Background: Participating in a #diabetes Self-Management Education and Support (DSMES) program improves self-care behaviors, quality of life, and health outcomes. However, language barriers and cultural differences can hinder participation, leaving many Vietnamese Americans with limited access to DSMES services. Objective: This study aims to evaluate the feasibility, acceptability, and preliminary efficacy of a 3-month Blended Automated Links Augmented by Nurse Call and Engagement (BALANCE) intervention designed to deliver culturally tailored DSMES in the Vietnamese language, with participants monitored for 12 months afterward to assess sustained effects on key outcomes. Methods: An explanatory sequential mixed methods design was used, guided by the Practical, Robust Implementation and Sustainability Model (PRISM) framework. Feasibility and acceptability were measured by the participation rate of eligible clinics and patients, patient message response rate, and retention rate. Focus groups were conducted to assess adoption and sustainability. A pilot single-arm, prospective interventional trial was conducted with a sample of 88 Vietnamese American adults with type 2 #diabetes from 10 primary care clinics. Surveys were administered at baseline and every 3 months over 12 months. Repeated measures ANOVA assessed changes in clinical outcomes at 3, 6, 9, and 12 months. Qualitative data from in-depth interviews and focus groups were thematically analyzed to validate and expand on quantitative findings. Integrated analysis using joint display enabled meta-inferences across data sources. Results: Among 88 participants (mean age 68, SD 9.8; range 35‐86 years), the intervention did not significantly affect glycated hemoglobin A (=.63) but led to a statistically and clinically significant reduction in low-density lipoprotein (=.001) and improvement in exercise performance (=.04). Qualitative data from 45 patient interviews reached data saturation, with 80% (n=36) describing the intervention as “convenient” and “helpful.” Clinic staff (n=18) participated in 3 focus groups and endorsed the intervention as acceptable and feasible. Mixed methods analysis confirmed high feasibility (83% clinic participation and 100% clinic retention) and acceptability (90.9% patient retention). Key barriers to sustainability included limited staffing and supply infrastructure. Conclusions: Intervention feasibility and acceptability were demonstrated but require further refinement to achieve long-term, consistent glycemic control. Findings indicated that clinic staff workload and clinic workflow were key determinants of the study’s feasibility and acceptability. Future research should test BALANCE in a fully powered randomized controlled trial to evaluate intervention effectiveness.

Background: Although progress has been made in improving the efficacy of Diabetes Self-Management Education (DSME) programs, there remains a dearth of research on culturally adapted, evidence-based DSMEs for Chinese Americans (CAs) with type 2 diabetes. Objective: Through collaborative partnerships with 2 large community recreation centers and the AHMC Hospital Network in San Gabriel Valley, California, we developed and pilot-tested a culturally tailored DSME program with integrated mobile health (mHealth) technology, entitled Culturally Appropriate Strategies for Chinese Americans with Diabetes (CASCADe). Methods: The CASCADe program utilized a combined, theoretically driven, and community-participatory approach and was developed based on information gleaned from focus groups, semistructured interviews, and a questionnaire survey conducted among CA patients with diabetes, physicians, and nurses, as well as from extensive literature reviews of evidence-based program curricula. A single-group pre- and posttest design with a 3-month study period was then employed to assess the program’s preliminary efficacy. The study protocols were registered on ClinicalTrials.gov. Results: The CASCADe program consisted of (1) a home visit in the first month for training in monitoring device use and WeChat app (a mobile instant-messaging platform widely used in the Chinese population) usage, as well as for acquiring family support; (2) 8 weekly sessions over the following 2 months, delivered in a combined format of group classes, games, group exercises, videos, and discussions; and (3) WeChat follow-up involving education tips, monitoring data summaries, and group discussions after each of the 8 weekly sessions. Topics covered in the weekly sessions included recognition of diabetes and its complications, risk factors, nutrition knowledge, dietary practices, exercise, behavioral self-monitoring, medication adherence, and stress management. The monitoring system used a smartphone to coordinate cloud-based data transmission from a set of wireless devices to capture daily monitoring data on physical activity, body weight, blood pressure, and blood glucose levels. Behavioral self-monitoring was further facilitated by the WeChat app, which provided daily messages related to the diabetes education curriculum; weekly summary reports of monitoring data; feedback; bidirectional 1-on-1 communication between intervention providers and participants; and group discussions among participants regarding readings and the implications of monitoring results. The pre- and postcomparison from the 3-month pilot trial showed a significant reduction in glycated hemoglobin (HbA1c; 7.48 vs 7.09, P=.03), with all but 1 participant demonstrating a reduction and 7 out of 12 (58%) achieving a >0.5 decrease in HbA1c. Significant improvements were also observed in self-efficacy in diabetes management (6.59 vs 8.01, P=.003), quality of life (3.21 vs 3.69, P=.005), and stress-coping skills (3.18 vs 3.74, P=.01) at 3 months after baseline among CA patients with type 2 diabetes. Conclusions: Our pilot study demonstrated the #feasibility of implementing the CASCADe program among CAs to improve diabetes self-management skills and yielded promising results, warranting further evaluation in a larger randomized trial. Trial Registration: ClinicalTrials.gov NCT04737499; https://clinicaltrials.gov/ct2/show/NCT04737499

