Perspectives on Diabetes Care

This is the official blog of the Association of Diabetes Care & Education Specialists where we share recent research and professional opinions on diabetes care and education.


Explore Helpful Views on Diabetes Care & Education

If you're looking for professional opinions on diabetes care and education, you're in the right place. Perspectives on Diabetes Care is the official ADCES® diabetes care and education blog that shares helpful views on diabetes care and education. 

This is where you'll find practical tips on working with people affected by prediabetes, diabetes and related cardiometabolic conditions and the latest research and viewpoints on issues facing diabetes care and education specialists and the people they serve.



Current & Past ADCES Blog Articles


ADCES24 Research Roundtables Series: How Social Determinants of Health Impact Diabetes Care and Education

Jun 3, 2024, 12:28 PM

By Eva Vivan, PhD

Dr. Vivian will share her findings in conversation this August at the ADCES24 Annual Meeting, where she is a featured contributor to the Research Roundtables Sessions. She can be reached for questions at [email protected].

Social determinants of health (SDOH) are linked to generational and cyclical factors, with parental influence affecting environment and quality of health care, among other determinants of health. In her years working with patients with diabetes in a pharmaceutical capacity, Eva Vivian, PhD, observed the myriad of factors impacting these patients as she expanded her own patient outreach to work with underserved communities. As she studied children at risk for diabetes within a Federally Qualified Health Center in Wisconsin, Dr. Vivian discovered that caregivers were of the greatest influence on children’s health.

Inspired to intervene at the caregiver level with a narrower focus, she turned her attention to grandmothers in the African-American community, many of whom are at risk for diabetes. Dr. Vivian developed the HOPE (Healthy Outcomes through Peer Educators) program to expand access to care, as Diabetes Prevention Programs and transportation are often inaccessible to this population. Working with a community senior center in Milwaukee, WI, she identified women who could serve as peer educators and support other women in the community.

Many of Dr. Vivian’s recruits struggled with access to fresh produce, as many must rely on convenience stores and local options. Many of the women, feeling unsafe walking in their own neighborhoods, formed a walking group to support each other and build exercise opportunities. Dr. Vivian found that the HOPE Program helped the women become more physically active, eat healthier and build social capital; the women worked together to counteract inhibiting factors such as lack of access to healthy foods or safety issues. She found that the women she recruited stayed in the peer education program, became active and lost weight, and 40% were able to reduce A1C. Many of the women were motivated to change their own behaviors as they realized their impact on the health of their grandchildren, creating change within the household and driving SDOH. Dr. Vivian is now recruiting again for a new study – this time both grandparents and grandchildren, as she aims to measure more directly the generational impact of health care.


Eva Vivian, PhD, is a professor at the University of Wisconsin-Madison School of Pharmacy. She received her Doctor of Pharmacy degree from the University of Illinois College of Pharmacy in 1995, Master of Science in Population Health from the University of Wisconsin School of Medicine and Public Health in 2013, and Doctorate of Philosophy from the University of Wisconsin-Madison School of Human Ecology in 2020. Dr. Vivian pushes for equity in underserved communities, with a specific emphasis on diabetes prevention. Her Healthy Outcomes through Peer Educators (HOPE) project in Madison and Milwaukee focuses on providing African-American community members with information and strategies to help prevent or manage type 2 diabetes.