title: The ABCs of diabetes: diabetes self-management education program for African Americans affects A1C, lipid-lowering agent prescriptions, and emergency department visits.
abstract: The purpose of the study was to examine the feasibility and impact of a concise community-based program on diabetes self-management education (DSME), according to frequency of emergency department visits and knowledge of, prescriptions for, and control of A1C, blood pressure, and low-density lipoprotein (LDL) cholesterol.
  
  
  
  A free community-based DSME program was placed in a public library. Adults with diabetes (N, 360) consented to participate in this prospective nonrandomized cohort study with preintervention-postintervention design. The small-group interactive DSME (two 2.5-hour classes) focused on improving cardiovascular disease risk factors and facilitating communication with the primary care physician.
  
  
  
  An increase in knowledge of American Diabetes Association-recommended targets for A1C, blood pressure, and LDL cholesterol from baseline to postintervention was seen among participants. Significant clinical outcomes included reduction in self-reported emergency department visits and reduction in mean A1C. However, despite an increase in prescriptions written for lipid-lowering drugs, blood pressure and LDL cholesterol did not change. Participants who started on insulin were more likely to achieve or maintain A1C < 7% compared to those who either did not take or stopped taking insulin during the study.
  
  
  
  Offering DSME classes for African Americans at a public library was feasible and significantly affected 6-month clinical outcomes, including a reduction in A1C, an increased likelihood of attaining a target A1C of < 7% if insulin was started during the study period, and a two-thirds reduction in emergency department visits for uncontrolled diabetes. Observed results suggest that partnering with community-based organizations such as public libraries offers an accessible and well-received location for offering DSME programs.
authors.affiliation: The MedStar Diabetes Institute, MedStar Health, Washington, DC (Magee, Youssef)|The Medstar Research Institute, MedStar Health, Washington, DC (Magee, Bowling, Fokar)
authors.forename: Michelle
authors.initials: M
authors.lastname: Magee
authors.affiliation: The Medstar Research Institute, MedStar Health, Washington, DC (Magee, Bowling, Fokar)
authors.forename: Andrea
authors.initials: A
authors.lastname: Bowling
authors.affiliation: The District of Columbia Department of Health Diabetes Prevention and Control Program, Washington, DC (Copeland)
authors.forename: James
authors.initials: J
authors.lastname: Copeland
authors.affiliation: The Medstar Research Institute, MedStar Health, Washington, DC (Magee, Bowling, Fokar)
authors.forename: Ali
authors.initials: A
authors.lastname: Fokar
authors.affiliation: The District of Columbia Public Libraries, Washington, DC (Pasquale)
authors.forename: Patricia
authors.initials: P
authors.lastname: Pasquale
authors.affiliation: The MedStar Diabetes Institute, MedStar Health, Washington, DC (Magee, Youssef)
authors.forename: Gretchen
authors.initials: G
authors.lastname: Youssef
mesh_terms: D000328:Adult; D001741:Black or African American; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000628:therapy*; D004219:District of Columbia; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007990:Libraries; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D012648:Self Care