Influence of social determinants, diabetes knowledge, health behaviors, and glycemic control in type 2 diabetes: an anal
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(2020) 20:130
RESEARCH ARTICLE
Open Access
Influence of social determinants, diabetes knowledge, health behaviors, and glycemic control in type 2 diabetes: an analysis from real-world evidence Rubén Silva-Tinoco1* , Teresa Cuatecontzi-Xochitiotzi1, Viridiana De la Torre-Saldaña1, Enrique León-García2, Javier Serna-Alvarado2, Arturo Orea-Tejeda3, Lilia Castillo-Martínez4, Juan G. Gay5, David Cantú-de-León6 and Diddier Prada6,7,8,9
Abstract Background: Although important achievements have been done in type 2 diabetes mellitus (T2D) treatment and glycemic control, new strategies may take advantage of non-pharmacological approaches and of other potential determinants of health (e.g., socioeconomic status, education, diabetes knowledge, physical activity, and self-care behavior). However, the relationships between these factors are not totally clear and have not been studied in the context of large urban settings. This study aimed to explore the relationship between these determinants of glycemic control (GC) in a low-income urban population from Mexico City, focused in exploring potential the mediation of self-care behaviors in the association between diabetes knowledge and GC. Methods: A multicenter cross-sectional study was conducted in patients with type 2 diabetes (T2D) from 28 primary care outpatient centers located in Mexico City. Using multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and GC. The mediation analyses to determine the pathways on glycemic control were done using linear regression models, where the significance of indirect effects was calculated with bootstrapping. (Continued on next page)
* Correspondence: [email protected] 1 Clínica Especializada en el Manejo de la Diabetes en la Ciudad de México, Servicios de Salud Pública de la Ciudad de México, Alfonso Toro s/n, Col. Escuadrón 201, Iztapalapa, 09060 Mexico City, Mexico Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise sta
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