Are Spanish Diabetes Self-Management Programs Effective?

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Spanish diabetes self-management with and without automated telephone reinforcement: two randomized trials, by K. Lorig and colleagues. Diabetes Care.Published online ahead of print on 20 December 2007

What is the problem and what is known about it so far?

Type 2 diabetes occurs nearly three times more often in Latinos than in non-Latinos, and is often more severe. The need for Spanish-language diabetes self-management education programs is clear, but few studies have measured their effectiveness.

Why did researchers do this particular study?

The researchers wanted to find out whether a Spanish diabetes self-management program and monthly follow-up contact would help participants improve their health and gain confidence in their ability to self-manage their disease.

Who was studied?

Participants included 567 Spanish-speaking adults with type 2 diabetes in the San Francisco Bay area of California.

How was the study done?

Participants were assigned to receive either usual diabetes care or usual care along with a 6-week peer-led Spanish diabetes self-care program. Some of those who attended the program were then assigned to receive 15 months of automated telephone messages reinforcing the education provided through the program and compared to others who completed the education program but did not receive follow-up phone calls. A1C levels were measured at the beginning of the study, after 6 months, and again after 18 months. Other information was collected through questionnaires.

What did the researchers find?

Program participants showed improvements in A1C, health-related distress, symptoms of hypo- and hyperglycemia, and confidence in their ability to self-mange their disease. After 18 months, all improvements were still apparent. Program participants also showed improvement in self-reports of their health and their communication with doctors and had fewer emergency room visits and slightly fewer doctor visits. The only difference between those who got monthly follow-up calls and those who did not was more frequent blood glucose monitoring for those who received calls.

What were the limitations of the study?

Because conducting a blinded study was not possible, differences between the two groups might have been influenced by the fact that participants knew which treatment they were receiving. Also, participants who did not complete the study may have been more likely to have greater health problems or poorer diabetes control than those who continued to the end. Finally, the study group may have differed in some ways from the larger population of Hispanic people with diabetes.

What are the implications of the study?

Peer-led diabetes self-management classes held in community settings may improve A1C levels and quality of life for Spanish-speaking people with diabetes.

FOR MORE INFORMATION

Latinos and diabetes

Diabetes information en español

Spanish language resources for diabetes