Vietnamese diabetic patients and their physicians: what ethnography can teach us

Objectives To describe the cultural context of type 2 diabetes mellitus amo ng Vietnamese immigrants in the United States, including people's ideas abo ut cause and proper treatment; and to suggest ways in which better control of the disease can be achieved in this population. . Design The method was ethnographic. A native speaker used a structured interview guide to talk wi th 38 Vietnamese patients, and family members of 2 other patients, being tr eated for type 2 diabetes. In addition, 8 Vietnamese health providers-5 phy sicians, 2 nurses, and an herbalist-were interviewed. . Setting A low-incom e area of southern California populated by a large number of Vietnamese. . Participants Forty patients being treated for type 2 diabetes and 8 health practitioners. . Results Three quarters of the patients had not achieved go od control of their diabetes. Ideas about the cause and proper treatment of the disease were culturally shaped. Many patients used eastern (herbal) me dicine and described a strong aversion to insulin injections. Patients stop ped taking their oral medications when using eastern medicine, and a quarte r lowered their dose whenever they felt "out of balance." Almost two thirds had used traditional home remedies for diabetes. Two had received nonstand ard medical care from neighborhood physicians trained in Viet Nam; 1 of the se patients died during the study. . Conclusion The Vietnamese community an d physicians serving that community need culturally appropriate education a bout type 2 diabetes and modem therapy for the disease.