Obesity, physical activity and prediabetes in adult children of people with diabetes.

OBJECTIVES: Determine prevalence of obesity / overweight, physical activity (PA) and prediabetes in adult children of parents with type 2 diabetes; identify differences according to sociodemographic variables, and describe the relationship of obesity/overweight with fasting glucose (FG) and glycosylated hemoglobin (A1C). METHODS: Cross-sectional study in 30 Mexican families with 53 participating adult children. Obesity / overweight was determined with Body Mass Index (BMI), Waist Circumference (WC) and body fat percentage (BFP); PA with the short International Physical Activity Questionnaire (IPAQ), and prediabetes with FG. RESULTS: 64% of participants presented obesity / overweight, 32% low PA, and 19% prediabetes. Men had higher WC than women (U= 219, p= 0.03). Women showed more BFP than men (U= 142, p <0.01). Blood glucose was related to BFP (rs= 0.336, p < 0.05), the A1C with the BMI (rs= 0.417, p <0.01), WC (rs= 0.394, p<0.01), BFP (rs= 0.494, p<0.01) and intense PA (rs= - 0.285, p<0.05). CONCLUSIONS: High prevalence of obesity / overweight and low PA were found. The FG was related only to BFP and A1C, in addition to BMI, WC and inversely with intense BP. It is recommended to modify the educational strategies of nursing at a family level.

Knowledge and Practices of Diabetes Foot Care and Risk of Developing Foot Ulcers in México May Have Implications for Patients of Méxican Heritage Living in the US.

Purpose The purpose of the study was to examine the relationship between knowledge and foot care practices among adults with type 2 diabetes. Methods A descriptive correlational study examined 200 patients with type 2 diabetes in México. Data collected included the Knowledge and Practices Self-Care Questionnaire and a Podiatry Examination Questionnaire. Data analysis included Pearson's correlations and chi-square tests. Results More than half of the participants had poor knowledge and poor foot care practices. A significant negative correlation between knowledge and practices of foot care and risk of developing diabetes foot ulcers was found. There was no relationship between sociodemographic variables and the risk of developing diabetes foot ulcers. Conclusions Patients with type 2 diabetes served in an outpatient clinic had poor knowledge and practices of foot care. They demonstrated decreased knowledge and practice of foot care and therefore showed a greater risk of developing diabetes foot, which may predispose patients to early complications.

Obesity, physical activity and prediabetes in adult children of people with diabetes / Obesidade, atividade física e pré-diabetes em filhos de pessoas com diabetes / Obesidad, actividad física y prediabetes en hijos de personas con diabetes

ABSTRACT Objectives: Determine prevalence of obesity / overweight, physical activity (PA) and prediabetes in adult children of parents with type 2 diabetes; identify differences according to sociodemographic variables, and describe the relationship of obesity/overweight with fasting glucose (FG) and glycosylated hemoglobin (A1C). Methods: Cross-sectional study in 30 Mexican families with 53 participating adult children. Obesity / overweight was determined with Body Mass Index (BMI), Waist Circumference (WC) and body fat percentage (BFP); PA with the short International Physical Activity Questionnaire (IPAQ), and prediabetes with FG. Results: 64% of participants presented obesity / overweight, 32% low PA, and 19% prediabetes. Men had higher WC than women (U= 219, p= 0.03). Women showed more BFP than men (U= 142, p <0.01). Blood glucose was related to BFP (rs= 0.336, p < 0.05), the A1C with the BMI (rs= 0.417, p <0.01), WC (rs= 0.394, p<0.01), BFP (rs= 0.494, p<0.01) and intense PA (rs= - 0.285, p<0.05). Conclusions: High prevalence of obesity / overweight and low PA were found. The FG was related only to BFP and A1C, in addition to BMI, WC and inversely with intense BP. It is recommended to modify the educational strategies of nursing at a family level.

