Factors Associated with Diabetes Control Among Low-income Adults in Virginia

The incidence of type 2 diabetes has greatly increased in the U.S. population over the last decade and continues to increase each year. Over 90% of those with diabetes have type 2 diabetes, for which obesity, diet, and inadequate physical activity remain the strong nongenetic determinants. In Virginia between 1994 and 1996, the estimated number of people with diabetes was 220,000 and another 75,000 were estimated to have the disease, but did not know it (http://www.vahealth.org accessed 7/10/01). A study has been conducted that involves two separate surveys. The Community Diabetes Education Survey (CDES) was an interview questionnaire or mailed questionnaire for assessing community diabetes education resources and was completed by Extension Nutrition and Wellness Specialty Agents and five Area EFNEP/FSNEP coordinators located throughout Virginia. The Diabetes Patient Survey was a client interview questionnaire assessing the attitudes, behaviors, and knowledge of persons with diabetes. This survey was conducted by FSNEP Program Assistants. More than 150 low-income adults who have type 2 diabetes and were enrolled in FSNEP at the time of data collection were interviewed.

The results from this study showed hospitals were the main health agency to fill out CDES-II. Most diabetes education done by extension is delivered through a combination of methods like group classes, individual counseling sessions, phone or e-mail, and providing handouts. Almost all of the health agencies offer diabetes diagnosis and treatment for adults.

Results from this study showed on gender, age, and race, the study sample was similar to the total FSNEP population, except that the percentage of African Americans was higher among the diabetes patients than among the general FSNEP population. The African American subjects also had diabetes longer (12 years vs. 8 years), although their current mean age was the same as Caucasians. The study did not reveal substantial differences in African Americans and Caucasians regarding recommendations they had received on dietary practices. Forty-nine percent of study's participants were physically active. Most participants exercised two to three times per week, for only 15 to 30 minutes at a time. The purpose of this research was to assess the extent to which diabetes education is available and easily accessible to the low-income adult population in Virginia and to assess FSNEP clients regarding attitudes, behaviors, and knowledge that may affect their management of diabetes.