Journal / Book Title
Current Developments in Nutrition
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.
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.
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.
Cardiovascular Diseases Commons, Clinical Epidemiology Commons, Community Health and Preventive Medicine Commons, Dietetics and Clinical Nutrition Commons, Environmental Public Health Commons, Epidemiology Commons, Health and Medical Administration Commons, Health and Medical Physics Commons, Health Services Administration Commons, Health Services Research Commons, International Public Health Commons, Nutrition Commons, Other Public Health Commons, Patient Safety Commons, Public Health Education and Promotion Commons