calculated (kg/ m2). Characteristics and diabetes care of CAA were self-reported Participants were screened by trained interviewers for heritage and diabetes status (inclusion criteria: self-reported having type 2 diabetes; age  35 years, male and female; not pregnant or lactating; no thyroid disorders; no major psychiatric disorders). Participants signed informed consent form. Statistical analyses used SPSS and included descriptive statistic, multiple logistic and ordinal logistic regression models, where all CI 95%. Results: Eighty-eight percent of CAA had BMI of ≥ 25 kg/ m2. Only 54% reported having a diet prescribed/told to schedule meals. We found CAA told to schedule meals were 3.62 more likely to plan meals (1.81, 7.26), p<0.001) and given a prescribed diet, controlling for age, corresponded with following a meal plan OR 4.43 (2.52, 7.79, p<0.001). The overall relationship for HbA1c < 8.5 to following a meal plan was OR 9.34 (2.84, 30.7. p<0.001). Conclusions: The advantage of having a medical professional prescribe a diet seems to be an important environmental support factor in this sample’s diabetes care, since obesity rates are well above the national average. Nearly half CAA are not given dietary guidance, yet our results indicate CAA may improve glycemic control by receiving dietary instructions.

The impact of dieting status and restraint on post-exercise energy intake in overweight females

This study investigated the impact of an acute bout of physical activity on postexercise energy intake (PE-EI) in overweight females who were dieting with high restraint (D-HR) and non-dieting with either high restraint (ND-HR) or low restraint (ND-LR). PE-EI at lunch and 12-hours after was compared on the exercise (E) and a nonexercise (NE) day. There was a significant interaction (F (2,33)= 4.12, p = 0.025) of dieting/restraint status and condition (E vs. NE day) on the 12-hour El. The D-HR ate 519 ± 596 kcal more on the E than on the NE day; while the ND-HR ate 177 ± 392 kcal less on the E than on the NE day. The results of this study demonstrate that the impact of exercise on PE-EI is determined by both a physiological and psychological response. Dieting status, dietary restraint, level of disinhibition and cognitive factors may influence PE-EI and weight.