Emory Latino Diabetes Education Program: Raising the Bar in Diabetes Care for Latinos in Georgia

Latinos with diabetes have a higher incidence of diabetic complications than other ethnic groups. Several healthcare barriers have been identified in highly populated ‘traditional' Latino areas in the US, but barriers to diabetes care in ‘non-traditional' areas as in the Southeast are not known. The Emory Latino Diabetes Education Program (ELDEP) is a non-profit program aimed to provide diabetes education and lifestyle intervention to Latinos in Georgia. We present our experience and results during the first 2 years of the program. A total of 431 patients (age: 47±13 yr) attended the first class and 124 returned for a follow-up class within 6 months. All subjects were foreign-born and most came from Mexico (71%) and Central America (18%). The initial mean indices included an A1C: 9.1±3%, BMI: 31±6 kg/m2, systolic BP: 129±22 mmHg, DBP: 81±15 mmHg. The mean A1C decreased to 8.1±2% (p<0.01). Women experienced better glycemic control than males. Patients that participated in both classes increased routine BG monitoring from 57% to 84% (p<.048), the use of BG log tools from 44% to 63% (p<0.5). The following barriers to diabetes care were identified: low literacy: ~15% of patients did not read or write Spanish; poor language proficiency: 49% do not speak, read or understand English; low health insurance coverage: 83% have no health insurance; low education level: 8% completed high school; lack of diabetes education: 74% had no previous diabetes education; and financial problems: 58% of subjects claimed severe financial limitations in buying food and prescribed diabetes regimen, with 81% of subjects having an annual income <$5,000.

Our results have identified important social and cultural barriers to diabetes care in Latinos. The ELDEP is a successful and easy to implement education model to improve diabetes care in underserved Hispanic population.