Expanding Diabetes Care and Prevention

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Patient education is an important part of diabetes outreach programs at Scripps.
Project Dulce has been fighting the diabetes epidemic for more than 16 years by providing diabetes care, self-management education and continuous support to low-income and uninsured populations throughout San Diego County.

Recognized for its impact, the comprehensive program serves as an international model of patient care and advocacy, helping individuals with the disease learn to improve their health — and their lives. In 2013, Project Dulce provided services to more than 20,000 patients through clinic-based services.

One of the primary components of the program is recruiting peer educators from the community to work directly with patients. These educators reflect the diverse population affected by diabetes and help teach others about changing eating habits, adopting exercise routines and other ways to help manage this chronic disease.

Dulce Mothers pilot program changes lives

In 2014, Project Dulce expanded its patient-focused efforts by creating Dulce Mothers, a pilot study specifically aimed at reducing type 2 diabetes and cardiovascular risk in Latino women through a culturally based curriculum.

“Although we’ve come a long way with diabetes care in the past three decades, there are still few prevention programs designed for low-income, Spanish-speaking populations,” says Athena Philis-Tsimikas, MD, corporate vice president of Scripps Whittier Diabetes Institute. “We want to help change that.”

Dulce Mothers included 84 participants, 18-45 years old, with a history of gestational diabetes mellitus (GDM). The women underwent an eight-week, peer educator-led group intervention tailored to the Latino culture and new mothers. Lifestyle changes and cardiovascular risks were assessed in participants at the beginning of the study, and at three and six months.

The results were extremely positive, with the women showing significant improvements in lipids, blood pressure levels, physical activity and dietary fat intake. The program also helped reduce preconceived ideas about the disease.

In FY14, Dulce Mothers will pilot another program with the goal of decreasing the incidence of type 2 diabetes by managing a major diabetes risk factor — obesity — in underserved, ethnically diverse populations. The program will test the effectiveness of a weight management curriculum designed for Latino women with gestational diabetes.