Effectiveness Of Diabetes Education Research Articles

The effect of diabetes education on maternal and neonatal outcomes in pregnant women diagnosed with gestational diabetes.

Education during pregnancy is important for the development of the pregnant woman's ability to adapt to change and for a healthy birth. In this study, we aimed to examine the effects of education through a diabetes education program on maternal and newborn health in women diagnosed with gestational diabetes. In our study, we compared the maternal and neonatal health outcomes of pregnant women who participated in the diabetes education program and were diagnosed with gestational diabetes with the outcomes of pregnant women who did not participate in the diabetes education program and were diagnosed with gestational diabetes. The study included patients who were diagnosed with diabetes between 24and 26 weeks gestation at a tertiary education and research hospital and who underwent a 75-gram OGTT test. Age, BMI, parity, method of delivery, weight gain during pregnancy, newborn birth weight, gestational age and Apgar scores were compared. The study included 119 patients and analyzed maternal-neonatal outcomes. There were no statistically significant differences in age (33 ± 5.7 versus 31 ± 5.2), body mass index (BMI) (32.2 vs. 31.2), gravidity, parity, number of miscarriages, mode of delivery, family history of diabetes, smoking, prenatal corticosteroid use, and gestational age at delivery. The HbA1c value (p: 0.013), the total weight gain during pregnancy (p: 0.015), the need for insulin treatment (p: 0.002), and the birth weight (0.005) were significantly higher in the group without diabetes education. In our study, diabetic school education was associated with lower HbA1c levels, less weight gain and less need for insulin therapy. When the results were categorized by insulin use, it was found that in patients using insulin, those who received diabetic school education had fewer macrosomic fetuses, whereas in patients not using insulin, those who received diabetic school education had lower maternal weight gain during pregnancy.

Effect of Diabetes Education on Complications and Diabetic Control Amongst Adult Patients with Diabetes in Madinah, Saudi Arabia.

Diabetes is a chronic condition that may become dangerous if there is insufficient insulin to help the body function properly. The proper care for diabetes depends on how well patients observe guidelines and prescriptions; consequently, patient education is critical. Poor learning may cause bad treatment and complications or other problems related to the disease. This study aims to evaluate patients' knowledge of diabetes, assigning a knowledge (K) score out of 100, and investigate the possible impact of educating patients, through general means or via healthcare professionals, on patient knowledge of diabetes control demonstrated in the absence/presence of diabetic complications. This multi-center interview-based cross-sectional study used a questionnaire in Madinah, Saudi Arabia. This study was conducted on adults with diabetes who were aged 15-80. We used the Michigan Diabetic Knowledge Test (MDKT) to assess the knowledge of patients with diabetes. This study included 364 participants. The gender distribution was 48.33% male and 51.67% female. Most of them had type 2 diabetes (T2DM) without insulin (48.63%), followed by those with T2DM on insulin (36.26%), and patients with type 1 diabetes (T1DM) (15.11%). Patients with T2DM had significantly higher K scores than patients with type 1. Additionally, T2DM non-insulin patients' k-scores significantly exceeded those with T1DM. General and healthcare education both helped increase patients' K-scores. Mostly, patients with diabetes without any complications had significantly higher knowledge compared to those having them. Lastly, regardless of whether the education was delivered by general or professional means, the effect on glycated hemoglobin (HbA1C) levels was not significant. Our study revealed that patients with T2DM exhibited higher knowledge than patients with T1DM. Furthermore, receiving education, whether by a healthcare professional or by general means, improved the knowledge levels of patients with T2DM but not patients with T1DM. Regarding diabetes complications, it was found that those with a higher level of knowledge had fewer complications. However, no evidence receiving education influenced the levels of HbA1C, neither in patients with T1DM nor T2DM.

