Levels of acculturation and effect on glycemic control in Mexicans and Mexican Americans with type 2 diabetes

Background: Acculturation of Mexican Americans toward the predominant American culture has been shown to influence health outcomes. Little is known about the role of acculturation in diabetes control. Objective: To measure the association between acculturation and diabetes control in Mexicans and Mexican Americans with type 2 diabetes mellitus (T2DM). Design: Cross-sectional survey and chart review. Setting: Ambulatory family medicine clinics. Patients: Sixty-six Mexican and Mexican American adults with T2DM for $ 1 year. Instrument and Outcomes: A survey tool was developed that included the General Acculturation Index developed by Balcazar et al to measure acculturation. Basic demographics, psychosocial factors, patient satisfaction, and patients' most recent hemoglobin A_1c (HbA_1c) levels were also obtained. Results: There was no significant correlation between acculturation score and HbA_1c levels. On binary logistic regression, HbA1c levels were associated with patient satisfaction in having their questions answered (odds ratio [OR], 0.44; P, 0.05), interference of diabetes with daily life (OR, 1.4; P, 0.05), male gender (OR, 3.93; P, 0.01), and number of diabetes complications (OR, 1.81; P, 0.05). In the multivariate linear regression model, age (beta, -0.348; P, 0.05) and frequency of physician visits (beta, -0.403; P, 0.05) were the only variables significantly associated with glycemic control. Variables included in the model that were not associated with glycemic control include family history of diabetes and confidence in diabetes treatment efficacy. Conclusions: Acculturation was not associated with glycemic control in this population. Family physicians should not assume that acculturation difficulties explain poor glycemic control in their Mexican American patients with T2DM.