| Abstrakt: |
Latinos have higher rates of type 2 diabetes, worse glycemic control, and higher rates of diabetic complications than other ethnic groups. The Emory Latino Diabetes Education Program (ELDEP) is a non-profit DSME program that provides free Spanish diabetes education and lifestyle intervention for Latinos with diabetes in Georgia. We present our experience with ELDEP and describe barriers to diabetes care. Results: A total of 1680 patients attended our program between 2006 and 2018. All subjects were foreign-born and most came from Mexico (71%). Their average age was 48±12 years, female: 63%, BMI: 31±7 kg/m2, 26% with more than 10 years of DM and the majority were not treated with medications (58%). A total of 297 (17.7%) patients returned for at least one follow-up class within 6 months. Most patients who returned were female (67%). The mean HbA1c at presentation was 8.9±2.6%, 7.7±2.0% at 3 months, and 7.4±1.3% at 6 months of follow-up. Compared to women, men had a larger reduction in HbA1c from baseline -1.6±3.0% vs. -0.9±2.1% at 3 months and -2.4±2.9% vs. -1.2±1.8% at 6 months follow-up (p=0.07). Major barriers to care identified: i) low literacy: 36% of patients did not read or write Spanish; ii) poor language proficiency: 87% did not speak, read, or write English; iii) low education level: 19% high school, and 6% college education; iv) low health insurance coverage: 76% had no health insurance, 9% had Medicare or Medicaid, and 8% had private insurance; v) financial: 63% have annual household income < $20,000 and most had severe financial limitations in buying prescribed diabetes regimen; vi) 41% had food insecurity and 47% consumed less than the recommended vegetable intake; and vii) 94% had a low level of acculturation. Conclusions: Our results identify important cultural and socio-economic challenges to diabetes care faced by Latinos in Georgia. The ELDEP is a successful and easy-to-implement education model that addresses some of these challenges to improve diabetes care in the underserved Latino population. Disclosure: J. Haw: None. I.C. Flores: None. D. Porras Fimbres: None. B. Rotberg: Employee; Self; Insulet Corporation, Novo Nordisk A/S. A. Migdal: None. H. Wang: None. F.J. Pasquel: Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Merck & Co., Inc. G.E. Umpierrez: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc. Research Support; Self; AstraZeneca, Merck & Co., Inc., Novo Nordisk Inc., Sanofi US. Funding: Sanofi [ABSTRACT FROM AUTHOR] |