RESUMO Objetivos: Determinar a prevalência de obesidade/sobrepeso, atividade física (AF) e pré-diabetes em filhos de pessoas com diabetes mellitus tipo 2; identificar diferenças de acordo com variáveis sociodemográficas e descrever a relação de obesidade/sobrepeso com a glicose em jejum (GJ) e a hemoglobina glicosilada (HbA1c). Métodos: Estudo transversal em 30 famílias mexicanas com 53 filhos participantes. A obesidade/sobrepeso foi determinada por meio do Índice de Massa Corporal (IMC), Circunferência da Cintura (CC) e percentual de gordura corporal (GC); a AF com o Questionário Internacional de Atividade Física curto (IPAQ) e pré-diabetes com a GJ. Resultados: 64% dos participantes apresentaram obesidade/sobrepeso, 32% baixa AF e 19% pré-diabetes. Os homens tiveram maior CC do que as mulheres (U= 219, p= 0.03). As mulheres mostraram mais GC do que os homens (U= 142, p <0.01). A glicose sanguínea esteve relacionada com a GC (rs= 0.336, p < 0.05), a HbA1c com o IMC (rs= 0.417, p <0.01), CC (rs= 0.394, p<0.01), GC (rs= 0.494, p<0.01) e AF intensa (rs= - 0.285, p<0.05). Conclusões: Foram encontradas altas prevalências de obesidade/sobrepeso e baixa AF. A GJ esteve relacionada somente com a GC e a HbA1c, além da GC, teve relação com o IMC, CC e de maneira inversa com a AF intensa. Recomenda-se modificar as estratégias educativas de enfermagem a nível familiar.

RESUMEN Objetivos: Determinar prevalencia de obesidad/sobrepeso, actividad física (AF) y prediabetes en hijos de personas con diabetes tipo 2; identificar diferencias de acuerdo a variables sociodemográficas y describir la relación de obesidad/sobrepeso con glucosa en ayuno (GA) y hemoglobina glucosilada (A1c). Métodos: Estudio transversal en 30 familias mexicanas con 53 hijos participantes. La obesidad/sobrepeso se determinó con Índice de Masa Corporal (IMC), Circunferencia de Cintura (CC) y porcentaje de grasa corporal (GC); la AF con el cuestionario IPAQ corto y prediabetes con GA. Resultados: 64% de los participantes presentó obesidad/sobrepeso, 32% baja AF y 19% prediabetes. Los hombres tuvieron mayor CC que las mujeres (U= 219, p= 0.03). Las mujeres mostraron más GC que los hombres (U= 142, p <0.01). La glucosa sanguínea estuvo relacionada con la GC (rs= 0.336, p < 0.05), la A1c con el IMC (rs= 0.417, p <0.01), CC (rs= 0.394, p<0.01), GC (rs= 0.494, p<0.01) y AF intensa (rs= - 0.285, p<0.05). Conclusiones: Se encontraron altas prevalencias de obesidad/sobrepeso y baja AF. La GA estuvo relacionada sólo con GC y la A1c además con el IMC, CC y de manera inversa con la AF intensa. Se recomienda modificar las estrategias educativas de enfermería a nivel familiar.

Self-Care Behaviors and Glycemic Control in Low-Income Adults in México With Type 2 Diabetes Mellitus May Have Implications for Patients of Mexican Heritage Living in the United States.

This study examined self-care behaviors and their relationship to glycemic control in low-income Mexican adults with type 2 diabetes in Southeastern Tamaulipas, México. A total of 135 patients were enrolled from 17 community health centers. The most frequent self-care behavior was medication management (80%), and the least frequent self-care behavior was self blood glucose monitoring (7%). All the patients demonstrated poor glycemic control, with glycated hemoglobin > 7%. Self-care behaviors were associated with fasting blood glucose (rs = .223, p = .005). Medication management was influenced by cognitive performance, F(1, 130) = 4.49, p = .036, and depression, F(1, 130) = 8.22, p = .005. Dietary behaviors were influenced by previous diabetes education, F(1, 130) = 6.73, p = .011. These findings indicate that education and cognitive behavioral interventions in Spanish for Mexican adults with type 2 diabetes are urgently needed.

Validity of the Mexican version of the combined Foot Care Confidence / Foot-Care Behavior scale for diabetes.

