Grant: Operating Grant

South Asian patients have 50% higher rates of diabetes than the general population and a high prevalence of diabetes related complications. Despite this burden of disease, diabetes self-management remains poor in South Asian patients. They are less likely to exercise, change their diet and less likely to adhere to diabetes medications that are proven to reduce complications. The reasons why South Asian patients have poor diabetes management are multi-factorial, but include language, communication barriers with care providers, lack of knowledge on diabetes and its management, and fundamentally different cultural beliefs about medications and diabetes management. Previous trials of culturally tailored diabetes management programs have been unsuccessful. We believe that these studies were unsuccessful because they largely focused on language translation and did not address barriers to diabetes management that are prevalent in the South Asian community. We propose a randomized controlled trial to improve type 2 diabetes mellitus management in South Asian patients. South Asian patients with diabetes will be randomized to a culturally tailored diabetes self management education program with peer support and integration of family. The intervention will focus on lifestyle modification and medication adherence compared to usual care with diabetes education. Patients will be enrolled from primary care clinics in the cities within the Fraser Health Authority in British Columbia Canada. Patients and at least one family member will be randomized to the diabetes education and weekly peer sessions (individual and group) using motivational interviewing and goal setting for 3 months. The main outcome is diabetes control (ie. A1C level). Other measures of interest include knowledge diet, exercise, and medication adherence. Diabetes is a critical health care issue for South Asian patients and a new culturally tailored approach to diabetes management is urgently needed.