Social Science & Medicine 64 (2007) 2223–2235 ‘‘Diabetes is my companion’’: Lifestyle and self-management among good and poor control Mexican diabetic patients Javier Garcia de Alba Garcia a,b , Ana L. Salcedo Rocha a,b , Ivette Lopez c , Roberta D. Baer d,Ã , William Dressler e , Susan C. Weller f a Social, Epidemiological and Health Services Research Unit of IMSS, Guadalajara, Jalisco, Mexico b Hospital Civil of Guadalajara, J.I, Menchaca, Guadalajara, Jalisco, Mexico c College of Pharmacy, Institute of Public Health, Science Research Center, Florida A&M University, Tallahassee, FL, USA d Department of Anthropology, University of South Florida Tampa, 4202 East Fowler Avenue, SOC 107, Tampa, FL 33620, USA e Department of Anthropology, University of Alabama, Tuscaloosa, AL 35487-0210, USA f Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555-1153, USA Available online 26 March 2007 Abstract This paper identifies naturally occurring lifestyle and self-care practices in managing type 2 diabetes mellitus that are associated with good glycemic control. In-depth, qualitative interviews were conducted in Guadalajara, Mexico, with 31 matched pairs of good and poor control diabetic patients (n ¼ 62), who were matched on their duration of disease and use of medications. While many themes were listed by both groups, a comparison of the responses indicated that themes of daily exercise with a preference for walking, eating beef and milk rather than chicken and fish, economic issues, and emotional issues distinguished poor-control patients. Good-control patients were more likely to have a negative reaction to their initial diagnosis, take a more comprehensive approach to control, eat only two meals a day (plus snacks), use noncaloric beverages to satisfy desires for more food, and know what their blood sugar levels should be. r 2007 Elsevier Ltd. All rights reserved. Keywords: Mexico; Diabetes mellitus; Qualitative research; Glycemic control; Hispanics/Latinos; Self-management Introduction This paper identifies lifestyle and self-care prac- tices related to successful glycemic control. Hyper- glycemia is associated with poorer outcomes in type 2 diabetes (Turner, Cull, Frighi, & Holman, 1999; UKPDS 33, 1998; UKPDS 34, 1998), and although self-management activities can improve glycemic control, improvements can be small and short lasting (Deakin, McShane, Cade, & Williams, 2005). Quantitative epidemiological studies of cor- relates of glycemic control have been limited by a focus on demographic variables, such as age, educational level, and gender. Qualitative anthro- pological studies have been limited by using a single group of patients and not distinguishing good- and poor-control patients in their study design. In this study, a case-control design is combined with qualitative interviewing. In addition, good- and poor-control patients are matched on their duration of disease and use of anti-diabetic medications. These latter two factors are known to affect ARTICLE IN PRESS www.elsevier.com/locate/socscimed 0277-9536/$ - see front matter r 2007 Elsevier Ltd. All rights reserved. doi:10.1016/j.socscimed.2007.02.001 Ã Corresponding author. Tel.: +1 813 974 2138/2140; fax: +1 813 974 2668. E-mail address: baer@chuma1.cas.usf.edu (R.D. Baer).