Effect of Diabetes education through social media in young patients with type 1 diabetes

Effect of Diabetes education through social media in young patients with type 1 diabetes

Given According to Knowledge, Motivation and Behavioral Skills (IMB Model) The Effect of Diabetes Education on Self-Care

Aim: It has been determined that the education given according to the information, motivation, and behaviour model is effective in AIDS, chronic diseases, glucose control in diabetes, and self-care behaviours such as diet and exercise. The aim of this study, which is planned from this point of view, is to evaluate the effect of education given according to the information, motivation, and behaviour model on diabetic self-care management. Material and Methods: This study was conducted as an experimental study with a nonrandomized control group that included 90 diabetes mellitus individuals, with 45 in the intervention group and 45 in the control group. The control group were given formal diabetes mellitus education. In contrast, the intervention group received an education based on the information, motivation, and behaviour model and diabetes mellitus cases were followed for six months. Data were collected with a questionnaire on the essential characteristics of the patients, an evaluation form on the level of knowledge about diabetes, an evaluation form on their motivation about diabetes, and a diabetes self-care activities questionnaire. An Independent Sample-t test was used to analyze the data, and Paired Sample-test statistics were used to compare two dependent groups. Mann-Whitney U test was used to compare the measurement values of two independent groups that did not have a normal distribution. Wilcoxon test statistics were used to compare two dependent groups. Results: At the end of the study, it was determined that while HbA1c in the intervention group decreased for 6 months, knowledge scores, motivation levels and self-care skill scores increased (t=7.067, p

The effect of Type 2 diabetes management using a smartphone-based blood glucose management training program

Background: Diabetes education is an important factor in blood glucose control. Reinforced education is necessary for effective diabetes education. However, it is difficult to provide reinforced diabetes education within Korea's medical environment. Therefore, we want to analyze the effect of continuous diabetes education using mobile health care that can effectively provide repeated education without having to face the patient. Methods: This study is a multicenter, randomized, controlled, pre-post design study conducted to analyze the effect of a continuous diabetes education method. A total of 109 people were registered at five hospitals in south Korea, and they were randomly assigned to the app group (34 people) who received real-time coaching and repetitive training, the logbook group (37 people) who received face-to-face training after writing a blood glucose logbook, and the general group (38 people) who received a one-time diabetes education. The study was conducted for a total of 24 weeks. Twenty-one patients withdrew their consent and failed to perform an HbA1c. A final 88 patients were analyzed. The difference in HbA1c, Self-management behavior, and Quality of life before and after education was analyzed. Results: The study involved 51 (58%) male subjects, mean age was 55.8 years and mean duration of diabetes was 7.6 years. After 24 weeks of intervention, there was no significant difference in self-care behavior and quality of life between the three groups, but the HbA1c of the app group significantly decreased after education compared to the logbook group and the general group (F=4.62, p=.013). Conclusion: It can be seen through the app group that receiving real-time education is more effective in improving blood glucose management and continuous diabetes education is important.

Difficulties and prospects of standardized management of type 1 diabetes

Type 1 diabetes patients require lifelong dependence on insulin therapy. It is a long-term challenge for patients to effectively deliver exogenous insulin to maintain glucose levels within the individual's target range as safely as possible for preventing the development and progression of diabetes complications. The management of type 1 diabetes involves multidisciplinary collaboration, referral from different hospitals, and effective diabetes education and management for patients and family members. Compared with the more mature diseases management system in the United States and the United Kindom, the standardized management of type 1 diabetes patients in China started late. Moreover, there are still some difficulties at present. Whereas, with the exploration and efforts of the hospitals at all levels for the management of type 1 diabetes patients, standardization of type 1 diabetes management will gradually step forward and truly realize the lifelong management for patients.

Diabetes Mellitus: Insights from Epidemiology, Biochemistry, Risk Factors, Diagnosis, Complications and Comprehensive Management

Diabetes mellitus has become a serious and chronic metabolic disorder that results from a complex interaction of genetic and environmental factors, principally characterized by hyperglycemia, polyuria, and polyphagia. Uncontrolled high blood sugar can result in a host of diabetic complications. Prolonged diabetes leads to serious complications some of which are life-threatening. The prevalence of diabetes patients is rising at epidemic proportions throughout the world. Every year, a major portion of the annual health budget is spent on diabetes and related illnesses. Multiple risk factors are involved in the etiopathogenesis of the disease and turning the disease into an epidemic. Diabetes, for which there is no cure, apparently can be kept under control by maintaining self-care in daily living, effective diabetes education, with comprehensive improvements in knowledge, attitudes, skills, and management. In this review, we focused on the biochemical aspects of diabetes, risk factors including both environmental and genetic, disease complications, diagnosis, management, and currently available medications for the treatment of diabetes.

Diabetes education to provide the necessary self-management skills.

