Pilot Pragmatic Trial of a Community Paramedic Diabetes Self-Management Education Program for Adults With Diabetes

OBJECTIVETo 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 METHODSIn 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.RESULTSSeventy 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).CONCLUSIONSCP-led DSMES improved glycemic management and care engagement in underserved populations. This scalable model warrants further study.