Association of Race/Ethnicity with Diabetes Medication Beliefs and Self-Management Behaviors in Breast Cancer Survivors

Abstract

Introduction:

Among breast cancer (BC) survivors, type 2 diabetes (DM) is associated with 40% increased BC mortality. Black and Latina BC survivors have worse BC mortality and are more likely to have DM. We aimed to assess the association of race/ethnicity with adherence to DM self-management behaviors (SMBs), medication beliefs, and control in BC survivors.

Methods:

We recruited Stages 0–III BC survivors ≥55 years with DM taking ≥1 DM medication. Adherence to DM SMBs and medication beliefs were assessed with validated questionnaires. Hemoglobin A1c (A1c) was measured at recruitment to assess DM control. We evaluated the relationship between race/ethnicity and SMBs, medication beliefs, and DM control with univariate analyses and multivariable regression.

Results:

Of 194 participants, median age was 67 years (interquartile range [IQR] = 60–72), median A1c was 7.4% (IQR = 6.4–7.9), 27% self-identified as non-Hispanic Black, 41% as non-Hispanic White (NHW), 18% as Latina, and 14% as other/unknown race (not Latina). Race/ethnicity was not significantly associated with adherence to most DM SMBs. In multivariate analyses, non-White race/ethnicity was significantly associated with poorly controlled DM and higher concerns about DM medications, and Black race had a significant association with lower belief of necessity of DM medications compared with NHWs.

Conclusions:

Race/ethnicity was not associated with DM SMBs in BC survivors, but non-White participants had greater concerns about DM medications and poorer DM control. Future studies exploring differences in DM medication beliefs could inform interventions that can improve DM care among minority BC survivors.