Diabetes is a chronic health condition requiring patients to provide 95% of their own care. Having control over this condition and the self-care behaviours necessary for good diabetes self-management can be achieved with patient empowerment and effective diabetes education. The patient must perceive that they have this level of control to maintain good diabetes self-management, enabling prevention or delay of diabetic complications. Currently, there are 3.9 million people who have been diagnosed with diabetes in the UK, 90% of whom have Type 2 diabetes. However, there has also been a rise in prevalence of Type 1 diabetes in recent years - caused by autoimmune disease rather than lifestyle factors. The number of individuals now living with diabetes exerts a huge toll on the NHS and community healthcare resources, making it crucial that patients manage their condition as well as possible to reduce the human and healthcare costs of treating diabetes complications.

P171 Adult cystic fibrosis diabetes patient education and care needs: have your say - a patient survey

Objectives: Cystic fibrosis-related diabetes (CFRD) impacts approximately 40 to 50% of adults with cystic fibrosis (CF). Effective diabetes education has been shown to improve long-term self-management and quality of life. This survey explores the educational needs of patients with or developing CFRD and sets out to identify the optimal mode of delivery for diabetes education. Methods: Adult pre- and post-transplant patients with CFRD and early glucose metabolism abnormalities from the Royal Prince Alfred Hospital CF Clinic were invited to partake in an online survey via email or text message in December 2020. The study protocol was approved by the Sydney Local Health District Ethics Committee (X20-0434). Results: 46 participants completed the survey with a response rate of 45% (female 54%;CFRD 78%;mean duration since CFRD diagnosis: 13 years;post-transplant 15%). Main sources of diabetes education for participants were the CF Clinic (65%);Google search (30%) and their general practitioner (13%). 72% of participants with CFRD felt they had enough information to manage their diabetes but favoured having a diabetes education resource package. The majority of participants preferred to receive CFRD information via an email package (61%), while others favoured perusing an educational website (37%) or phone app (24%), when requested (44%) or every 6 months (31%). The most common categories of diabetes-related information requested by participants with CFRD were updated diabetic technology (75%), CF diet and food diaries (58%), exercise (56%), management of hyper-(58%) or hypoglycemia (47%) and diabetes and alcohol consumption (42%). Conclusion: Patients with CFRD and early glucose metabolism abnormalities have ongoing educational needs and may require improved resources, preferably via virtual platforms, to supplement in-person care. Future research on the clinical impact of increasing virtual education will be necessary during this COVID-19 pandemic and beyond.

The effectiveness of diabetes education in rural clinical practice

Objective: Type 2 Diabetes affects approximately 10% of the population in the United States. Diabetes is associated with acute and long-term complications are more severe. Studies are providing a correlation between better self-care actions and a reduction of undesired diabetes outcomes. The purpose of this study was to evaluate the implementation of a diabetes self-management education (DSME) program on glycemic control that was expected to improve staff knowledge and diabetes outcomes.Methods: This study conducted a quality improvement design. Providers and nursing staff in three primary care clinics were recruited. Diabetes Knowledge Test (DKT) and HbA1c were measured pre and post intervention.Results: Data from 15 staff participants were analyzed. The mean score for the pre-test was 81% while the mean score for the post-test was 87%. A paired t-test revealed t = 1.533, df = 3.998 and p = .160. The HbA1c percentage mean over 6 months decreased by 0.02% and subsequently in 3 months by 0.17%. The Friedman rank sum test was used to compare the differences, χ2(2) = 14.79, p < .001. Post-hoc analysis identified a statistical significance in the HbA1c from implementation to post implementation.Conclusions: There was an increase in the percent score in the provider and nursing staff knowledge after implementation of the DSME program. A decrease in percent change of the HbA1c was identified over the three- month implementation period. This study demonstrated that the implementation of a DSME program may contribute to improved glycemic control.

