Barbara Davis Center, University of Colorado, Aurora, Colorado.
Pediatr Diabetes. 2019 Jun;20(4):468-473. doi: 10.1111/pedi.12852. Epub 2019 Apr 15.
BACKGROUND/OBJECTIVE: Latino patients with type 1 diabetes (T1D) face cultural and language barriers leading to poor outcomes. Shared medical appointments (SMAs) are recognized as effective models of care. Our aim is to develop a culturally sensitive, cost effective SMA program for Latino T1D.
Spanish speaking Latinos 1 to 20 years with T1D (n = 88) and their families.
Routine care alternating with SMAs that included group education was provided. Teens, ages >11 received the SMA separate from parents. Younger children were seen together. Hemoglobin A1c (HbA1c), behavioral questionnaires, and use of diabetes technology were measured at baseline and every 3 to 6 months.
57.7% of children and 77.27% of teens completed the 2 years of the Program. There was a significant association between age and change in HbA1c from baseline to year 1 (P = .001) and baseline to year 2 (P = <.0001). For participants <12 years, there was a significant improvement in HbA1c from baseline to year 1 (P = .0146) and from year 1 to year 2 (P = .0069). Participants ≥12 years, had an increase in HbA1c from year 1 to year 2 (P = .0082). Technology use increased significantly from baseline to year 2 for participants <12 years of age (19%-60%, P = .0455) and for participants who were ≥12 years of age (10%-23%, P = .0027). Participants reported a 98% satisfaction rate.
The culturally sensitive SMA proved to be an appreciated, feasible, and effective alternative to care for Latinos with T1D.
背景/目的：患有 1 型糖尿病（T1D）的拉丁裔患者面临着文化和语言障碍，导致治疗效果不佳。共同就诊（SMA）被认为是一种有效的治疗模式。我们的目标是为拉丁裔 T1D 患者开发一种文化敏感且具有成本效益的 SMA 项目。
西班牙语裔拉丁裔 1 至 20 岁的 T1D 患者（n=88）及其家属。
提供常规护理和 SMA 交替服务，其中包括小组教育。11 岁以上的青少年将在与父母分开的 SMA 中接受治疗。年幼的孩子则一起接受治疗。在基线和每 3 至 6 个月测量糖化血红蛋白（HbA1c）、行为问卷和糖尿病技术的使用情况。
57.7%的儿童和 77.27%的青少年完成了该项目的 2 年治疗。从基线到第 1 年（P=0.001）和从基线到第 2 年（P<.0001），HbA1c 的变化与年龄之间存在显著关联。对于<12 岁的参与者，HbA1c 从基线到第 1 年（P=0.0146）和从第 1 年到第 2 年（P=0.0069）都有显著改善。≥12 岁的参与者从第 1 年到第 2 年 HbA1c 有所增加（P=0.0082）。对于<12 岁的参与者，从基线到第 2 年，技术使用率显著增加（19%-60%，P=0.0455）；对于≥12 岁的参与者，技术使用率也显著增加（10%-23%，P=0.0027）。参与者的满意度为 98%。
这种文化敏感的 SMA 被证明是一种为拉丁裔 T1D 患者提供的可接受、可行且有效的治疗替代方案。
