Illness perceptions and diabetes self-care behaviours in Maori and New Zealand Europeans with type 2 diabetes mellitus: a cross-sectional study

AIMS: This study investigated differences in illness perceptions and self-care behaviours between Maori and New Zealand (NZ) Europeans with type 2 diabetes mellitus (T2DM), and how these perceptions were related to clinical outcomes. METHODS: Participants were 85 Maori and 85 NZ European adults, recruited from outpatient clinics, who completed a cross-sectional questionnaire on illness perceptions and self-care behaviours. Clinical data, including HbA1c, retinopathy, neuropathy and nephropathy, were collected from medical records. RESULTS: Compared to NZ Europeans, Maori had higher HbA1c, lower adherence to medication and a healthy diet, and were more likely to smoke. Maori reported greater perceived consequences of diabetes on their lives, and more severe symptoms than NZ Europeans did. Maori were more likely to attribute T2DM to food and drink, whereas NZ Europeans were more likely to attribute T2DM to weight. Perceiving that treatment could help control diabetes was associated with lower HbA1c and higher medication adherence in Maori and NZ Europeans independently. CONCLUSIONS: Maori experienced and perceived worse T2DM outcomes than NZ Europeans did. Research is needed to develop and test clinical interventions to address these inequities and improve outcomes, possibly by asking patients about their perceptions, providing tailored and culturally appropriate education, and discussing patients' concerns.