Peer-Led Diabetes Education Programs in High-RiskMexican Americans Improve Glycemic Control Compared With Standard Approaches

OBJECTIVE—To evaluate the effect of a culturally sensitive diabetes self-management edu-cation program that uses a low-cost, peer-educator format (Project Dulce) on glucose control and metabolic parameters in low-income Mexican Americans with type 2 diabetes. RESEARCH DESIGN AND METHODS—A total of 207 Mexican-American patients recruited from federally funded community health centers in San Diego County with HbA1c.8 % were randomly assigned to the Project Dulce peer intervention or continuation of standard diabetes care. The primary outcome of interest was HbA1c. RESULTS—Themajority of subjects were born inMexico, were female, were middle-aged, had less than an eighth-grade education, and had high baseline HbA1c levels. Significant time-by-group interaction effects for HbA1c (P = 0.02) and diastolic blood pressure (P = 0.04) indicated that the Project Dulce group exhibited greater improvement (i.e., decreases) across time.Within-group analyses showed that the intervention group exhibited significant improvements from baseline to month 4 in absolute levels of HbA1c (21.7%, P = 0.001) and HDL cholesterol (+1.4 mg/dL, P = 0.01) and from baseline to month 10 in absolute levels of HbA1c (21.5%, P = 0.01), total cholesterol (27.2 mg/dL, P = 0.04), HDL cholesterol (+1.6 mg/dL, P = 0.01), and LDL cholesterol (28.1 mg/dL, P = 0.02). No significant changes were noted in the control group