Background: The prevalence of Type 2 diabetes (T2D) is high among non-Hispanic Black persons. This population also has a high rate of poorly controlled T2D and a high burden of T2D related complications. To address this, various interventions have been studied to improve glycemic control. We performed a meta-analysis of published interventions on Black persons with T2D and their effects on HbA1c outcomes.
Methods: An electronic search of literature in PubMed, Scopus, CINAHL, PsycINFO, and Medline was conducted from 1985 to 20for studies evaluating T2D interventions among predominantly minority populations. This analysis was limited to non-pharmacologic randomized controlled trials (RCTs) and studies that had an average ≥12.5% of total participants identifying as Black, utilizing the 2020 US Census as standard. Interventions were aimed at improving outcomes including blood pressure, weight, and lipids. For this analysis, we focused on the outcome HbA1c and its differences between experimental and control groups. A random effects meta-analysis was performed to calculate the pooled effect size of the various outcomes. Results: For this analysis, 35 RCTs were included (n=6467) . The participants were 61% Black and 65% female with a mean age of 56 years. Interventions included interdisciplinary T2D management, telehealth-based support, lifestyle focused programs, and peer support programs. There was a statistically significant reduction in HbA1c in the experimental group when compared to the control group (-0.17, 95% CI -0.28 to -0.06, p<0.01, I2=70%) .
Conclusion: This meta-analysis found non-pharmacologic interventions were effective in reducing HbA1c among Black persons to a small degree. Future research is needed to estimate the effects of the level of intervention (i.e. individual, community, societal, or multi-level) in reducing HbA1c among this population to inform future public health programming and policy.
F.Osman: None. C.Jiang: None. A.Deckard: None. W.Wan: n/a. J.Alexander: None. E.M.Staab: None. A.W.Rodriguez: None. R.Shetty: None. N.Laiteerapong: None.