Technology Intensified Diabetes Education Study in African Americans

African Americans (AA) with type 2 diabetes (T2DM) have higher prevalence of diabetes, poorer
metabolic control (i.e. poorer blood glucose, blood pressure, and lipid control), and greater
risk for complications and death compared to White Americans. Hemoglobin A1c (HbA1c) is the
primary marker for glycemic control and is a strong independent predictor of development of
complications and increased mortality in T2DM. Key self-care behaviors that influence
glycemic control (and HbA1c) include diet, physical activity, self-monitoring of blood
glucose and medication adherence. Systematic review of multiple randomized clinical trials
(RCTs) show that self-care interventions that include diabetes education and skills training
are effective in improving metabolic control in diabetes. Recent findings indicate that
patients with diabetes, especially ethnic minority patients, prefer telephone-delivered
diabetes education to group visits or internet-based education. Multiple RCTs have documented
the effectiveness of telephone-delivered self-care interventions in T2DM. Preliminary data
from our group also suggest that a culturally-tailored telephone-delivered diabetes education
and skills training intervention is an effective strategy to improve metabolic control in AA
patients with T2DM.

This study provides a unique opportunity to address gaps in the literature by testing the
efficacy of a technology-intensified diabetes education/skills training (TIDES) intervention
in AAs with poorly controlled T2DM. The long-term goal of the project is to identify
effective strategies to improve metabolic control and hence reduce diabetes complications and
mortality rates in AAs with T2DM.

Inclusion Criteria:

- Age ≥21 years

- Clinical diagnosis of T2DM and HbA1c ≥8% at the screening visit

- Self-identified as AA

- Subject must be willing to use the FORA monitoring system for 12 months

- Subjects must be able to communicate in English

- Subjects must have access to a telephone (landline for data uploads) for the study
period

Exclusion Criteria:

- Mental confusion on interview suggesting significant dementia

- Participation in other diabetes clinical trials

- Alcohol or drug abuse/dependency

- Active psychosis or acute mental disorder

- Life expectancy <12 months