2025/10/07 by Allison Ducharme‐Smith, Michael B. Juntunen, Anna Espinoza +5 · 1 voice
Health Professions · Medicine · #Diabetes Management and Education #Hyperglycemia and glycemic control in critically ill and hospitalized patients #Primary Care and Health Outcomes
paper · doi:10.2337/dc25-1580
openalex publication_date 2025/10/07 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/28
OBJECTIVE: To evaluate the impact of community paramedic (CP)-delivered, in-home diabetes self-management education and support (DSMES) for adults with poorly managed diabetes. RESEARCH DESIGN AND METHODS: In a pragmatic, single-arm pilot trial, adults with HbA1c ≥9% and a recent emergency department or hospital visit received a 1-month CP-led DSMES intervention. Outcomes included HbA1c, health care engagement, and patient-reported satisfaction. RESULTS: Seventy participants (median age 61 years, 50% rural, 84% with type 2 diabetes) completed the intervention. HbA1c declined from 9.8% to 8.2% at 4 months (P < 0.001). Engagement with primary care, endocrinology, and DSMES improved. Satisfaction was high (mean rating 9 out of 10). CONCLUSIONS: CP-led DSMES improved glycemic management and care engagement in underserved populations. This scalable model warrants further study.