Community-based type 2 diabetes education program: Dining with Diabetes in Virginia

INTRODUCTION: Dining with Diabetes in Virginia (DwDVA) was piloted in 2006-2007 in eight counties with high prevalence of type 2 diabetes via collaboration between Virginia Cooperative Extension and Virginia's Diabetes Prevention and Control Project. METHODS: DwDVA, managed by local Extension agents, included four weekly 2-hour sessions and a 3-month follow-up class taught by registered dietitians or Certified Diabetes Educators, and was designed to improve diabetes self-management and blood glucose control. Participants (n=146) were 80% female, mean age 66.4±10.3 years, (66% over 60 yrs). Fifty-three percent reported incomes below $30,000, 17% were African-American, 77% Caucasian, and 3% Asian. Class attrition averaged 30%. RESULTS: At follow-up participants were much more likely to use a plan to control carbohydrate consumption (38% vs 74%, OR=4.64, 95% CI=2.50¨C8.61; t=5.36, p<.01). Self-reports of 30 minutes of physical activity at least 3 days/week also increased, albeit marginally (73% vs 82%, OR = 1.68; 95% CI=0.84¨C3.37; t=1.49; p=.07). Overall glycosylated hemoglobin (A1c) level did not significantly change from baseline to follow-up (7.36±1.60 to 7.27±1.47); however, among participants whose baseline levels were ≥ 7.00, A1c decreased from 8.50±1.58 to 8.00±1.54 (n=45, paired t-test, p<.001). DISCUSSION: Lessons learned include: 1) coalition building is essential to obtain support for the research component of the program; 2) stand-alone programs attract more committed participants (compared to programs immersed in, for example, Bible study classes); 3) visible support and encouragement from community leaders increases participation, and 4) an enhanced physical activity component and organized support groups could improve adherence and outcomes.