What is the clinical evidence from this study?

Study design: Cohort. Population: Uncontrolled type 2 diabetes mellitus (T2DM) (n=50). Intervention: Population health-enhanced DSMES program vs. Baseline (pre-intervention). Primary outcome: T2DM control (A1c change) (Median decrease -2.1, p=<0.0001).

What does this research mean for the field?

A population health-enhanced Diabetes Self-Management Education and Support (DSMES) program that includes supplemental social support services is feasible and significantly reduces A1c levels in urban patients with uncontrolled type 2 diabetes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

June 7, 2026

2751-LB: Implementing a Population Health–Enhanced DSMES Program

Q: What are the key findings of this study?

A population health-enhanced DSMES program significantly reduced A1c in patients with uncontrolled T2DM, with a median decrease of 2.1% for individual participants (P<0.0001).

Q: What does this research mean for the field?

A population health-enhanced Diabetes Self-Management Education and Support (DSMES) program that includes supplemental social support services is feasible and significantly reduces A1c levels in urban patients with uncontrolled type 2 diabetes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

The central aim was to assess the feasibility of a new Diabetes Self-Management Education and Support (DSMES) program for Black individuals with uncontrolled T2DM in a community setting.

Key Result

A population health-enhanced DSMES program significantly reduced A1c in patients with uncontrolled T2DM, with a median decrease of 2.1% for individual participants (P<0.0001).

Key Points

The central aim was to assess the feasibility of a new Diabetes Self-Management Education and Support (DSMES) program for Black individuals with uncontrolled T2DM in a community setting.
Conducted a feasibility study with 50 patients from Jul-Dec 2025 at an urban community hospital.
Enrolled patients with uncontrolled T2DM in individual or group DSMES sessions, recording demographics and health characteristics.
Evaluated primary outcomes of engagement, support service usage, and A1c control using Wilcoxon signed-rank tests.
Individual participants experienced a median decrease in A1c of -2.1 after 27 weeks (Z= -4.486, P<0.0001, r= -0.75).
Group participants showed a median A1c decrease of -1.3 after 21 weeks (Z= -2.497, P=0.0098, r= -0.79).
Participants attended 100% of sessions on average, with 16.7% receiving UberHealth assistance.

Study Design

Type

Cohort (n=50)

Multicenter

Structured PICO

Does a Population Health-enhanced DSMES program improve A1c and engagement in patients with uncontrolled T2DM?

Population

50 patients with uncontrolled T2DM enrolled in a feasibility study of a population health-enhanced DSMES program, followed for a mean of 21 to 27 weeks.

Intervention

Diabetes Self-Management Education and Support (DSMES) program with embedded Population Health services (standard ADA educational curriculum plus extra nutrition and transport services).

Outcome

Engagement (DSMES hours/patient or percent sessions attended), support services (UberHealth use), and T2DM control (A1c change).surrogate

A Population Health-enhanced DSMES program with supplemental support services like transportation is feasible and significantly improves A1c in urban patients with uncontrolled T2DM.

Main Result

Effect estimate: Median decrease -2.1

p-value: p=<0.0001

Abstract

Introduction and Objective: People with T2DM who are Black and of lower SES often carry a higher disease burden in the US. Social determinants of health (SDoH) influence this, such as nutrition access and transportation to appointments. The ADA designed the Diabetes Self-Management Education and Support (DSMES) Program to standardize education but SDoH still act as barriers to care. Methods: We conducted a feasibility study with 50 patients to evaluate a new DSMES program with embedded Population Health services at our urban community hospital from Jul-Dec 2025. We enrolled patients with uncontrolled T2DM in individual or group visits per patient preference. We recorded demographics, social factors and baseline disease characteristics. We taught the standard ADA educational curriculum and offered extra nutrition and transport services. Our primary outcomes were of engagement (DSMES hours/patient or percent sessions attended); support services (UberHealth use); and T2DM control (A1c change). We used Wilcoxon signed-rank tests to compare our primary metrics before and after the program. Results: Forty individuals (65% female, 60% non-Hispanic Black) and 10 group participants (70% female, 70% NH Black) were included. We spent 1-2 hours with most (N=24) individuals. Excluding one patient lost to follow-up, the group participants who completed the program attended a median (IQR) of 100% (83.3%, 100%) of 6 sessions. To support transportation needs, we provided UberHealth for 16.7% of individuals and 60% of group participants. The Wilcoxon signed-rank test showed a significant decrease in A1c from program start to end for individuals, with a median (IQR) decrease of -2.1 (-3.65, -0.5) after a mean follow-up time of 27 weeks (Z= -4.486, P0.0001, r= -0.75), and for group participants, with a decrease of -1.3 (-3.1, -0.6) after a mean follow-up time of 21 weeks (Z= -2.497, P=0.0098, r= -0.79). Conclusion: Implementing individual and group DSMES programs with supplemental support services for Baltimore City patients with T2DM was feasible at our urban community hospital. Disclosure E.B. Costello: None. L.M. Davis: None. E. Getlan: Stock/Shareholder; Current; Dexcom, Inc. K. Whitaker: None. S. Bose: None. A. Limpuangthip: None.

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