Diabetes Self-Care Management in a Community Health Center: Improving Clinical Outcomes through Health Education

Introduction: Diabetes self-care management is a crucial element of good diabetes care and can improve glycemic control. However, self-care management interventions must meet the needs of underserved minority populations. The purpose of this 2 year health education intervention was to improve self-care management behaviors and outcomes of underserved ethnic minorities at a federally-qualified health center in Texas. Individual one-on-one and group self-management education sessions were provided with trained bilingual health educators. Subjects comprised of 417 individuals with diabetes. However, only 100 participants were tracked over 18-months for changes in clinical outcomes. Result and Discussion: The majority were females (69.5%), Hispanic/Latino (66%), and uninsured (95%). African Americans had higher levels of hypertension than other patients. The focus on goal setting led to 62.3% of patients achieving at least one goal (out of nine) and included nutrition, exercise, blood glucose management, and weight management. Of those goals that were sustainable, 70% of patients kept up their behavior change for 6 months post initial goal setting in a random sample of 100 patients. A1c lowered significantly in Whites (p =0.03), Hispanics ( p =.001 ) and African Americans ( p =.001) as well as in both males (p=.003) and females (p<.001). While intervention reduced weight in the subsample (approaching significance; p=.097), it was not significant by ethnicity or gender. Systolic blood pressure reduced among males (p=.083) and fasting blood glucose among African Americans (p=.097). Conclusion: Health education was effective in significantly reducing A1c levels and improving goal setting especially among minorities.