Successful Treatment Of Type 2 Diabetes In Older Black And Hispanic Community Members

Abstract

PURPOSE: As the seventh leading cause of death in the United States, diabetes continues to have a major impact on morbidity and mortality. Diabetes is significantly more prevalent in Black (18.7%) and Hispanic Americans (11.8%) compared to non-Hispanic white populations (7.1%). Specific daily physical activities (PA) guidelines for people with chronic diseases, particularly for ethnic minorities, is lacking. Our hypothesis is that lower levels (moderate or low, rather than high intensity) of physical activities can reduce HbA1c in older Black and Hispanic Americans with type 2 diabetes. METHODS: Seventeen participants were conveniently recruited from UConn Health outpatient clinics and surrounding communities for JUMP in 2019-2020. Participants completed four face-to-face interviews, established SMART goals, and wore an activity tracker to measure their daily PA for three months. The activity tracker classifies PA into high, moderate and low intensity levels. HbA1c was measured through a fingerstick at each visit. Change scores for minutes engaged in each PA level and HbA1c values were created. A linear mixed model for longitudinal data was used to analyze these relationships over time. The study protocol was approved by the university IRB. RESULTS: Eleven Black and six Hispanic individuals (mean age 56) completed the study. At baseline, mean HbA1c was 8.58 mmol/mol, mean BMI was 34.8, and mean systolic/diastolic blood pressure was 135/81. Over three months, HbA1c linearly declined from 8.58 at baseline to 8.21 at Month 1, 8.19 at Month 2, and 7.96 at Month 3 (p < 0.05). Average daily minutes of moderate intensity PA increased from 15.8 (Month 1) to 20.3 (Month 2) (p = 0.045) to 20.8 (Month 3) (p = 0.022). These changes were significantly associated with the reduction of HbA1c. Lastly, average daily minutes of high intensity PA increased from 12.1 (Month 1) to 13.6 (Month 2) (p = 0.075) to 15.2 (Month 3) (p = 0.051). CONCLUSION: Over time, increases of 4 to 5 minutes to moderate daily PA were associated with decreased HbA1c in Black and Hispanic Americans with type 2 diabetes. Increasing moderate daily physical activity may be a manageable guideline for glycemic control.