Effect of a bilingual diabetes education interactive telenovela on glycemic control among hispanic patients with type 2 diabetes: A randomized clinical trial

Background: Hispanic adults with T2DM exhibit lower glycemic control than other racial/ethnic groups. Optimal diabetes control requires adherence to multiple complex self-care behaviors. This study tested whether a culturally and linguistically appropriate interactive diabetes education program improved glycemic control, as measured by reduction in glycosylated hemoglobin A1c (HbA1c). Methods: Participants were Hispanic adults with poorly controlled T2DM (HbA1c ≥ 8.0) recruited from 4 community health clinics and randomized to intervention (n = 125) or usual care control (n = 125) group. Intervention patients viewed a diabetes interactive telenovela (DIT) incorporating key diabetes management strategies (diet, exercise, and medication). Psychosocial and selfcare measures were obtained at baseline and three months. Laboratory measures, including HbA1c, were abstracted from medical records. Results: Intervention patients exhibited significant HbA1c reduction (intervention mean = -1.4 ± 0.20 vs. control mean = -0.7 ± 0.19, p = 0.04). Further reduction in HbA1c was observed among patients with microvascular complications (intervention mean = -1.7 ± 0.37 vs. control mean = -0.4 ± 0.30, p = 0.01). There was greater reduction in HbA1c among women (women mean = -1.3 ± 0.17 vs. men mean = -0.8 ± 0.24). However, insulin therapy attenuated HbA1c reduction in women, but not in men (women mean = -0.7 ± 0.22 vs. men mean = -0.9 ± 0.29). Conclusion: Findings indicate that the DIT is an effective diabetes management tool for Hispanic patients. Diabetes education and counseling messages should consider gender differences in diabetes management and reinforce that insulin therapy is an effective control strategy.