Document Type
Article
Publication Date
4-29-2020
Journal / Book Title
Current Developments in Nutrition
Abstract
Background: Type 2 diabetes (T2D) is a worldwide epidemic and a leading cause of death in Mexico, with a prevalence of 15.9%, and >70% of diagnosed adults have poor glycemic control [glycated hemoglobin (HbA1c) >7.5%]. We developed a diabetes self-management education program contextualized to the study population, including dietary preferences, health literacy, and health system.
Objectives: We aimed to evaluate the efficacy of a self-management + text message program (¡Sí, Yo Puedo Vivir Sano con Diabetes!) on primary (HbA1c), and secondary behavioral (self-management), clinical, and psychosocial outcomes in adults with T2D in Mexico City.
Methods: Participants were recruited at public primary healthcare centers (Seguro Popular), and randomly allocated to treatment (n = 26) or wait-list control groups (n = 21) with data collected at 3 and 6 mo. The program included 7 weekly sessions and 6 mo of daily text/picture messages. Descriptive statistics and a generalized linear mixed model with intent-to-treat analysis were calculated.
Results: Participants were 55.5 ± 8.8 y of age (mean ± SD), 68% female, 88.6% overweight/obese, and 57% lived in food-insecure households. Mean ± SD T2D duration was 11.9 ± 7.8 y and HbA1c was 9.2% ± 1.5%. There was 89% attendance at sessions and 6.4% attrition across both groups at 6 mo. Group-by-time effects were seen in self-monitoring of blood glucose (P < 0.01) and diabetes self-efficacy (P < 0.04); and a trend for lower HbA1c was seen in the intervention group at 6 mo (P = 0.11). Significant improvements in dietary behavior (P < 0.01) were demonstrated in the intervention group over time, but this did not reach statistical significance compared with the control group.
Conclusions: The program was associated with clinically significant improvements in T2D self-management, self-efficacy, and HbA1c over time. Thus, T2D self-management skills, including diet, were improved in a vulnerable metropolitan population. This trial was registered at clinicaltrials.gov as NCT03159299.
DOI
https://doi.org/10.1093/cdn/nzaa074
MSU Digital Commons Citation
Whittemore, Robin; Vilar-Compte, Mireya; De La Cerda, Selene; Delvy, Roberta; Jeon, Sangchoon; Burrola-Méndez, Soraya; Pardo-Carrillo, Mariana; Lozano-Marrufo, Annel; and Pérez-Escamilla, Rafael, "¡Sí, Yo Puedo Vivir Sano con Diabetes! A Self-Management Randomized Controlled Pilot Trial for Low-Income Adults with Type 2 Diabetes in Mexico City" (2020). Department of Public Health Scholarship and Creative Works. 218.
https://digitalcommons.montclair.edu/public-health-facpubs/218
Published Citation
Whittemore, Robin, Mireya Vilar-Compte, Selene De La Cerda, Roberta Delvy, Sangchoon Jeon, Soraya Burrola-Méndez, Mariana Pardo-Carrillo, Annel Lozano-Marrufo, and Rafael Pérez-Escamilla. "¡ Sí, yo puedo vivir sano con diabetes! A self-management randomized controlled pilot trial for low-income adults with Type 2 Diabetes in Mexico City." Current Developments in Nutrition 4, no. 5 (2020): nzaa074.
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