AFRICAN-AMERICAN WOMEN WITH DIABETES

Examining Weight Management in African-American Women with Diabetes

Abstract

This descriptive study examined depressive symptoms, cardiovascular risk, and diabetes self-care strategies in African American women (N = 45) with type 2 diabetes (T2D). All completed a questionnaire packet during structured interviews. Significant associations were found between two individual depressive symptoms and mean cardiovascular disease (CVD) risk scores, which suggest that in African American women with T2D, depressive symptoms may be correlated with a specific CVD profile and/or are unrecognized and/or unexpressed. Further analysis is warranted to determine the extent of this relationship in African American women with T2D.

Introduction4

Statement of problem6

Description of Problem6

Literature review6

Methodology9

Sample and Setting10

Instruments11

Results13

Depressive Symptoms13

Cardiovascular Risk14

Diabetes Self-Care Behaviors15

Discussion16

Limitations18

Conclusions and Implications18

Recommendations19

References20

Examining Weight Management in African-American Women with Diabetes

Introduction

DIABETES MELLITUS is one of the most prevalent chronic diseases in the United States with 798,000 new cases diagnosed every year (Harris et al., 1998). Approximately 17 million people in the United States have diabetes. Compared with White Americans, individuals from minority ethnic groups suffer disproportionately from type 2 diabetes (T2D) and its long-term complications (Dagogo-Jack, 2003). African Americans with T2D have been shown to have an increased risk of developing micro- or macrovascular disease complications (Ferdinand, 2005). Consequently, African Americans with diabetes have a higher rate of cardiovascular disease (CVD), retinopathy, microalbuminuria, end-stage renal disease, lower extremity amputation, and mortality compared with White Americans (Marshall, 2005 and Ness et al., 1999). Notably, the relationship between these comorbidities and T2D is not well understood. The prevalence of one particular psychiatric morbidity, major depression, is approximately twofold higher in individuals with diabetes than in those without diabetes (Katon et al., 2005 and U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health, 2000). Unfortunately, African American women with T2D represent one of the highest risk groups in terms of prevalence and diabetes disease burden (Samuel-Hodge et al., 2000). Compared to women without diabetes, women with diabetes have from two to six times the risk of heart disease and heart attack and are at much greater risk of having a stroke (American Heart Association, 2006). Yet, depressive symptoms in this population are largely unexplored.

Depression, CVD, and T2D impose a particularly high burden on African Americans (Braithwaite & Taylor, 2001, Burt et al., 1995 and Gavin et al., 2003). These diseases are found in higher prevalence among African Americans and are associated with reduced quality of life, increased morbidity and disability, and even death (Braithwaite & Taylor, 2001 and Gavin et al., 2003). African American women suffer with higher mortality rates (187.5 per 100,000) from CVD than White women (145.3 per 100,000) (American Heart Association, 2006), but a comorbidity of T2D escalates the mortality rate so that together, CVD and T2D produce the highest mortality rate of all groups of women in the United States (American Heart Association, 2004 and U.S. Department of Health and Human Services, Office on Women's Health, National Women's Health Information Center, 2003).

Statement of problem

This study examines depressive symptoms, cardiovascular risk, and ...