Rubén Silva-Tinoco|Teresa Cuatecontzi-Xochitiotzi|Viridiana De la Torre-Saldaña|Enrique León-García|Javier Serna-Alvarado|Arturo Orea?Tejeda|Lilia Castillo?Martínez|Juan G. Gay|David Cantú-de-León|Diddier Prada
Influence of social determinants, diabetes knowledge, health behaviors, and glycemic control in type 2 diabetes: an analysis from real-world evidence
Federal Government of Mexico|Federal Government of Mexico|Instituto Nacional de Enfermedades Respiratorias|Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán|Instituto Nacional de Cancerología|Universidad Nacional Autónoma de México|Instituto Nacional de Cancerología|Universidad Nacional Autónoma de México
abstract background although important achievements done type 2 diabetes mellitus t2d treatment glycemic control new strategies may take advantage nonpharmacological approaches potential determinants health eg socioeconomic status education diabetes knowledge physical activity selfcare behavior however relationships factors totally clear studied context large urban settings study aimed explore relationship determinants glycemic control gc lowincome urban population mexico city focused exploring potential mediation selfcare behaviors association diabetes knowledge gc methods multicenter crosssectional study conducted patients type 2 diabetes t2d 28 primary care outpatient centers located mexico city using multivariableadjusted models determined associations diabetes knowledge selfcare behaviors gc mediation analyses determine pathways glycemic control done using linear regression models significance indirect effects calculated bootstrapping results population n 513 mean age 538 years standard deviation 113 yrs 659 women socioeconomic status level education directly associated diabetes knowledge using multivariableadjusted linear models found diabetes knowledge associated gc 0102 95 confidence interval 95 ci 0189 0014 diabetes knowledge also independently associated selfcare behavior physical activity 0181 95 ci 0088 0273 selfcare behavior associated gc physical activity 0112 95 ci 0194 0029 association diabetes knowledge gc observed adjustment selfcare behaviors especially physical activity 0084 95 ci 0182 0014 p value 0062 finally mediation models showed effect diabetes knowledge gc 17 independently mediated physical activity p value 0049 conclusions socioeconomic educational gradients influence diabetes knowledge among primary care patients type 2 diabetes selfcare activities particularly physical activity mediated effect diabetes knowledge gc results indicate diabetes knowledge reinforced lowincome t2d patients emphasis benefits physical activity improving gc