OBJECTIVE: To 1) translate / transculturally adapt the original (English-language) combined Foot Care Confidence Scale / Foot-Care Behavior instrument (FCCS-FCB) to produce a Mexican-Spanish version and 2) determine its validity and reliability in a population with diabetes in Tijuana, Mexico. METHODS: The original FCCS-FCB was translated (and back-translated), the content validated (by a group of health professional experts), and the instrument applied to 304 patients 23-78 years old in diabetes support groups in Tijuana, Mexico. Internal consistency for the study constructs ("self-efficacy," and risk / preventive foot self-care behaviors) was measured using Cronbach's alpha. The constructs were validated using principal component factor analysis. RESULTS: The Cronbach's alpha values for internal consistency were 0.782 for self-efficacy and 0.505 for behaviors. Based on the analysis, two factors explained 49.1% of the total variance for self-efficacy, and six factors explained 57.7% of the total variance for behaviors. The results were consistent with those for the original (English) version of the FCCS-FCB. CONCLUSIONS: The Mexican version of the FCCS-FCB is a reliable and valid instrument recommended for use with Mexican-Spanish-speaking patients with diabetes.

Validity of the Mexican version of the combined Foot Care Confidence / Foot-Care Behavior scale for diabetes / Validez de la versión mexicana del instrumento combinado de las escalas Foot Care Confidence Scale y Foot Care Behavior para la diabetes

OBJECTIVE: To 1) translate / transculturally adapt the original (English-language) combined Foot Care Confidence Scale / Foot-Care Behavior instrument (FCCS-FCB) to produce a Mexican-Spanish version and 2) determine its validity and reliability in a population with diabetes in Tijuana, Mexico. METHODS: The original FCCS-FCB was translated (and back-translated), the content validated (by a group of health professional experts), and the instrument applied to 304 patients 23-78 years old in diabetes support groups in Tijuana, Mexico. Internal consistency for the study constructs ("self-efficacy," and risk / preventive foot self-care behaviors) was measured using Cronbach's alpha. The constructs were validated using principal component factor analysis. RESULTS: The Cronbach's alpha values for internal consistency were 0.782 for self-efficacy and 0.505 for behaviors. Based on the analysis, two factors explained 49.1% of the total variance for self-efficacy, and six factors explained 57.7% of the total variance for behaviors. The results were consistent with those for the original (English) version of the FCCS-FCB. CONCLUSIONS: The Mexican version of the FCCS-FCB is a reliable and valid instrument recommended for use with Mexican-Spanish-speaking patients with diabetes.

OBJETIVO: 1) traducir o adaptar transculturalmente el instrumento original combinado (en inglés) de las escalas Foot Care Confidence Scale (Escala de Competencia en el Cuidado del Pie) y Foot Care Behavior (Comportamientos del Cuidado del Pie) (FCCS-FCB) para crear una versión en español de México, y 2) determinar su validez y fiabilidad en una población de personas con diabetes de Tijuana, México. MÉTODOS: Se tradujo al español la escala original FCCS-FCB (y se volvió a traducir al inglés), su contenido fue validado (por un grupo de expertos), posteriormente se aplicó el instrumento a 304 pacientes de 23 a 78 años de edad, pertenecientes a grupos de apoyo al control de la diabetes de Tijuana, México. Mediante el alfa de Cronbach, se midió la coherencia interna de los constructos ("competencia personal" y "comportamientos de riesgo o preventivos de autocuidado del pie"). Los constructos fueron validados mediante análisis factorial de componentes principales. RESULTADOS: El valor de alfa de Cronbach correspondiente a competencia personal fue de 0,782 y de 0,505 para los comportamientos. En el análisis factorial, dos factores explicaron el 49,1% de la variancia total para la competencia personal, y seis factores explicaron el 57,7% de la variancia total para los comportamientos. Los resultados concordaron con los de la versión original (en inglés) del FCCS-FCB. CONCLUSIONES: La versión mexicana del FCCS-FCB es un instrumento fiable y válido recomendado para su empleo en pacientes mexicanos de habla hispana con diabetes.

