October 12, 2009

School of Nursing researcher expands diabetes study among Korean-Americans

A new Johns Hopkins University School of Nursing study will test a community-based glucose control intervention program for Korean-American immigrants who have type-2 diabetes mellitus.

Miyong Kim, a professor in Nursing Systems and Outcomes, has been awarded a $3.1 million grant for the study. Throughout her career, Kim has conducted immigrant community–based, culturally sensitive research aimed at educating people on better health and preventing disease. Her five-year study, which started in September, will involve patients in the Baltimore-Washington area.

A pilot study that included 79 participants with type-2 diabetes, which Kim conducted in the same area from 2006 to 2008, yielded what she called “very promising” results—a more than 1 percent hemoglobin A1C reduction in the intervention group—and shed “much light upon diabetes mellitus control and [the] prevention of life-threatening complications.”

The intervention in the pilot and upcoming studies have three key components: a culturally sensitive education program designed to develop skills that patients can use to control their diabetes, a glucose and blood pressure machine with a phone transmission system to assist in self-monitoring, and telephone counseling and case management by a bilingual nurse who prepares participants to better communicate with their medical providers.

According to Kim, Korean-Americans are among the most medically underserved ethnic groups in the country. Her new study is being done to increase those patients’ ability to manage diabetes, which in turn will prevent complications. Her previous research found that a high number of Korean-American immigrants suffer from uncontrolled diabetes, and that their lack of adequate health care results in part from their sense of isolation due to language and cultural barriers. More than half of Korean American immigrants, she said, lack health insurance, and few go for routine checkups. Their risk for diabetes is increased by the fact that Asian emigrants to the West tend to gain weight and develop type-2 diabetes and other chronic diseases.

Low health literacy among Korean immigrants is worsening “the already high rates of undetected, undertreated or poorly managed chronic illnesses, often leading  to costly and tragic consequences,” Kim said.

The prevalence of diabetes among Asian-Americans generally, and Korean-Americans specifically, is “alarmingly high” and requires “immediate attention,” she said. “There is a strong need for effective, community-based interventions. This community-based diabetes intervention project is the very first of its kind for Korean-Americans during their U.S. immigration history, which dates more than 100 years.”