Abstract
Background: The prevalence of type 2 diabetes is increasing at an alarming rate in Latin America and in the Caribbean. We present evidence that a cost-effective and sustainable approach to lifestyle modification in underdeveloped countries can be implemented using community members as healthcare champions. Methods: Of 222 community members screened in the impoverished community of Villa Juana, Santo Domingo, 69% had prediabetes or diabetes and 79 of these were enrolled. In a 1-day session, trained lifestyle educators from the USA trained ten lay community members to lead groups oriented to lifestyle change. Community leaders met with assigned patient groups monthly for 1 year. Glycated hemoglobin (HbA1c; average plasma glucose concentration), blood pressure, weight and waist circumference were measured at baseline, 6 months and 1 year. Results: 59 individuals completed follow-up. Patients showed significant improvements after 6 months in systolic blood pressure (p=0.001), diastolic blood pressure (p=0.000002) and HbA1c (p=0.015). HbA1c improved further at 1 year (p=0.005). Conclusion: Our pilot experience demonstrates the efficacy and feasibility of a novel, low-cost, community-based educational initiative to improve blood glucose control and reduce cardiovascular risk in individuals with type 2 diabetes or prediabetes. Replication of our model in other underserved areas could have a substantial impact on global health.
Original language | English (US) |
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Article number | iht039 |
Pages (from-to) | 118-124 |
Number of pages | 7 |
Journal | International Health |
Volume | 6 |
Issue number | 2 |
DOIs | |
State | Published - Jun 2014 |
Keywords
- Behavior modification
- Cardiovascular disease
- Community-based participatory research
- Hypertension
- Lifestyle
- Type 2 diabetes mellitus
ASJC Scopus subject areas
- Health(social science)
- Public Health, Environmental and Occupational Health