Patient-Centered Community Diabetes Education Program Improves Glycemic Control in African-American Patients with Poorly Controlled Type 2 Diabetes: Importance of Point of Care Metabolic Measurements

Abstract

African-Americans with type 2 diabetes (T2DM) have higher morbidity and mortality partly attributed to poor glucose control and lack of formal diabetes self-management education and support (DSMES) programs compared to Whites. Therefore, the objective of this study was to compare the clinical and metabolic parameters during DSMES vs. standard care in African-Americans with T2DM attending primary care inner city clinics. We recruited 124 African-American patients with T2DM, randomized into Group 1-DSMES (n = 58) and Group 2-standard care group (n = 38) for 6 months. Body weight, blood pressure, random blood sugars and point-of-care (POC) hemoglobin A1C (A1C) and lipids/lipoproteins were measured at 0, 3, and 6 months. At 6 months, Group 1 had significant reduction in A1C (8.2 ± 1.4% vs. 7.5 ± 1.5%, p = 0.02) and random glucose (190.4 ± 77.6 vs. 160.6 ± 59.8 mg/dl, p = 0.03). However, there were no changes in body weight, blood pressure, or lipids/lipoprotein levels. We found no significant changes in the clinical/metabolic parameters in Group 2. We concluded that DSMES, supplemented with POC testing, was associated with significant improvements in glycemic control without changes in body weight, blood pressure, or lipids/lipoproteins. We recommend the inclusion of DSMES with POC testing in managing African-American patients with T2DM attending inner city primary care clinics.