Impact of Diabetes Education on Health Status of Diabetes Patients in Khartoum State

Diabetes education, with its role in improvement in knowledge, attitude and practice, lead to better control of the disease, and is accepted to be an important part of diabetes management. The Study aimed to determine the effect of diabetes education on health status of type 2 diabetes patients attending Diabetes Mini Clinics at Primary Health Care centers in Khartoum state, Sudan. The study design was quasi-experimental. Sample of seventy-eight type 2 diabetes patients was selected from eleven reverence family health centers, which contain diabetes mini clinic. Seventy of participants continued until the end of the study. A pre –post questionnaire was used to collect the data, which entered and analyzed by using Statistical Package for the Social Sciences, percentage, mean and standard deviation and paired T. test were used to analyze the data. The level of statistical significance was set at P. value ˂ 0.05. The results showed Diabetes education had positive effect on glycemic control (P. value = .001), diastolic blood pressure (P. value = .017), and quality of life (P. value = .001). The study recommended that coverage of primary health care centers with diabetes education service is very important and other studies is needed for more evaluation. 

Culturally sensitive diabetes education supporting ethnic minorities with type 2 diabetes

Abstract Background Ethnic minorities of non-Western origin are at higher risk of type 2 diabetes and diabetes complications, compared to the general population. Diabetes education programmes are essential to support people with diabetes to initiate and sustain behaviours needed to manage their condition throughout their lives. However, shaping diabetes education that provide culturally sensitive education that is acceptable to and supports diabetes self-management among members of ethnic minorities is needed. Objectives In this study, we develop and evaluate a culturally sensitive diabetes education programme in a community health setting, focusing on Arabic, Urdu or Turkish languages (n = 100). The programme aims to support ethnic minorities with type 2 diabetes in making health-promoting decisions about their care. Also, it will produce knowledge about methods and tools to improve content and format, and about the skills of those delivering the education. Using design-based research, the development comprised three phases: needs assessment, co-creation and testing. The target groups were actively involved in all phases. Results The needs assessment was based on fieldwork, workshops and interviews with the target groups and educators. Data showed that self-blame and learned helplessness undermined health-promoting decisions in the target groups. Also, a lack of clear roles between educators and peer educators, and a limited focus on goal setting in the educational setting was observed. The needs assessment informed the development of a 6 week group-based programme, supported by 11 dialogue tools. Preliminary findings show a high level of programme acceptability and participation as well as engagement in diabetes and care in the target groups. Conclusions By actively involving the target groups, health care professionals and as well as health services directly engaged with the target group, the outcomes of the programme are likely to be relevant to individuals and institutions. Key messages This study gives voice to ethnic minorities with type 2 diabetes through the co-creation of a diabetes education programme aiming to support health-promoting decisions. Innovative and involving methods are highly relevant to develop acceptable and effective diabetes education programmes targeting ethnic minority groups.

Effects of diabetes education combined with dynamic glucometer on blood glucose control and inflammatory factors in patients with type 2 diabetes mellitus

Objective To investigate the effect of diabetes education combined with dynamic blood glucose meter on blood glucose control and inflammatory factors in type 2 diabetic patients. Methods A total of 88 patients with type 2 diabetes admitted to this hospital from January 2016 to January 2017 were collected.They were randomly divided into observation group and control group, 44 cases of each group.The control group performed only dynamic blood glucose monitoring, while the observation group continued to teach according to the specific conditions of the patients on the basis of the control group.Blood glucose control, general indicators, knowledge of diabetes, self-management level, changes in quality of life and the effects on serum C-reactive protein(CRP) and tumor necrosis factor-alpha(TNF-α) levels were compared and analyzed after 3 months of follow-up. Results At 3 months after treatment, fasting blood glucose, 2h postprandial blood glucose, and HbA1c were significantly decreased in both groups, and the decline trend was more obvious in the observation group, and the differences were statistically significant(P<0.05). Compared with the control group, the duration of blood glucose control and hospital stay were shorter in the observation group, and the differences were statistically significant(P<0.05). BMI, waist circumference, and systolic/diastolic pressure were improved in both groups, and the improvement effect in the observation group was even more pronounced, and the differences were statistically significant(P<0.05). Diabetes knowledge, self-management level and quality of life level were improved in both groups, and the improvement trend was more obvious in the observation group, and the differences were statistically significant(P<0.05). The levels of CRP and TNF-α in the two groups were lower than before treatment, and the decrease trend was more in the observation group(P<0.05). Conclusion Diabetes education combined with dynamic glucometer intervention can significantly improve blood glucose control in patients with type 2 diabetes, improve the level of self-management of diabetes knowledge and quality of life, and have a certain inhibitory effect on serum inflammatory factors, providing a first-line basis for the prevention and treatment of diabetes. Key words: Diabetes education; Dynamic glucometer; Blood glucose; Inflammatory factors

Effect of Diabetes Education Through Pattern Management on Self-Care and Self-Efficacy in Patients with Type 2 Diabetes.

