Associations between economic hardship and markers of self-management in adults with type 2 diabetes

Results from Diabetes MILES - Australia

A. O'Neil, E.D. Williams, J.L. Brown, R. Horne, F. Pouwer, J. Speight

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Abstract

Objective:
A socioeconomic gradient exists in Australia for type 2 diabetes mellitus (T2DM). It remains unclear whether economic hardship is associated with T2DM self–management behaviours.
Methods:
Cross-sectional data from a subset of the Diabetes MILES – Australia study were used (n=915). The Economic Hardship Questionnaire was used to assess hardship. Outcomes included: healthy eating and physical activity (Diabetes Self-Care Inventory – Revised), medication-taking behaviour (Medication Adherence Rating Scales) and frequency of self-monitoring of blood glucose (SMBG). Regression modelling was used to explore the respective relationships.
Results:
Greater economic hardship was significantly associated with sub-optimal medication-taking (Coefficient: −0.86, 95%CI −1.54, −0.18), and decreased likelihood of regular physical activity (Odds Ratio: 0.47, 0.29, 0.77). However, after adjustments for a range of variables, these relationships did not hold. Being employed and higher depression levels were significantly associated with less-frequent SMBG, sub-optimal medication-taking and less-regular healthy eating. Engaging in physical activity was strongly associated with healthy eating.
Conclusions:
Employment, older age and depressive symptoms, not economic hardship, were commonly associated with diabetes self-management.
Implications:
Work-based interventions that promote T2DM self-management in younger, working populations that focus on negative emotions may be beneficial.
Original languageEnglish
Pages (from-to)466-472
JournalAustralian and New Zealand Journal of Public Health
Volume38
Issue number5
DOIs
Publication statusPublished - 2014

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Type 2 Diabetes Mellitus
Blood Glucose Self-Monitoring
Depression
Medication Adherence
Odds Ratio
Equipment and Supplies
Healthy Diet

Cite this

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title = "Associations between economic hardship and markers of self-management in adults with type 2 diabetes: Results from Diabetes MILES - Australia",
abstract = "Objective: A socioeconomic gradient exists in Australia for type 2 diabetes mellitus (T2DM). It remains unclear whether economic hardship is associated with T2DM self–management behaviours.Methods: Cross-sectional data from a subset of the Diabetes MILES – Australia study were used (n=915). The Economic Hardship Questionnaire was used to assess hardship. Outcomes included: healthy eating and physical activity (Diabetes Self-Care Inventory – Revised), medication-taking behaviour (Medication Adherence Rating Scales) and frequency of self-monitoring of blood glucose (SMBG). Regression modelling was used to explore the respective relationships.Results: Greater economic hardship was significantly associated with sub-optimal medication-taking (Coefficient: −0.86, 95{\%}CI −1.54, −0.18), and decreased likelihood of regular physical activity (Odds Ratio: 0.47, 0.29, 0.77). However, after adjustments for a range of variables, these relationships did not hold. Being employed and higher depression levels were significantly associated with less-frequent SMBG, sub-optimal medication-taking and less-regular healthy eating. Engaging in physical activity was strongly associated with healthy eating.Conclusions: Employment, older age and depressive symptoms, not economic hardship, were commonly associated with diabetes self-management.Implications: Work-based interventions that promote T2DM self-management in younger, working populations that focus on negative emotions may be beneficial.",
author = "A. O'Neil and E.D. Williams and J.L. Brown and R. Horne and F. Pouwer and J. Speight",
year = "2014",
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language = "English",
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Associations between economic hardship and markers of self-management in adults with type 2 diabetes : Results from Diabetes MILES - Australia. / O'Neil, A.; Williams, E.D.; Brown, J.L.; Horne, R.; Pouwer, F.; Speight, J.

In: Australian and New Zealand Journal of Public Health, Vol. 38, No. 5, 2014, p. 466-472.

Research output: Contribution to journalArticleScientificpeer-review

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T1 - Associations between economic hardship and markers of self-management in adults with type 2 diabetes

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AU - Horne, R.

AU - Pouwer, F.

AU - Speight, J.

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N2 - Objective: A socioeconomic gradient exists in Australia for type 2 diabetes mellitus (T2DM). It remains unclear whether economic hardship is associated with T2DM self–management behaviours.Methods: Cross-sectional data from a subset of the Diabetes MILES – Australia study were used (n=915). The Economic Hardship Questionnaire was used to assess hardship. Outcomes included: healthy eating and physical activity (Diabetes Self-Care Inventory – Revised), medication-taking behaviour (Medication Adherence Rating Scales) and frequency of self-monitoring of blood glucose (SMBG). Regression modelling was used to explore the respective relationships.Results: Greater economic hardship was significantly associated with sub-optimal medication-taking (Coefficient: −0.86, 95%CI −1.54, −0.18), and decreased likelihood of regular physical activity (Odds Ratio: 0.47, 0.29, 0.77). However, after adjustments for a range of variables, these relationships did not hold. Being employed and higher depression levels were significantly associated with less-frequent SMBG, sub-optimal medication-taking and less-regular healthy eating. Engaging in physical activity was strongly associated with healthy eating.Conclusions: Employment, older age and depressive symptoms, not economic hardship, were commonly associated with diabetes self-management.Implications: Work-based interventions that promote T2DM self-management in younger, working populations that focus on negative emotions may be beneficial.

AB - Objective: A socioeconomic gradient exists in Australia for type 2 diabetes mellitus (T2DM). It remains unclear whether economic hardship is associated with T2DM self–management behaviours.Methods: Cross-sectional data from a subset of the Diabetes MILES – Australia study were used (n=915). The Economic Hardship Questionnaire was used to assess hardship. Outcomes included: healthy eating and physical activity (Diabetes Self-Care Inventory – Revised), medication-taking behaviour (Medication Adherence Rating Scales) and frequency of self-monitoring of blood glucose (SMBG). Regression modelling was used to explore the respective relationships.Results: Greater economic hardship was significantly associated with sub-optimal medication-taking (Coefficient: −0.86, 95%CI −1.54, −0.18), and decreased likelihood of regular physical activity (Odds Ratio: 0.47, 0.29, 0.77). However, after adjustments for a range of variables, these relationships did not hold. Being employed and higher depression levels were significantly associated with less-frequent SMBG, sub-optimal medication-taking and less-regular healthy eating. Engaging in physical activity was strongly associated with healthy eating.Conclusions: Employment, older age and depressive symptoms, not economic hardship, were commonly associated with diabetes self-management.Implications: Work-based interventions that promote T2DM self-management in younger, working populations that focus on negative emotions may be beneficial.

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