國家衛生研究院 NHRI:Item 3990099045/10938

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Title:	Multidimensional effects of a diabetes management program in a Taipei community hospital - a 7-year prospective follow-up study
Authors:	Hsu, CC;Chang, YK;Lin, JY;Wong, PY;Lin, IC;Lien, IJ;Chung, CH;Tai, TY
Contributors:	Institute of Population Health Sciences
Abstract:	Background: Multidisciplinary diabetes management program has often been deemed as the important strategy to improve quality of diabetes care. However, value-added effects of the embodied health education remain unclear. We therefore used a 7-year longitudinal diabetes cohort to demonstrate the effects of usual medical care and the additional benefits to diabetes control after implementing an accredited diabetes management program in a community hospital. Methods: We used descriptive statistics and trajectory analyses to investigate the changes of diabetes care indicators in two time periods: before and after implementation of the diabetes management program. The investigated diabetes care indicators included fasting blood glucose, HbA1c, blood pressure, triglyceride, total cholesterol, low-density lipoprotein cholesterol (LDL-C), smoking rate and frequency of exercise per week. Results: Since 2006, the investigated community hospital has implemented a diabetes management program, strengthening dietetic consultation, health education, and case management. The data surveillance center has currently recorded 300 enrollees to this program. Of the enrollees, 52.7% were male, 52.0% had education level ≦6 years, mean age was 61.2 ± 10.4 years at the first visit, and diabetes duration was 8.6 ± 8.0 years upon participating in the program. Compared to one year before participation, the following indicators had been significantly improved one year after recruited in the diabetes management program: diastolic blood pressure (75.5 vs. 74.0 mmHg; P = 0.001), fasting blood sugar (148.9 vs. 135.0 mg/ dL; P < 0.001), HbA1c (8.0 vs. 7.4%; P < 0.001), total cholesterol (192.6 vs. 181.4 md/dL; P < 0.001), LDL-C (121.2 vs. 113.4 mg/dL; P = 0.007), triglyceride (181.2 vs. 152.3 mg/dL; P = 0.011), male smoking rate (30.1 vs. 25.8%; P = 0.032), and regular exercise (3.7 vs. 4.1 times per week; P < 0.001). Inspecting the 7-year trajectory pattern, we found systolic and diastolic blood pressure, total cholesterol, and LDL-C had continuously been reduced since the patients received usual medical care; however, glycemic control, triglyceride level, male smoking rate, and frequency of exercise have not been improved until the diabetes patients were recruited in the diabetes management program. Conclusion: Our results indicate the healthy behaviors modification, an essential component in diabetes management, can be effectively strengthened by multidisciplinary care in the accredited diabetes management program. Without health education and dietetic consultation, the usual medical care provided by physicians alone is hard to optimize diabetes care, especially in bettering glycemic control, normalizing triglyceride level and changing healthy lifestyle.
Date:	2016-10
Relation:	Diabetes Research and Clinical Practice. 2016 Oct;120(Suppl. 1):S58-S59.
Link to:	http://dx.doi.org/10.1016/S0168-8227(16)31043-9
JIF/Ranking 2023:	http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0168-8227&DestApp=IC2JCR
Cited Times(WOS):	https://www.webofscience.com/wos/woscc/full-record/WOS:000416113300173
Appears in Collections:	[Chih-Cheng Hsu] Conference Papers/Meeting Abstract

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