This study investigated the effect of applying a customized diabetes education program through pattern management (PM), using continuous glucose monitoring system (CGMS) results, on individual self-care behaviors and self-efficacy in patients with type 2 diabetes mellitus. Patients with type 2 diabetes who had never received diabetes education, enrolled from March to September 2017, were sequentially assigned to either PM education or control groups. In the PM education group, the CGMS test was first conducted one week before diabetes education and repeated three times by PM in order to obtain data on self-care behaviors and self-efficacy. These results were then compared before and after education at three and six months. The control group received the traditional diabetes education. Self-efficacy showed statistically significant interactions between the two groups over time, indicating a significant difference in the degree of self-efficacy between the PM education and control groups. Diabetes education by PM using CGMS result analysis improved life habits with a positive influence on self-care behaviors and self-efficacy for diabetes management. Further studies are needed to further develop and apply individual diabetes education programs in order to sustain the effects of self-care behaviors and self-efficacy in patients with diabetes who experience a decrease in self-efficacy after three months of education.

2371-PUB: Addition of a GLP-1 Agonist to Safety Net Hospital System Formulary to Improve Glycemic Control

Parkland Health and Hospital System (PHHS) is one of the largest safety net health systems in the United States serving the indigent population of Dallas County. The majority of patients with diabetes seen in the PHHS Primary Care clinics receive their medications through PHHS pharmacies which offer subsidized prices for medications on the PHHS formulary. The GLP-1 agonist, liraglutide, was added to the formulary at the end of 2016. To improve glycemic control in the primary care clinics, bi-monthly webinars providing diabetes education, in conjunction with e-consultations between primary care providers and diabetes specialists, were begun in early 2017 with an emphasis on using GLP-1 agonists. GLP-1 agonist prescriptions in the PHHS primary care clinics increased 435% (34 to 148) between 2016-2017 and 168% (148 to 248) from 2017-2018, an overall increase in prescribing of 729%. Of the 469 patients who were prescribed GLP-1 agonists from 2015-2018, 316 patients had baseline and post-prescription Hba1c values available. The average baseline Hba1c at time of prescription was 9.0% with an average final Hba1c value of 8.4% (p=0.0005). This data shows how an institutional formulary can be used as an agent of change to improve glycemic control. Of note, 90% of prescriptions were written for liraglutide with the other 10% including other GLP-1 agonists such as exenatide, albiglutide, and dulaglutide, showing the effect of diabetes education in prescribing practices. Disclosure U. Gunasekaran: None.

651-P: Validation of a Clinically Relevant Knowledge Assessment in Pediatric Type 1 Diabetes

Objective assessment of diabetes knowledge is essential to providing effective diabetes education. There is currently no such resource or instrument designed for pediatric clinical use and validated in the target population. We developed and validated the Knowledge Assessment in T1D (KAT-1) for this purpose. The KAT-1 has a total of 109 multiple choice items divided into 11 subscales designed to be taken individually. Following a pilot study to optimize the KAT-1, a validation study was performed with 200 participants (60% privately insured; 70% female; mean child A1c 8.2%; 10% African American, 11% Hispanic), including 50 parents of children with T1D &amp;lt;10 years; 50 parents of children with T1D ages 11-15 years; 50 adolescents with T1D ages 11-15 years; and fifty 16-21 year olds with T1D. All completed the KAT-1, Diabetes Knowledge Test 2 (DKT2), and a demographic survey. SPSS was used to evaluate the results. The complete KAT-1 scale demonstrated strong internal consistency (Cronbach’s α = 0.92, mean score 84.6, SD = 16.1). Nine of the 11 topical subscales demonstrated strong internal consistency and each took &amp;lt;5 minutes to complete: Supplies/Insurance (α = 0.82, mean time = 2.3 minutes, 9 questions), Hypoglycemia (α = 0.57, time = 3.1 minutes, 8Q), Sick Days/Ketones (α = 0.73, time = 3.2 minutes, 11Q), Basic Management (α = 0.63, time = 3.7 minutes, 13Q), Insulin (α = 0.67, time = 1.7 minutes, 12Q), Pathophysiology (α = 0.66, time = 4.1 minutes, 10Q), Technology/Devices (α = 0.86, time = 2.1 minutes, 15Q), Nutrition (α = 0.51, time = 2 minutes, 7Q), and Diabetes at School (α = 0.52, time = 4.3 minutes, 9Q). Subscale scores were positively correlated with one another. Total scores were positively correlated with the DKT2 and negatively correlated with the child’s reported A1c. All correlations were significant. The validated KAT-1 facilitates objective and expedient assessment of T1D knowledge. Its subscales will be integrated into the EHR as patient-facing surveys to quickly identify individual learning needs and allow for targeted T1D education. Disclosure A. Albanese-O'Neill: None. J.W. MacInnes: None. N.T. Thomas: None. M.J. Haller: Advisory Panel; Self; Pancreum, SAB Biotherapeutics. D. Schatz: None. J. Silverstein: None. J. Adams: None. R. Oyetoro: None. B.A. Kershaw: None. K. Anderson: None. A. Bernier: None.

