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Food Label Use Improves Dietary Quality and Mediates Improved Glycemic Control in Latinos with Type 2 Diabetes: The DIALBEST trial
Author(s) -
SAMUEL GRACE KOLLANNOOR,
Shebl Fatma M,
SeguraPérez Sofia,
Chhabra Jyoti,
VegaLópez Sonia,
PérezEscamilla Rafael
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.422.5
Subject(s) - medicine , glycemic , glycated hemoglobin , type 2 diabetes , randomized controlled trial , intervention (counseling) , gerontology , generalized estimating equation , odds ratio , glycemic index , diabetes mellitus , physical therapy , endocrinology , nursing , statistics , mathematics
Background Culturally‐ and health literacy‐appropriate education has proven benefits in type 2 diabetes management among Latinos who disproportionately suffer from the disease and related complications. There is limited empirical evidence documenting the effect of diabetes‐specific education on food label (FL) use. Similarly, little is known about the effect of FL use on glycemic control among individuals with T2D. Objectives To determine the impact of a community health worker (CHW)‐led intervention on FL use, and if FL use and diet mediate the intervention's impact on blood glucose control. Methods Latinos (N=203; intervention=100; control=103) with type 2 diabetes were enrolled in a randomized control trial and assessed at baseline, 3, 6, 12 and 18 months. Intervention included 17 home‐based sessions over a 12‐month period from CHWs in addition to the ‘standard of care’ available to all. Data on FL use, dietary quality (Healthy Eating Index‐2010 assessed from one 24hr recall), covariates, and glycemic control (glycated hemoglobin (HbA1c)) were collected at baseline, 3, 6, 12 and 18 months. Data were analyzed using mixed effects and multi‐level structural equation modelling. Results FL use among the intervention group (vs. control) was significantly higher at 3, 12, and 18m; Overall repeated measures analyses suggests higher odds of FL use among the intervention participants compared to the controls [OR=2.99 (95% CI: 1.69, 5.29)]. FL use and dietary quality mediated improved HbA1c levels [intervention vs. controls: −0.09% (−0.23, −0.02)]. Conclusions Culturally tailored CHWs‐led intervention increased FL use. FL use and better dietary quality mediated the HbA1c intervention effect among Latinos with type 2 diabetes. Support or Funding Information This study was funded by the Connecticut NIH Export Center for Eliminating Health Disparities among Latinos (NIH‐ NCMHD grant # P20MD001765 to Rafael Pérez‐Escamilla).