Article

Comprehensive Diabetes Management Program for Poorly Controlled Hispanic Type 2 Patients at a Community Health Center

Baystate Health Systems, Springfield, MA 01105, USA.
The Diabetes Educator (Impact Factor: 1.79). 09/2011; 37(5):680-8. DOI: 10.1177/0145721711416257
Source: PubMed

ABSTRACT

Technology and improved care coordination models can help diabetes educators and providers meet national care standards and provide culturally sensitive diabetes education that may improve diabetes outcomes. The purpose of the study was to evaluate the clinical usefulness of a nurse-led diabetes care program (Comprehensive Diabetes Management Program, CDMP) for poorly controlled Hispanic type 2 diabetes (T2DM) patients in an urban community health center setting. Patients were randomized to the intervention condition (IC; n = 21) or an attention control condition (AC; n = 18). IC and AC conditions were compared on rates of adherence to national clinical practice guidelines (blood glucose, blood pressure, foot exam, eye exam), and levels of diabetes distress, depression, and treatment satisfaction. IC patients had a significant improvement in A1C from baseline to 12-month follow-up compared with AC (-1.6% ± 1.4% versus -0.6% ± 1.1%; P = .01). The proportion of IC patients meeting clinical goals at follow-up tended to be higher than AC for A1c (IC = 45%; AC = 28%), systolic blood pressure (IC = 55%; AC = 28%), eye screening (IC = 91%; AC = 78%), and foot screening, (IC = 86%; AC = 72%). Diabetes distress and treatment satisfaction also showed greater improvement for IC than AC (P = .05 and P = .06, respectively), with no differences for depression. The CDMP intervention was more effective than an attention control condition in helping patients meet evidence-based guidelines for diabetes care.

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    • "These efforts not only aimed to ensure referral to skilled providers but also acknowledged the important cultural role played by traditional birth attendants in supporting women before, during and after birth[41]. In an American study, bicultural/bilingual nurses were employed as part of a diabetes team to provide culturally acceptable care to poor Hispanic patients with type 2 diabetes[72]. The findings of two papers in the review noted the importance of collaboration with the public health sector at the national level and international donors to ensure that efforts to deliver nurse-led HIV/AIDS care are coordinated , well supported and contributed to health system strengthening efforts[47,48]. "
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