Effects of Diabetes Education on Emotional Distress in Patients with Type 2 Diabetes—An Experimental Study

Objective: It was to evaluate the effect of diabetes education on emotional distress in type 2 diabetes patients treated with oral medications. Methods: The experimental study took place in Albania and overall, 200 type 2 diabetes patients were enrolled (in both groups, intervention, and control) treated with oral medications, having levels of Glycated hemoglobin HbA1c > 6.5% as well the absence of associated diseases such as dementia and psychiatric disorders. Patients were randomly selected from the medical registry of family physicians in the Tirana region. Patients were screened for the emotional distress before and after the intervention with the self-administered questionnaire Problem Areas in Diabetes PAID 5. In addition, the levels of HbA1c in % were evaluated before and after intervention in both groups. Only intervention group underwent four diabetes education sessions offered by trained nursing staff while the control group continued the previous regime. The questionnaire reliability analysis was estimated by the Cronbach alpha coefficient. To compare the groups the t-test was used and the value of p < 0.05 was considered significant. Results: Mean age of patients in intervention and control group was respectively 54.03 ±9.57 and 55.82 ± 7.86. Before and after health education PAID 5 scores for the intervention group were respectively 11.3 vs. 8.75 while for the control group 11.9 vs. 11.35, p = 0.018. Levels of HbA1c% before and after education for the intervention group were 7.02 vs. 6.2 while for the control group 6.9 vs. 6.8, p = 0.001. Positive and significant correlation (r = 0.321, p = 0.001) was between level of emotional distress and the age of the patients. Conclusions: The study found that besides better control of diabetes, additional education of diabetic patients seemed to significantly improve the level of emotional distress due to diabetes in diabetic patients.

Self-management of gestational diabetes among Chinese migrants: A qualitative study

BackgroundGestational diabetes mellitus is one of the most common complications of pregnancy. Women with Gestational diabetes are at increased risk of serious health outcomes, such as pre-eclampsia, obstructed labor, and the development of Type 2 diabetes later in life. Chinese migrants, the third largest cultural group in Australia, are more likely to develop Gestational diabetes than Australian-born women. However, to date, Gestational diabetes self-management has not been investigated in this population. AimTo explore the understanding and self-management experiences of Gestational diabetes among Chinese migrants. MethodsData were collected through individual semi-structured face-to-face interviews. Participants were recruited from the antenatal clinic at the Royal Prince Alfred Hospital. Interviews were audio-recorded, transcribed verbatim and thematically analyzed. FindingsAlthough the majority of participants demonstrated a good understanding of Gestational diabetes, some did not understand the principles behind healthcare advice and faced challenges in self-management. Confusion about self-monitoring of blood glucose and fear of insulin were also evident. Participants relied on both formal and informal sources of information. Some had difficulty obtaining adequate support. Cultural influences on self-management included meeting family needs, Chinese diet and use of Chinese medicines. ConclusionTo assist Chinese women with Gestational diabetes to better self-manage their condition, there is a need for clinicians to: (1) provide more effective diabetes education to ensure clear understanding of self-management principles; (2) actively elicit and respond to women’s confusion and concerns; (3) provide women with adequate practical support; and (4) develop greater cultural awareness.

