Association between diabetes self-management education and glycemic control in patients living with type 2 diabetes in French Guiana: a cross-sectional analysis of the CODIAM cohort study.
. The prevalence of diabetes mellitus in French Guiana (11.6%) is marked by a significant proportion of type 2 diabetes (T2D). The high level of poverty and ethnic diversity of the French Guiana population may limit access to care, delay diabetes management and increase the risk of complications. Diabetes Self-Management Education (DSME) teams have been implemented since 2017 to improve diabetes care in the region. This study aimed to evaluate the effect of DSME on glycemic control in patients living with type 2 diabetes (T2D) in French Guiana.
. - This cross-sectional study analyzed inclusion data from patients living with T2D who participated in the French Amazon Diabetes Cohort Study (CODIAM) conducted between April 2019 and June 2021. The main outcome was the achievement of the patient's individual HbA1c target. Associations between the main outcome and DMSE were investigated with simple and multiple regression analysis.
. - Among the 796 included participants, 51.3% were women with a median age of 58 years. Individualized HbA1c targets were achieved by 35.3% of participants, and 38% had attended at least one DSME session. Participation in DSME was associated with higher odds of achieving the HbA1c target. Participants with better glycemic control were more likely to be older, more likely to have been born in France, in a relationship, not working, and had better French-language proficiency. Clinically, these participants more frequently had comorbidities and a longer duration of disease. No association was found between glycemic control and gender or education level.
. - These results suggest that DSME may improve glycemic control in patients living with T2D in French Guiana, in the context of a multicultural population with high precarity levels and low health literacy. Improving and guaranteeing the access to DSME to all is thus critical, in particular for the most vulnerable.
. - This cross-sectional study analyzed inclusion data from patients living with T2D who participated in the French Amazon Diabetes Cohort Study (CODIAM) conducted between April 2019 and June 2021. The main outcome was the achievement of the patient's individual HbA1c target. Associations between the main outcome and DMSE were investigated with simple and multiple regression analysis.
. - Among the 796 included participants, 51.3% were women with a median age of 58 years. Individualized HbA1c targets were achieved by 35.3% of participants, and 38% had attended at least one DSME session. Participation in DSME was associated with higher odds of achieving the HbA1c target. Participants with better glycemic control were more likely to be older, more likely to have been born in France, in a relationship, not working, and had better French-language proficiency. Clinically, these participants more frequently had comorbidities and a longer duration of disease. No association was found between glycemic control and gender or education level.
. - These results suggest that DSME may improve glycemic control in patients living with T2D in French Guiana, in the context of a multicultural population with high precarity levels and low health literacy. Improving and guaranteeing the access to DSME to all is thus critical, in particular for the most vulnerable.
Authors
Carbonnier Carbonnier, Lambert Lambert, Fanou Fanou, Giove Giove, Faurous Faurous, Mergeay-Fabre Mergeay-Fabre, Adenis Adenis, Fahrasmane Fahrasmane, Ntoutoum Ntoutoum, Tabellah Tabellah, Aurelus Aurelus, Mistlin-Tritsch Mistlin-Tritsch, Nacher Nacher, Sabbah Sabbah
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