Culturally Specific Diabetes Management

"Better management results in reduced long-term complications, such as blindness, stroke, amputation and nerve damage,” said lead researcher Todd Gilmer, Ph.D, an associate professor in the department of family and preventive medicine at the University of California, San Diego. The research focused on 3,893 people with diabetes. The target population was primarily low-income, underinsured Latino people.

Study participants showed “clinically significant improvements in A1c, blood pressure, low-density lipoprotein and triglycerides,” said Gilmer. Hemoglobin A1c — a measure of how well patients control their blood glucose — low-density lipoprotein (“bad cholesterol”) and blood pressure are commonly managed risk factors among diabetes patients.

The clinical team included a registered nurse/certified diabetes educator and a medical assistant and a registered dietitian who were bilingual and bicultural. Patients underwent an initial 50-minute visit with a nurse and were asked to return for additional visits. They also had a 25-minute visit with the dietitian and were called by team members for appointment reminders. Patients also participated in a group self-management training program consisting of an eight-week curriculum delivered by trained peer educators who had diabetes themselves and were of the same cultural or ethnic group as the participants.

Direct medical costs over a patient’s lifetime were higher for patients who received case-management and self-management training help. Nevertheless, a further breakdown showed that about one-third of the additional costs of implementing the intervention were offset by reduced expenses of diabetes-related complications over patients’ lifetimes. “If these individuals live longer without these complications … it gives them a higher quality of life,” Gilmer said. “It is worth it.”; Source: Health Behavior News Service