761-P: Historical Trauma, Contemporary Trauma, and Type 2 Diabetes Self-Management among American-Indian/Alaska-Native Women

Endemic type 2 diabetes mellitus (T2DM) is one of the leading causes of mortality among American Indian/Alaska Natives (AI/ANs). Trauma and stress have been shown to impact the progression of diabetes and can negatively impact health-related behaviors. Previous studies have not examined the relationship between historical and contemporary trauma and T2DM self-management among AI/AN women. The purpose of this research was to examine the relationship between historical loss, historical loss associated loss symptoms, stressful life events, microaggressions (microinsults and microinvalidations), and T2DM self-management (glucose management, dietary control, physical activity, healthcare-use) among AI/AN women with diabetes. Historical trauma theory was the basis of this study and explains the consequences of colonization resulting in contemporary trauma that affects physical and mental health. A cross-sectional survey design included data from a convenience sample of AI/AN adult women. Multiple regression analyses showed that the more experiences with microinvalidations predicted poorer glucose management (B = -0.283, p < .05), less physical activity (B = -0.272, p < .05), less health care use (B = -0.248, p < .05), and poorer overall T2DM self-management

(B = -0.848, p < .05). Also, more experiences of historical loss predicted poorer glucose management (B = -0.054, p < .05), and the more stressful life events predicted poorer dietary control (B = -0.040, p < .05). The study demonstrated that microaggressions and historical loss had a significant and negative impact on T2DM self-management among AI/AN women. The results may be used to improve T2DM self-management and the high levels of mortality, morbidity, costs, and quality of life among AI/AN women.