Alyssa Lo

In 2022, the Hmong-speaking population had the lowest rates of optimal diabetes care in Minnesota at only 35%. There have been significant barriers to diabetes care in the Hmong population, including difficulties understanding information about diabetes and required self-care, adherence to medications, and one of the most significant barriers: cultural practices. Comorbidities as a contributing factor have not yet been explored. This study aimed to understand how comorbidities may affect confidence in self-management and sense of treatment burden in Hmong patients with T2DM in Minnesota. We conducted 12 in-depth individual interviews with open-ended questions crafted to understand how comorbidities affect diabetes management. Interviews were recorded and transcribed. We used deductive and inductive coding and conducted descriptive statistics on demographics. The average participant age was 57 (39-75) with half of the participants identifying as female. We found that comorbidities can act as a barrier, inhibiting a patient’s capacity to engage in self-management as well as adding to the patient's workload, increasing the treatment burden. Furthermore, social factors and life demands such as work and social pressure also affect patient engagement in self-management. These factors all fit into the Cumulative Complexity Model (Shippee, 2012), which encompasses how different factors can contribute to engagement in self-management of T2DM. Moreover, themes surrounding previously known barriers and sentiments such as difficulties understanding diabetes, adherence to medication, and following a diabetes diet were reconfirmed by participants. Moving forward, tailoring treatment and management plans to meet patients where they are may be beneficial in increasing confidence in self-management as well as engagement. Additionally, a focus on diabetes education that also encompasses outside factors such as comorbidities may be successful in increasing optimal diabetes care for Hmong patients in Minnesota.