Diabetes-related distress and glycemic control outcomes after a diabetes self-management intervention for Native Hawaiians and Pacific Islanders

Abstract

Native Hawaiians and Pacific Islanders tend to have a higher prevalence rate of type 2 diabetes than Caucasians. Culturally adapted diabetes interventions are needed to reduce the diabetes-related morbidity and mortality rates among Native Hawaiians and Pacific islanders. The purpose of this study is to test the effectiveness of a culturally-adapted diabetes self-management intervention. Participants were randomly assigned in an unbalanced design to the Partners in Care intervention (n=48) or wait list control group (n=34). Assessments of hemoglobin A1c and diabetes-related distress were measured at baseline and 3 months (post intervention). Analysis of covariance was used to test between-group differences. Intervention participants experienced a significant improvement in A1c values (P<0.002) in contrast to the delayed group. A1c among intervention participants improved by 1.5% compared to 0.4% in the delayed group. The change in diabetes-related distress was not significant in both the intent to treat and complete case analysis . This study showed no correlation between the change in A1c and the Problem Areas in Diabetes (PAID) in the intervention group after three months. A culturally-adapted diabetes self-management intervention was effective in improving glycemic control and reducing diabetes related distress. There was no correlation between the change in A1c and the PAID in the intervention group after three months. Future studies should examine improved methods for assessing diabetes-related distress among populations that may tend to provide socially desirable responses or not feel comfortable providing information about emotional and mental health status.