Alcohol Consumption and Compliance Among Inner-city Minority Patients With Type 2 Diabetes Mellitus

OBJECTIVE: To examine the relation between alcohol consumption and self-reported compliance with prescribed therapies for type 2 diabetes mellitus among underserved minority patients. DESIGN: Cross-sectional sampling of consecutive patients with diabetes was performed following routine visits to their primary care physicians. Interviewers measured compliance using the Summary of Diabetes Self-Care Questionnaire 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 services to low-income residents of South Central Los Angeles, Calif. PARTICIPANTS: A total of 392 ethnic minority patients (61% Hispanic, 29% African American) with type 2 diabetes mellitus. MAIN OUTCOME MEASURES: Self-report compliance with prescribed diet, exercise, home glucose monitoring, medications, and outpatient follow-up. RESULTS: Drinking any alcohol-containing beverage within 30 days was associated with poorer adherence to prescribed dietary recommendations for the consumption 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 exercise for at least 20 minutes per day (t = 2.2; P<.05), comply with oral medication 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 A(1c) levels, although there was a trend toward higher hemoglobin A(1c) levels among drinkers (11.0 vs 10.4). Multivariate analysis of the data demonstrates that when demographic characteristics, health care utilization, and other diabetes-related variables are held constant, the relation between alcohol use and dietary compliance remained significant. CONCLUSION: Alcohol consumption may be associated with poorer compliance with recommendations for some self-care behaviors among inner-city minority patients with diabetes. Arch Fam Med. 2000;9:964-970