Culturally sensitive diabetes education can lead to significant improvements in glycemic control for older African Americans with mild cognitive impairment, finds a new study.

Diabetes self-management education designed for ethnic minorities has been shown to improve quality of care and outcomes. But few of these interventions have targeted persons with mild cognitive impairment, though they are at higher risk for poor outcomes, the researchers said. The study compared the efficacy of this educational therapy, provided by a community health worker, with outcomes from an occupational therapy behavioral intervention provided by therapists versed in cognitive impairment. 

Participants entered the study with hemoglobin A1c levels of 7.5% or greater and poor medication adherence. Interventions were delivered in the home and were designed take cultural factors into account, including participants’ beliefs about medication and healthcare.

Both interventions were successful, reported geriatric psychiatrist Barry W. Rovner M.D. At six months, 61% of occupational therapy participants and 48% of diabetes self-management education participants had reduced their hemoglobin A1c level by at least 0.5%. At one year, the respective rates were 54% and 49%.

“This result reinforces the American Diabetes Associationʼs recommendation to assess cognition in older persons with diabetes and demonstrates the potential to improve glycemic control in this high‐risk population,” the authors concluded.

The study was published in the Journal of the American Geriatrics Society.