Behavioral Interventions to Improve Glycemic Control in African Americans with T2dm

Diabetes is predicament with the body that results in blood sugar level to rise higher than the average levels. Type 2 diabetes that is indicated by the situation when the body does not make use the insulin well and is the most common type of diabetes (Varanasi, 2012 p. 140). Type 1 diabetes is indicated by state when the body immune system assail the insulin-producing cells in the pancreas thus destroying the body’s ability to produce or manufacture insulin. Most of the effects of diabetes result from lack of blood glucose control, high blood pressure, and high cholesterol levels (Varanasi, 2012 p. 140).

Prevalence and Impact of Diabetes

From the article, it is deduced that diabetes affected approximately 25.8 million people of the total United States population and regarded as seventh leading cause of mortality in United States (Walker, 2013 p.401). Diabetes is one of the significant causes of kidney failure, heart disease, and painful lower limb amputations. Recent research also indicates that, diabetes can also cause blindness among adults and that 90 percent of diseases caused by diabetes classified as type 2 diabetes. Because of the dominance and economic burden if diabetes, it is regarded as the most challenging health hurdle of the 21st century (Walker, 2013 p.401).

Disparities in Diabetes Among Ethnic Groups

Though type 2 diabetes is a can affect all groups of people in terms of race and ethnicity, the ethnic minorities are said to be the most affected and exposed to high risks of complications and mortality. Among the ethnic groups, the most vulnerable ones are the non-Hispanic Black and Latinos residing in America. Once African Americans diagnosed, they are 2.6 time more probable to develop final-stage renal disease and the chances to undergo lower limb amputation is high. Report from researchers states that, the minority groups are more likely to have shoddier self-management and effects compared to non-Hispanic White. It increases the disproportionate burden of disease that already exists and adding the disproportion to complications relating to diabetes. African Americans in specific have propensity to experience worse outcomes that include glycemic control compared to other minority groups and non-Hispanic Whites (Walker, 2013 p.402).

The Role of Lifestyle Changes

In improving glycemic control, lifestyle changes such as diet, exercise, and medication adherences are a necessity and have been proved to alter the progression of diseases through improvement of glycemic control (Walker, 2013 p.402). Behavioral interventions are used to improve glycemic control and also improve patients with type 2 diabetes ‘quality of life. However, there is no clear understanding of behavioral interventions for African Americans. For this reason, a literature review was conducted examine the results in articles elaborates the effectiveness of behavioral interventions towards improving glycemic control in African Americans (Walker, 2013 p.403).

Findings on Behavioral Interventions

From the study, it was identified that effective behavioral interventions in African Americans with type 2 diabetes based on the impact on glycemic control. From the study, it was noted that aspect of problem-solving was used to find solutions and positive problem-solving skills associated with self-management behaviors (Walker, 2013 p.404). The review indicated that of all the interventions allowed for problem-solving, half of them improved glycemic control that suggested that problem-solving may be a crucial aspect when indulging African Americans with type 2 diabetes. Also, it was deduced that, cultural tailoring can improve outcomes that include modifying dietary suggestions, provide demonstrations, discuss choices of food at social events and using local health care providers. It can be done by involving education providers as they are regarded to be important in intervention effectiveness because African Americans indicates to have trust issues with health care providers (Walker, 2013 p.402).

Economic Burden and Limitations

From the reviews, it is seen that, African Americans have the highest probabilities of diabetes diagnosis and greater disability from complications relating to diabetes than the non-Hispanic Whites. Also, it is deduced that the medical cost of people living with diabetes is double the medical expenses of those people living without diabetes. In the process of trying to understand the effectiveness of behavioral interventions in improving glycemic control, there are limitations encountered (Walker, 2013 p.407). It limited the findings that include: the research was constrained to articles published in the year 2000 and the year 2012. Another challenge was that the review was limited to understanding of glycemic control as an outcome that restricts the number of interventions being examined. But it can be improved by incorporating behavioral intervention such as quality of life as another expected outcome. Also, publication biases are possible since the chances of publishing results of studies with positive are high. The limited number of RCTs and heterogeneous methodology posed as a challenge in performing meta-analysis during the review of the literature (Walker, 2013 p.407).

Future Research Directions

In conclusion, it is advised that, research should be conducted further to test the effectiveness of behavioral interventions in African Americans (Walker, 2013 p.407). Studies should be done to investigate whether problem-solving should be incorporated to improve glycemic control of the provision of information without inclusion of problem-solving is effective. Also, further investigations should be conducted to determine the relationship that exists between the outcomes and the persons of professionals providing the interventions. Also, use of reminders in interventions was seen to be an important contributor to the effectiveness of provider behavior and that the research targeted African American with type 2 diabetes for behavioral interventions in improvement of glycemic control (Walker, 2013 p.408).