{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:00:05Z","timestamp":1791554405215,"version":"4.3.4"},"reference-count":15,"publisher":"American Diabetes Association","issue":"12","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"Mayo Clinic Center for Health Equity"},{"name":"Montgomery County, Maryland and The University of Maryland Strategic Partnership"},{"name":"MPowering the State"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To evaluate the impact of community paramedic (CP)-delivered, in-home diabetes self-management education and support (DSMES) for adults with poorly managed diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>In a pragmatic, single-arm pilot trial, adults with HbA1c \u22659% 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Seventy 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 &amp;lt; 0.001). Engagement with primary care, endocrinology, and DSMES improved. Satisfaction was high (mean rating 9 out of 10).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>CP-led DSMES improved glycemic management and care engagement in underserved populations. This scalable model warrants further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc25-1580","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T18:08:57Z","timestamp":1759860537000},"page":"2089-2094","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":3,"title":["Pilot Pragmatic Trial of a Community Paramedic Diabetes Self-Management Education Program for Adults With Diabetes"],"prefix":"10.2337","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1707-8985","authenticated-orcid":false,"given":"Allison","family":"Ducharme-Smith","sequence":"first","affiliation":[{"name":"Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine 1 , Mayo Clinic, Rochester, MN"},{"name":"Mayo Clinic Ambulance 2 , Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Juntunen","sequence":"additional","affiliation":[{"name":"Mayo Clinic Ambulance 2 , Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Espinoza","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, & Nutrition, Department of Medicine 3 , Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad","family":"Liedl","sequence":"additional","affiliation":[{"name":"Mayo Clinic Ambulance 2 , Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Fischer","sequence":"additional","affiliation":[{"name":"Clinical Trials and Biostatistics 4 , Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Meilander","sequence":"additional","affiliation":[{"name":"Early Cancer Therapeutics 5 , Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaxon","family":"Quillen","sequence":"additional","affiliation":[{"name":"Clinical Trials and Biostatistics 6 , Mayo Clinic, Phoenix, AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rozalina G.","family":"McCoy","sequence":"additional","affiliation":[{"name":"Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine 1 , Mayo Clinic, Rochester, MN"},{"name":"Mayo Clinic Ambulance 2 , Rochester, MN"},{"name":"Division of Endocrinology, Diabetes, & Nutrition, Department of Medicine 3 , Mayo Clinic, Rochester, MN"},{"name":"University of Maryland Institute for Health Computing 7 , North Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"2026061714581467700_B1","article-title":"2019\u20132021 National Health Interview Survey (NHIS)","author":"National Center for Health Statistics, Centers for Disease Control and Prevention."},{"key":"2026061714581467700_B2","doi-asserted-by":"crossref","first-page":"26","DOI":"10.2337\/dci23-0085","article-title":"Economic costs of diabetes in the U.S. in 2022","volume":"47","author":"Parker","year":"2024","journal-title":"Diabetes Care"},{"key":"2026061714581467700_B3","doi-asserted-by":"crossref","first-page":"e200618","DOI":"10.1001\/jamanetworkopen.2020.0618","article-title":"Association of neighborhood measures of social determinants of health with breast, cervical, and colorectal cancer screening rates in the US Midwest","volume":"3","author":"Kurani","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2026061714581467700_B4","doi-asserted-by":"crossref","first-page":"1358-P","DOI":"10.2337\/db23-1358-P","article-title":"Disparities in acute and chronic complications of diabetes in rural U.S","volume":"72","author":"Steiger","year":"2023","journal-title":"Diabetes"},{"key":"2026061714581467700_B5","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1056\/NEJMsa2032271","article-title":"Trends in diabetes treatment and control in U.S. adults, 1999-2018","volume":"384","author":"Fang","year":"2021","journal-title":"N Engl J Med"},{"key":"2026061714581467700_B6","doi-asserted-by":"crossref","first-page":"e3410","DOI":"10.1002\/dmrr.3410","article-title":"Burden and management of type 2 diabetes in rural United States","volume":"37","author":"Dugani","year":"2021","journal-title":"Diabetes Metab Res Rev"},{"key":"2026061714581467700_B7","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1111\/scs.12659","article-title":"The core components of Community Paramedicine - 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