Ocho Pasos a la Buena Salud (Eight Steps to Better Health)—A Diabetes Education Program for Low-Literacy Latinos With or at Risk for Type 2 Diabetes (T2D)

Ocho Pasos (Eight Steps) is a culturally relevant diabetes education program designed for low-income, low literacy Latino adults. The main focus is to improve health for those challenged with multiple socio-economic barriers. Classes are taught in Spanish over 8 weeks in a community setting. Diabetes-friendly diet modifications, compatible with culturally appropriate food traditions (e.g., reducing Tortilla consumption), are emphasized. Education, covering T2D risk factors, self-monitoring, stress management, and physical activity, is delivered using images, food models, and visual and tactile teaching aids. HBA1C [A1C Now® (PTS Diagnostics, Indianapolis, IN)], BMI, and waist circumference (WC), are measured at first and last classes. Between July 2015- Dec 2017, 478 adults were enrolled with complete pre- and post-class data available for 127 [77% women]. Of these 38 had HBA1C ≥6.5%, 43 between 5.7-6.4%, and 46 &amp;lt;5.7% at entry. For those with initial HBA1C≥6.5%, this decreased 0.74% [p&amp;lt;0.01]. For those between 5.7-6.4%, HBA1C fell 0.13% vs. entry, [p&amp;lt;0.05]. BMI decreased from 30.7±6.2 to 30.2±6.1 kg.m2 (p&amp;lt;0.01) and WC from 39.5±5.5 to 38.6±5.1 in, [p&amp;lt;0.01]. Daily average Tortilla consumption decreased from 5.1±2.7 to 2.4±2.7 tortillas/day [p&amp;lt;0.01]. Participants who decreased daily tortilla consumption showed a significant reduction in their HBA1C (p&amp;lt;0.05), and 52% also reported more exercise after attending. Participants with HBA1C ≥6.5% had the greatest class attendance; 55% attended &amp;gt;5 classes. Ocho Pasos a la Buena Salud is an effective diabetes education program for Latinos who face serious health care challenges for achieving optimal glycemic control or prevention of T2D. Disclosure J. Creason: None. M.M. Conneely: None. C. Axelrod: None. W.C. Bevier: None. J. Swartzentruber: None. D. Kerr: Advisory Panel; Self; Glooko, Inc.. Research Support; Self; Eli Lilly and Company. Speaker's Bureau; Self; Sanofi-Aventis. Stock/Shareholder; Self; Cellnovo. Advisory Panel; Self; Novo Nordisk Inc..

Use of Continuous Glucose Monitoring during Dose Adjustment for Normal Eating Course Favors the Emergence of Positive Patient–Provider Language Code

Personalized approach to diabetes care and educations are worldwide recognized to favor health outcomes and health-related quality of life. Continuous glucose monitoring (CGM) can be a powerful tool to help diabetes education. Language and the way clinicians use it has an interactive impact on education. The aim of the study is to explore the language in narrative form emerging from the patient-provider interactions mediated by the use of CGM readings. Researchers transcribed and coded the data collected during the seven sessions of Dose Adjustment For Normal eating course taking place at University Hospital of Geneva in Switzerland. The course involved 3 health care providers (dietician, nurse and medical doctor) and 12 participants. All the sessions were filmed and semi-structured interviews of 10 participants and the 3 providers completed the data. Conversation Analysis of the interactive and discursive space created by the narrative’s experiences from participants mediated by CGM readings was investigated as well as Content analysis of the semi-structured interviews in order to put in perspective learning traces through participant's discourses. The results have shown that health care providers adjust and coordinate their languages through CGM readings in order to organize the narrative’s experiences from the participants. The use of technology reduced judgmental and negative words and promoted the development of a patient-provider narrative useful for learning. The narrative organization clearly impacted the participants. Diabetes technology and particularly CGM readings are powerful tools to develop a specific patient-provider language code promoting effective diabetes education. Disclosure M. Dos Santos Mamed: None. G. Gastaldi: Speaker's Bureau; Self; Abbott, Eli Lilly and Company, Novo Nordisk A/S, Medtronic, Dexcom, Inc., Sanofi, Roche Diabetes Care Health and Digital Solutions, Boehringer Ingelheim GmbH.