Diabetes Self-management Education for African Americans: The LIFE Study

Objective: To determine the effect of a culturally-competent self-management intervention in African Americans with co-morbid diabetes and hypertension. Methods: A randomized controlled trial was conducted with 59 low-income African American adults with type 2 diabetes and hypertension. Participants were randomized to an intensive intervention or control group. The intensive intervention, targeting diet, activity, and self-monitoring of blood glucose, consisted of 12 weekly and six bi-weekly group sessions led by a dietitian and 2 peer supporters and weekly phone calls from peer supporters. Control group participants received 6 hours of diabetes self-management education from a community health worker. Hemoglobin A1c (HbA1c) and weight were measured at baseline, 3 months, and 6 months. Results: The overall retention rate was 90%. A greater proportion of intervention than control participants reduced HbA1c by ≥0.5% at three months (I: 48%, C: 14%, p<0.01) and six months (I: 52%, C: 22%, p<0.05). Change in mean HbA1c at 6 months was 0.06% in the control group and -0.53% in the intervention group, for a difference of 0.6% between groups (p=0.09). A greater proportion of intervention participants lost ≥ 5% of body weight at three months (I: 32%, C:7%, p=0.02) but not at six months (I: 28%, C: 25%, p=0.80). Change in weight at 6 months was -3.24 kg in the intervention group and -1.1 kg in the control group, for a net difference of 2.2 kg (p=0.09). Conclusion: The intervention resulted in improved glycemic control and weight in low income African Americans with co-morbid diabetes and hypertension.