Background: The high prevalence of type 2 diabetes (T2D) and associated complications disproportionately affect low-income Latino populations, who also experience disparities in diabetes self-management (DSM), including poor medication adherence, physical activity, diet, and glycemic control. Objective: This study examined, through an academic-community partnership, the effectiveness of ¡Salud, Salud! (an evidence-based, family-centered diabetes self-management education and support [DSMES] program) on primary (glycemic control and quality of life) and secondary (social, psychological, and behavioral factors related to T2D management) outcomes among low-income Latino adults with T2D or prediabetes. Methods: In total, 81 adults (mean age 48.90 years, SD 12.57; n=57, 70.4%, female; n=66, 81.5%, Latino) with T2D or prediabetes were enrolled in a 12-week, single-arm quasi-experimental study conducted in two Central Texas Young Men’s Christian Association (YMCA) locations. ¡Salud, Salud! incorporated individual coaching by community health workers (CHWs), online family-centered DSMES training lessons, and a YMCA family membership. The delivery of ¡Salud, Salud! was supported and facilitated by digital technologies, including a dashboard to deliver intervention content and monitor participants’ engagement in intervention activities. Outcomes measured at baseline and 12 weeks (ie, postintervention) included hemoglobin A1c (HbA1c); quality of life; anthropometrics; self-reported physical activity and diet; mindfulness; perceived stress; and diabetes-related knowledge, self-efficacy, and support. Participant engagement in program activities was assessed via four index variables that underlay multiple dimensions of influences on ¡Salud, Salud! uptake: family engagement and support, participation in self-management education, program support and facilitation, and participation in self-monitoring. Paired t-tests and McNemar chi-square tests were used to examine the change in outcomes from baseline to 12 weeks. The number of program activities participants completed for each engagement index variable was converted to percentages to estimate the mean proportion of activities completed. Results: In total, 48 (59.3%) participants completed the 12-week posttest. At the end of the program, participants demonstrated a marginally significant reduction in HbA1c (–0.30%, P≤.09) and a significant increase in participants reporting good-to-excellent health from baseline (n=19, 39.6%) to posttest (n=28, 58.3%; P≤.003). There were significant reductions in body weight (–1.30 kg, P=.02), body fat percentage (–1.26%, P=.01), perceived stress (–0.28, P=.02), added sugar intake (–2.15 teaspoons/day, P=.001), and time spent sedentary per week (–70.27 minutes, P=.003) from baseline to posttest. Mindfulness increased significantly (2.21, P=.01). Participant engagement in ¡Salud, Salud! varied, with participants exhibiting a high completion rate in program support and facilitation activities (88%) and a moderate-to-low completion rate in self-management training (66%), self-monitoring (56%), and family engagement and support (49%) activities. Conclusions: ¡Salud, Salud! shows promising preliminary effects on key diabetes-related outcomes. Future research should investigate how to enhance participant engagement and optimize uptake of evidence-based T2D self-management practices among low-income Latino adults with diabetes.

