Over half of Hispanics/Latinos will develop type 2 diabetes in their lifetime. This increases the risk of death and other health issues such as amputation by 50 percent to 100 percent compared with non-Hispanic white patients with type 2 diabetes.
Diabetes telemanagement programs (DTM) can now use technology to connect patients with their care provider for a weekly “tele-visit” and allow them to have their blood sugar and vital signs monitored daily. The purpose of this study is to see whether providing this kind of programming will improve care for patients with type 2 diabetes, compared with comprehensive outpatient management, the most common treatment approach for Hispanic patients from lower-income and health access communities.
This study has two parts. The first part uses qualitative methods to “adapt” the DTM program intervention for Hispanic/Latino disparity patients, using a Community Advisory Board comprising patients, caregivers, community leaders, and other important stakeholders such as community-based organizations (Vida Si, Diabetes No) and the American Diabetes Association. The second part tests this adapted program scientifically using a randomized controlled trial to see if it is more effective than comprehensive outpatient management. Patients who receive comprehensive outpatient management receive clinic care to manage their type 2 diabetes, while the patients who receive DTM (and their caregivers, such as their children) will be given tablets that easily connect them to the nurse practitioner. The caregiver part of the program was suggested by our Community Advisory Board, as well as by interviews with patients. The idea is that patients who are more engaged in their care through DTM will experience less illness and hospitalization, have a better quality of life, and be more self-confident in their ability to manage their diabetes. We also want to see if involving caregivers improves the care and quality of life of patients. While this kind of intervention has been studied in the general population and has found that sugar management improves, no one has studied whether this will be better for Hispanic disparity patients with type 2 diabetes, so this will be the first study of its kind.
This study is important because our patients tell us (and other studies have shown) that the outcomes we are focusing on—quality of life, confidence in managing diabetes, hospitalizations, use of emergency department services, and distress about their diabetes—are important to them. Patients and other stakeholders are very involved in this project—both as part of the research team and as members of the Community Advisory Board, which guides the research team through all aspects of the study. We also test the intervention with patients.
Training and Education Interventions
Low Health Literacy/Numeracy
Individuals with Multiple Chronic/co-morbid Conditions