The DIALBEST Peer-counseling Program in a Latin American Population

A best practices diabetes peer-counseling program is effective in a Latin population, according to preliminary results presented at the American Diabetes Association’s 70th Scientific Sessions in Orlando by Rafael Perez-Escamilla, PhD, a professor in the Division of Chronic Disease Epidemiology at the Yale School of Public Health.

In his session titled “The DIALBEST Study—Diabetes Interventions for an Urban Hispanic Population,” Perez-Escamilla presented preliminary results from the DIALBEST study, which included 208 Latinos from the Hartford area who were 21 or older with type 2 diabetes and an A1C of 7% or higher, without an advanced medical condition that would limit their physical activity. DIALBEST was born from preliminary results of a study of 201 Latinas in Hartford that revealed that this demographic had low levels of nutrition and disease management education, inadequate levels of disease prevention and management, inadequate access and use of healthcare, and a lack of social support.

In DIALBEST, researchers compared the intervention group against a control group over the course of a 12-month intervention. Participants received 17 peer-counseling visits and data was collected at baseline and at 3-, 6-, 12-, and 18-months. The peer counseling aspect included education, advocacy, support, communication with the medical team, and care coordination. Perez-Escamilla’s said that the educational portion included teaching participants about diabetes and its complications, blood glucose monitoring, the importance of physical activity, and medication adherence, which Perez-Escamilla said was the biggest challenge that researchers didn’t anticipate.

Of the 208 participants, 51% took part in all 17 educational sessions, with a mean attendance of 15 sessions. The sessions averaged 88 minutes, had very high patient satisfaction scores, and focused on things such as grocery shopping, physical activity, and heart health. The educational sessions were guided by trainers from similar cultural and ethnic backgrounds as the participants who went through 65 hours of training with a healthcare team consisting of dieticians, nutritionists, nursing students, nutrition doctoral students, and other medical professionals.

At baseline, both groups involved in the study had similar lipid profiles and glucose levels. After three months, glucose levels in the intervention group dropped 1.02% compared with only 0.6% in the control group. At six months, the intervention group saw a drop of 1.02% compared with 0.41% in the control group. And at 12 months, the drop in glucose remained at 1.02% in the intervention group with the control group dropping by only 0.32%. These results have led Perez-Escamilla to declare that DIALBEST has had a significant impact on Latin Americans with diabetes, but he is still awaiting the final results, which will be the data collected at 18 months.