Self Management of Diabetes for Persons with HIV February 27, 2019 Self Management of Diabetes for Persons with HIV Julie Zuñiga, PhD, RN Research reported here was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number P30NR015335. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Purpose Report findings from the TCRSS pilot Discuss lessons learned from collecting biological samples Propose solutions to biological sample collection

Background 15% of people living with HIV also have a diagnosis of diabetes HIV and Diabetes have overlapping symptoms, and biological system activations (ie immune, vascular, neurological) Less than half of PLWH+DM are able to control both conditions adequately

Study Design and Population One group pre-test post-test of a diabetes self-management intervention that was adapted for PLWH+DM 6 hours of education and activities provided by an RN and SW Able to attend intervention meetings at David Powell Clinic Two study visits for survey data collection – Knowledge and Behaviors Fasting labs were to be drawn twice at a commercial lab– Viral Load, CD4, and A1c Adults, both conditions for at least 6 months

Findings (N=30) Over all attendance was low Increased specific self-management behaviors, such as checking shoes and feet Only 1 of the 24 who participated in the educational intervention completed both time sets of blood draw Unable to assess change in A1c, bench mark for diabetes care or other HIV labs Blood was not drawn during the study visit, participants had to go to a commercial lab

Solutions: Know your population Tailor intervention to population’s barriers and preferences Focus groups One-on-One interviews Point of Care (POC) technology Partnership with Health and Integrative Physiology (HIP) Lab DXA Scan POC for A1C and Lipids Primo Parking Cost is comparable,

Point of Care A1C: High reliability and validity for A1C Sample size of blood varies by machine Very high A1C might not be accurate Teaching can be done on the spot with immediate feedback of A1C level.

Lessons learned Trust you know your population Use fast technology for immediate feedback Maximize the time you have with your participants. Partner with researchers on campus

Next Steps Refining Self-Management model for PLWH+DM Identify pathway that can explain symptoms Develop an intervention that is acceptable for my population Based on large data set I have now funded by NINR

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