Alcohol consumption and compliance among inner-city minority patients withtype 2 diabetes mellitus

Objective: To examine the relation between alcohol consumption and self-rep orted compliance with prescribed therapies for type 2 diabetes mellitus amo ng underserved minority patients. Design: Cross-sectional sampling of consecutive patients with diabetes was performed following routine visits to their primary care physicians. Interv iewers measured compliance using the Summary of Diabetes Self-Care Question naire and alcohol use using the timeline followback method and the Alcohol Use Disorders Identification Test. Setting: Seven inner-city medical clinics that provide primary care service s to low-income residents of South Central Los Angeles, Calif. Participants: A total of 392 ethnic minority patients (61% Hispanic, 29% Af rican American) with type 2 diabetes mellitus. Main Outcome Measures: Self-report compliance with prescribed diet, exercis e, home glucose monitoring, medications, and outpatient follow-up. Results: Drinking any alcohol-containing beverage within 30 days was associ ated with poorer adherence to prescribed dietary recommendations for the co nsumption of fiber (t=2.4; P<.05), fat (t=4.2; P<.01), sweets (t=2.7; P<.01 ), and energy(calories) (t=2.0; P<.05). Drinkers were also less likely to e xercise for at least 20 minutes per day (t=2.2; P<.05), comply with oral me dication regimens (t=4.6; P<.01), or attend outpatient follow-up visits (r= -0.11; P<.05). Alcohol use did not significantly alter compliance with home glucose monitoring, insulin use, or hemoglobin Al, levels, although there was a trend toward higher hemoglobin Al, levels among drinkers (11.0 vs 10. 4). Multivariate analysis of the data demonstrates that when demographic ch aracteristics, health care utilization, and other diabetes-related variable s are held constant, the relation between alcohol use and dietary complianc e remained significant. Conclusion: Alcohol consumption may be associated with poorer compliance wi th recommendations for some self-care behaviors among inner-city minority p atients with diabetes.