Diabetes
Associations between economic hardship and markers of self‐management in adults with type 2 diabetes: results from Diabetes MILES – Australia

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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.

Key words

economic hardship
self‐management
type 2 diabetes mellitus
blood glucose monitoring
medication taking

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The authors have stated they have no conflict of interest.