Behavioral Interventions to Improve Glycemic Control in African Americans with T2dm

Introduction

Diabetes is a condition that results in blood sugar levels rising higher than average. Type 2 diabetes occurs when the body does not use insulin effectively and is the most common form of diabetes (Varanasi, 2012, p. 140). Type 1 diabetes is characterized by the immune system attacking insulin-producing cells in the pancreas, thus impairing the body's ability to produce insulin. Most effects of diabetes result from lack of blood glucose control, high blood pressure, and high cholesterol levels (Varanasi, 2012, p. 140).

Diabetes Prevalence and Impact

According to the article "Behavioral Interventions to Improve Glycemic Control in African Americans with T2DM," diabetes affects approximately 25.8 million people in the United States and is the seventh leading cause of mortality (Walker, 2013, p. 401). Diabetes is a significant cause of kidney failure, heart disease, and painful lower limb amputations. Recent research indicates that diabetes can also lead to blindness among adults, and 90% of diabetes cases are classified as type 2 diabetes. Due to its prevalence and economic burden, diabetes is considered one of the most challenging health issues of the 21st century (Walker, 2013, p. 401).

Disparities in Diabetes Outcomes

While type 2 diabetes can affect all racial and ethnic groups, ethnic minorities are more vulnerable to complications and mortality. Among these groups, non-Hispanic Black and Latino individuals in America are particularly at risk. African Americans diagnosed with diabetes are 2.6 times more likely to develop end-stage renal disease, and the likelihood of undergoing lower limb amputation is high. Researchers report that minority groups tend to have poorer self-management and outcomes compared to non-Hispanic Whites, increasing the disproportionate burden of disease and related complications. African Americans, in particular, experience worse outcomes, including glycemic control, compared to other minority groups and non-Hispanic Whites (Walker, 2013, p. 402).

Behavioral Interventions for Glycemic Control

Improving glycemic control requires lifestyle changes such as diet, exercise, and medication adherence, which have been proven to alter disease progression (Walker, 2013, p. 402). Behavioral interventions aim to enhance glycemic control and improve the quality of life for patients with type 2 diabetes. However, there is limited understanding of effective behavioral interventions for African Americans. A literature review was conducted to examine articles detailing the effectiveness of these interventions in improving glycemic control among African Americans (Walker, 2013, p. 403).

The study identified that effective behavioral interventions for African Americans with type 2 diabetes focus on problem-solving skills associated with self-management behaviors. The review indicated that interventions incorporating problem-solving improved glycemic control, suggesting its importance for African Americans with type 2 diabetes. Additionally, cultural tailoring, such as modifying dietary suggestions and involving local healthcare providers, can improve outcomes. Education providers play a critical role in intervention effectiveness, as African Americans often have trust issues with healthcare providers (Walker, 2013, p. 404).

Challenges and Limitations

Despite the potential benefits, there are limitations in understanding the effectiveness of behavioral interventions in improving glycemic control (Walker, 2013, p. 407). The research was limited to articles published between 2000 and 2012, and the review focused solely on glycemic control as an outcome, restricting the number of interventions examined. Future research should incorporate other outcomes, such as quality of life. Publication bias is possible, as studies with positive results are more likely to be published. The limited number of randomized controlled trials (RCTs) and heterogeneous methodologies posed challenges for meta-analysis (Walker, 2013, p. 407).

Conclusion

Further research is recommended to test the effectiveness of behavioral interventions for African Americans (Walker, 2013, p. 407). Studies should explore whether incorporating problem-solving improves glycemic control and examine the relationship between outcomes and the professionals providing interventions. The use of reminders in interventions was identified as an important factor in enhancing provider behavior. Targeted research on African Americans with type 2 diabetes is crucial for improving glycemic control through behavioral interventions (Walker, 2013, p. 408).

References

Varanasi, S. (2012). Diabetes and You: A Comprehensive, Holistic Approach. p. 140.

Walker, R. J. (2013). Behavioral Interventions to Improve Glycemic Control in African Americans with T2DM. Journal of Community Health, 38(2), 401-408.