Background: People of Black African and Black Caribbean ethnicity experience higher rates and poorer outcomes of type 2 #Diabetes (T2D) than people of White European ethnicity; these inequalities are compounded by poor healthcare access. Cultural tailoring of #Diabetes self-management education and support (DSMES) programs has the potential to improve healthcare engagement and clinical outcomes for ethnic minority groups. Healthy Eating & Active Lifestyles for #Diabetes (HEAL-D) is a co-designed, culturally tailored group-based DSMES program for adults of Black African and Black Caribbean ethnicity. Objective: This trial aims to evaluate the clinical and cost effectiveness of the HEAL-D intervention, compared to standard DSMES programs, in Black African and Black Caribbean adults living with T2D. Methods: A 24-month, multicenter, pragmatic, open-label, 2-arm, parallel-group, individually randomized group treatment trial will be conducted, with primary end point (glycated hemoglobin [HbA1c]) assessment at 12 months. Black African and Black Caribbean adults with T2D (n=300), recruited from 3 to 5 centers in the United Kingdom (including London, West Midlands, and Greater Manchester), will be randomized in a 1:1 ratio to HEAL-D (intervention) or a standard DSMES program (control). HbA1c, blood lipids, anthropometric outcomes, blood pressure, physical activity, and patient-reported outcome measures relating to psychological well-being and self-management support, lifestyle behaviors, and health economics will be collected at baseline and follow-up visits (6, 12, and 24 months). Cost-effectiveness will be assessed through a cost-utility analysis conducted from a health and social care perspective. A mixed methods process evaluation will provide a formative evaluation of delivery, intervention fidelity, and implementation of HEAL-D, and an embedded #Study within a project will assess the impact of multiple long-term conditions on uptake of, and engagement with HEAL-D, and the impact of HEAL-D on multiple long-term conditions. The trial received #Research Authority and #Research Ethics Council approval on April 22, 2024. Results: Funding began in August 2023. Site “green light” was received on August 15, 2024, for London; November 29, 2024, for Manchester; and January 31, 2025, for the West Midlands. Recruitment commenced in August 2024 and is due to run for 11 months. As of March 26, 2025, a total of 76 participants have consented. Last patient, last visit is expected in June 2027; primary data analysis is expected to begin in July 2027. Final results are anticipated to be available in September 2027, and publication is expected by the end of 2027. Conclusions: The HEAL-D trial will address whether a culturally tailored DSMES program, provided in-person or via videoconferencing, is clinically and cost-effective compared to standard DSMES at improving #Diabetes management in Black African and Black Caribbean adults. If effective, this would provide an evidence-based model of equitable DSMES services and improve the implementation of healthcare programs for ethnic minority groups. Trial Registration: ISRCTN 1434448; https://www.isrctn.com/ISRCTN14344948

OBJECTIVE. To investigate the effects of diabetes self-management education and support (DSMES) and real-time continuous glucose monitoring (RT-CGM) on lif

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Refer to this list of terms explained in everyday language to use during DSMES sessions.

This is a new training on diabetes self-management education and support (DSMES) services that was created with and for nurse practitioners (NPs) to make it easier for you to learn about DSMES services that can help your patients, including how to refer. DSMES services require a referral from a health care provider and are highly effective, evidence-based services (training, counseling, follow-up activities) that help people manage diabetes in ways that fit their lifestyle. DSMES is offered in person and online and can improve A1C levels, help prevent or delay diabetes complications, and improve quality of life. For you, DSMES services can result in fewer readmissions, improved quality measures, and less time spent on patient education and management as patients learn better how to self-manage their diabetes. This 1-hour training and companion fact sheet were developed through a collaborative effort of CDC and NP association staff and members. (Fact sheet & slide deck can be found on CDC Train: https://www.train.org/cdctrain/course/1129485/details ) This video can also be viewed at https://www.cdc.gov/diabetes/videos/DSMES-patient-connections-lowres.mp4

Introduction Diabetes self-management education and support (DSMES) services are often underutilized, partly due to low referral rates by clinicians. This examines if using a Best Practice Advisory (B...