Participant-Directed Intervention Tailoring Is Associated With Improvements in Glycemic Control for South Asian Adults With Type 2 Diabetes

Abstract

ObjectivesOur aim was to determine the impact of a 3-month diabetes self-management education and support (DSME/DSMS) intervention involving both professional and peer support on glycemic control and diabetes distress in South Asian adults with type 2 diabetes (T2D) living in Metro Vancouver. MethodsWe recruited 114 South Asian adults with T2D for a study conducted across 7 sites in Metro Vancouver. A previous DSME/DSMS intervention was modified using participant feedback. Participants attended the updated intervention involving 6 biweekly group-based DSME sessions co-led by a diabetes educator and peer leader and 6 biweekly DSMS sessions delivered by a peer leader. Assessments were conducted at baseline and 3 months. Primary outcomes were glycated hemoglobin (A1C) and diabetes distress. Secondary outcomes included apolipoprotein B, blood pressure (BP), height and weight, waist circumference, diabetes support and depressive symptoms. ResultsAfter the 3-month intervention, linear mixed-effects modelling demonstrated A1C decreased significantly from 8.2% (66 mmol/mol) to 7.8% (62 mmol/mol) (p<0.0001), as did body mass index (from 30.02 to 29.7 kg/m2; p=0.0005) and diastolic BP (from 75.86 to 70.78 mmHg; p<0.0001). These reductions persisted after adjusting for the fixed-effects of age, sex, intensification of diabetes and BP medication, as well as random effects for subject and location. ConclusionsParticipation in a professional plus peer-led intervention tailored by South Asian adults with T2D is associated with improved glycemic control and other favourable health outcomes.