Not Scared of Sugar™: Outcomes of a structured type 2 diabetes group education program for Chinese Australians

Type 2 diabetes disproportionately affects the Chinese population yet there are no structured diabetes education programs specifically designed for this community in Australia. This project aimed to develop and evaluate a pilot type 2 diabetes group education program designed specifically for Chinese migrants living in Australia. A non-randomised pre- versus post-intervention trial was conducted between March 2017 and November 2018. A culturally tailored group education program (Not Scared of Sugar™) was developed and piloted with Melbourne-based Cantonese-speaking people with type 2 diabetes. Program teaching styles were aligned with the Confucian cultural process of learning and incorporated culturally specific strategies to promote healthy behaviour change. Thirty-four individuals (35% male) attended five education sessions over ten weeks, delivered by a Cantonese-speaking facilitator and multidisciplinary clinicians. Data were collected from participants at baseline, on program completion and at 6 months follow-up. Mean (SD) participant age was 69 (9) years, with a mean time of 25.7 (10.8) years in Australia and a median duration of diabetes of 10 (IQR = 2.8-20.5) years. At program completion, mean participant waist circumference (90.5 versus 89.2 cm, p < .001) and waist-to-height ratio (0.574 vs. 0.566, p < .001) was significantly reduced and both were further reduced at 6-month follow-up (p < .05). There was a significant increase in the median frequency of diabetes self-care behaviours undertaken, with American Association of Diabetes Educators Questionnaire Score: 30 (22-32.3) versus 33 (29.8-35.0), p < .001 at 6-month follow-up. Diabetes-related distress assessed by PAID-C was also significantly reduced at 6-month follow-up (p < .05). Mean HbA1c was unchanged after 6 months; 51 (7.9) versus 50 (7.8) mmol/mol, p = .316. Program attrition was 6%. Not Scared of Sugar™ successfully reduced waist circumference, increased diabetes self-management behaviours and reduced diabetes distress in Cantonese-speaking Australians, which may positively impact long-term risk of vascular complications.