Validity of the Mexican version of the combined Foot Care Confidence / Foot-Care Behavior scale for diabetes / Validez de la versión mexicana del instrumento combinado de las escalas Foot Care Confidence Scale y Foot Care Behavior para la diabetes

Objective. To 1) translate / transculturally adapt the original (English-language) combined Foot Care Confidence Scale / Foot-Care Behavior instrument (FCCS-FCB) to produce a Mexican-Spanish version and 2) determine its validity and reliability in a population with diabetes in Tijuana, Mexico. Methods. The original FCCS-FCB was translated (and back-translated), the content validat-ed (by a group of health professional experts), and the instrument applied to 304 patients 23–78 years old in diabetes support groups in Tijuana, Mexico. Internal consistency for the study constructs (“self-efficacy,” and risk / preventive foot self-care behaviors) was measured using Cronbach’s alpha. The constructs were validated using principal component factor analysis. Results. The Cronbach’s alpha values for internal consistency were 0.782 for self-efficacy and 0.505 for behaviors. Based on the analysis, two factors explained 49.1% of the total variance for self-efficacy, and six factors explained 57.7% of the total variance for behaviors. The results were consistent with those for the original (English) version of the FCCS-FCB. Conclusions. The Mexican version of the FCCS-FCB is a reliable and valid instrument recommended for use with Mexican-Spanish–speaking patients with diabetes.

Objetivo. 1) traducir o adaptar transculturalmente el instrumento original combi¬nado (en inglés) de las escalas Foot Care Confidence Scale (Escala de Competencia en el Cuidado del Pie) y Foot Care Behavior (Comportamientos del Cuidado del Pie) (FCCS-FCB) para crear una versión en español de México, y 2) determinar su validez y fiabilidad en una población de personas con diabetes de Tijuana, México. Métodos. Se tradujo al español la escala original FCCS-FCB (y se volvió a traducir al inglés), su contenido fue validado (por un grupo de expertos), posteriormente se aplicó el instrumento a 304 pacientes de 23 a 78 años de edad, pertenecientes a grupos de apoyo al control de la diabetes de Tijuana, México. Mediante el alfa de Cronbach, se midió la coherencia interna de los constructos (“competencia personal” y “comporta¬mientos de riesgo o preventivos de autocuidado del pie”). Los constructos fueron validados mediante análisis factorial de componentes principales. Resultados. El valor de alfa de Cronbach correspondiente a competencia personal fue de 0,782 y de 0,505 para los comportamientos. En el análisis factorial, dos factores explicaron el 49,1% de la variancia total para la competencia personal, y seis factores explicaron el 57,7% de la variancia total para los comportamientos. Los resultados concordaron con los de la versión original (en inglés) del FCCS-FCB. Conclusiones. La versión mexicana del FCCS-FCB es un instrumento fiable y válido recomendado para su empleo en pacientes mexicanos de habla hispana con diabetes.

Cognitive performance associated with self-care activities in Mexican adults with type 2 diabetes.

PURPOSE: The purpose of this study was to determine the effect of memory-learning on self-care activities in adults with type 2 diabetes moderated by previous education/understanding in diabetes and to explore the explicative capacity of age, gender, schooling, diabetes duration, and glycemic control in memory-learning. METHODS: A descriptive correlational study was conducted in a randomized sample of 105 Mexican adult patients with type 2 diabetes at a community-based outpatient clinic. Evaluation measures included the Wechsler Memory Scale for memory-learning; 2 questionnaires for self-care activities and previous education/understanding in diabetes, respectively; and glycosylated hemoglobin for glycemic control. Multiple linear regression analysis was used to examine the effect of memory-learning on self-care activities and the moderator capacity of previous education/understanding on diabetes. Multivariate analysis was used to identify the capacity of age, schooling, diabetes duration, and glycemic control in memory-learning types. RESULTS: A significant positive effect of memory-learning on self-care activities was found. Education/understanding in diabetes moderated the relationship between immediate and delayed memory-learning and self-care in glucose monitoring and diet. Gender, schooling, and the gender-glycemic control interaction explained memory-learning performance. CONCLUSIONS: Immediate and delayed verbal and visual memory-learning were important for the patient to carry out self-care activities, and this relationship can be moderated by previous education/understanding in diabetes. These findings suggest potential benefits in emphasizing cognitive strategies to promote relearning of self-care behaviors in persons who live with diabetes.