PMID- 29256089
OWN - NLM
STAT- MEDLINE
DCOM- 20191111
LR  - 20191111
IS  - 1525-1497 (Electronic)
IS  - 0884-8734 (Print)
IS  - 0884-8734 (Linking)
VI  - 33
IP  - 4
DP  - 2018 Apr
TI  - Diabetes Mellitus Management Among Patients with Limited English Proficiency: A 
      Systematic Review and Meta-Analysis.
PG  - 524-532
LID - 10.1007/s11606-017-4237-1 [doi]
AB  - BACKGROUND: Patients with limited English proficiency (LEP) and type 2 diabetes 
      mellitus (T2DM) have several health disparities, including suboptimal 
      patient-provider interactions, poorer glycemic control, and T2DM complications. 
      Understanding existing interventions for improving T2DM outcomes in this 
      population is critical for reducing disparities. METHODS: We performed a 
      systematic review of randomized controlled trials (RCTs) and observational 
      studies examining the effectiveness of interventions in improving T2DM outcomes 
      among patients with LEP in North America. Quality was assessed using the Cochrane 
      risk of bias tool for RCTs and the Newcastle-Ottawa Scale for non-RCT studies. 
      Meta-analysis was conducted using the random-effects model. RESULTS: Fifty-four 
      studies, 39 of which reported sufficient data for meta-analysis of glycemic 
      control, were included. The interventions were associated with a statistically 
      significant reduction in hemoglobin A(1c) (HbA(1c)) (weighted difference in 
      means, -0.84% [95% CI, -0.97 to -0.71]) that was, however, very heterogeneous 
      across studies (I(2) = 95.9%). Heterogeneity was explained by study design (lower 
      efficacy in RCTs than non-RCTs) and by intervention length and delivery mode 
      (greater reduction in interventions lasting <6 months or delivered face-to-face); 
      P < 0.05 for all three covariates. The interventions were also associated in most 
      studies with improvement in knowledge, self-efficacy in diabetes management, 
      quality of life, blood pressure, and low-density lipoprotein cholesterol. 
      DISCUSSION: Multiple types of interventions are available for T2DM management in 
      patients with LEP. Multicomponent interventions delivered face-to-face seem most 
      effective for glycemic control. More research is needed to better understand 
      other aspects of multicomponent interventions that are critical for improving 
      important outcomes among patients with T2DM and LEP.
FAU - Njeru, Jane W
AU  - Njeru JW
AD  - Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA. 
      njeru.jane@mayo.edu.
FAU - Wieland, Mark L
AU  - Wieland ML
AD  - Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA.
FAU - Kwete, Gracia
AU  - Kwete G
AD  - Mayo Clinic School of Medicine, Mayo Clinic College of Medicine and Science, 
      Rochester, MN, USA.
AD  - Massachusetts General Hospital, Boston, MA, USA.
FAU - Tan, Eugene M
AU  - Tan EM
AD  - Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA.
FAU - Breitkopf, Carmen Radecki
AU  - Breitkopf CR
AD  - Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA.
FAU - Agunwamba, Amenah A
AU  - Agunwamba AA
AD  - Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 
      Mayo Clinic, Rochester, MN, USA.
FAU - Prokop, Larry J
AU  - Prokop LJ
AD  - Mayo Medical Library, Mayo Clinic, Rochester, MN, USA.
FAU - Murad, M Hassan
AU  - Murad MH
AD  - Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 
      Mayo Clinic, Rochester, MN, USA.
AD  - Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 
      Rochester, MN, USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20171218
PL  - United States
TA  - J Gen Intern Med
JT  - Journal of general internal medicine
JID - 8605834
SB  - IM
CIN - J Gen Intern Med. 2018 Jun;33(6):947. PMID: 29633126
MH  - *Communication Barriers
MH  - Diabetes Mellitus, Type 2/*ethnology/*therapy
MH  - *Disease Management
MH  - Humans
MH  - Observational Studies as Topic/methods
MH  - Randomized Controlled Trials as Topic/methods
MH  - Self Care/*methods
PMC - PMC5880756
OTO - NOTNLM
OT  - chronic disease
OT  - diabetes
OT  - disease management
OT  - health communication
OT  - language barriers
OT  - limited English proficiency
COIS- The authors declare that they do not have a conflict of interest.
EDAT- 2017/12/20 06:00
MHDA- 2019/11/12 06:00
PMCR- 2019/04/01
CRDT- 2017/12/20 06:00
PHST- 2017/03/06 00:00 [received]
PHST- 2017/11/13 00:00 [accepted]
PHST- 2017/06/14 00:00 [revised]
PHST- 2017/12/20 06:00 [pubmed]
PHST- 2019/11/12 06:00 [medline]
PHST- 2017/12/20 06:00 [entrez]
PHST- 2019/04/01 00:00 [pmc-release]
AID - 10.1007/s11606-017-4237-1 [pii]
AID - 4237 [pii]
AID - 10.1007/s11606-017-4237-1 [doi]
PST - ppublish
SO  - J Gen Intern Med. 2018 Apr;33(4):524-532. doi: 10.1007/s11606-017-4237-1. Epub 
      2017 Dec 18.