Key Findings from Presley’s GRADE EDS analyses:

• Long-Term Study: Researchers followed 1,739 participants with Type 2 Diabetes (T2DM) over three years, checking in with them every six months. During the three-year follow-up, 525 participants were expected to start long-acting insulin and 325 participants were expected to start rapid-acting insulin after reaching Hemoglobin A1c levels of higher than 7.5%.
• Insulin initiation was lower than expected: One-third of participants did not start long-acting insulin and two-thirds of participants did not start rapid-acting insulin.
• Emotional Distress was not associated with insulin initiation: The study found that emotional distress, including feelings of depression and specific worries about diabetes, was not related to a person’s decision about whether to start insulin.
• Support is Key: Other strategies are needed to support individuals who need to start insulin to achieve better blood glucose control; these may include demonstrations and examples about insulin use, discussion about benefits of insulin therapy, and collaborative decision-making.

Presley’s research is a collaborative effort that includes contributions from Forge AHEAD MPI Andrea L. Cherrington, M.D., MPH, a renowned expert in diabetes care. Their joint work showcases the collaborative nature of the Forge AHEAD Center, bringing together diverse expertise to tackle complex health issues.

Richard R. Rubin Lecture and Award

Presley’s presentation was part of the prestigious Richard R. Rubin Lecture. During the ADA conference, Paula M. Trief, Ph.D., received the 2024 Richard R. Rubin Award for her outstanding contributions to understanding the behavioral aspects of diabetes.

Presley’s Work at Forge AHEAD

In addition to her impactful presentation at the ADA Scientific Sessions, Presley is leading a core FAC project. Her project, “Remotely-delivered Mindfulness-Based Diabetes Education for Rural Adults with Uncontrolled Diabetes and Elevated Distress,” aims to test the feasibility and acceptability of an integrated Mindfulness-Based Stress Reduction (MBSR) and Diabetes Self-Management Education (DSME) program.

MBSR has been adapted to focus conditions, including hypertension and prediabetes, with a focus on relating mindfulness to specific behaviors or behavior change activities. However, few research studies have focused on rural populations with limited access to DSME. By combining MBSR and DSME, the project aims to help participants manage both their diabetes and their stress, improving their overall health and well-being.

Project Highlights:

• Primary Aim: To evaluate how well this new approach works for rural Black adults with Type 2 Diabetes who also experience high levels of distress.
• Study Locations: The program is being tested at Federally Qualified Health Centers in Alabama’s Black Belt region.
• Participants: The study will enroll 80 Black adults with Type 2 Diabetes, high blood sugar levels (hemoglobin A1c of 8.0% or higher), and high levels of stress related to diabetes.
• Community Partners: The Alabama Primary Health Care Association is helping to support and implement the study.
• Outcome Measures: Researchers are looking at how practical and acceptable the program is, with evaluations at the beginning and six months into the study.

The Forge AHEAD Center is at the forefront of advancing health equity through innovative research and community engagement. Presley’s work at the ADA Scientific Sessions and her ongoing projects exemplify our commitment to improving health outcomes in underserved communities.

To learn more Presley’s impactful research on remotely-delivered diabetes education and support, and to get involved, visit her project page here. Together, we can forge ahead towards a healthier, more equitable future.