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Alcohol Consumption and Compliance Among Inner-city Minority Patients With Type 2 Diabetes Mellitus
Karlon H. Johnson, MD;
Mohsen Bazargan, PhD;
Eric G. Bing, MD, PhD, MPH
Arch Fam Med. 2000;9:964-970.
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 A1c levels, although there was a trend toward higher hemoglobin A1c 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.
From the Department of Family Medicine (Drs Johnson and Bazargan) and Psychiatry (Dr Bing), Collaborative Alcohol Research Center, Charles R. Drew University of Medicine and Science, Los Angeles, Calif.
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