Authors (including presenting author) :
Wong RYM (1), Leung BSF (2), Lau MSW (2), Lin GLH(3), Yeung SK (3), Lee KY (1), Leung WS(2)
Affiliation :
(1) Diabetes and Endocrine Centre, Prince of Wales Hospital, (2) Diabetes and Endocrine Centre, Alice Ho Miu Ling Nethersole Hospital, (3) Diabetes and Endocrine Centre, North District Hospital
Introduction :
The globally rising prevalence of diabetes and associated late complications is posing immense pressure on the health care system. The optimal diabetic control should aim at glycated hemoglobin (HbA1c) 7%, blood pressures (BP) <130/80 mmHg and low density-lipoprotein cholesterol (LDL-C) <2.6 mmol/l. Studies shown optimal control of risk factors reduced risks of micro- and macrovascular complications, but the rates of attaining metabolic targets remained poor. These low attainment rates might be in part due to suboptimal adherence to self-care activities and lifestyle modification through lack of knowledge and motivation.
Objectives :
To empower diabetic patients to understand the targets of optimal diabetic control and strategies to achieve lifestyle modification and self-care activities
Methodology :
After attending diabetic complication screening (DCS), patients would be arranged to attend a 1.5 hours empowerment program. Patients would receive their own DCS reports and an educational pamphlet on chronic diabetic complications. The pamphlet was a structured summary of the patient’s recent metabolic profile highlighting: HbA1c, lipids, renal function and blood pressure. It was given to the patient with the intention to empower the patient in self-care, understanding on optimal diabetes control, risks of complication and management of diabetes. Patients were invited to fill in a self-developed knowledge questions before and after the program. A satisfaction survey was also given to patients at the end of the program.
Result & Outcome :
Total 218 patients were recruited at the program. 67.4% were male and 32.6% were female with mean age 67 years. 50.5% patients with disease duration were over 10 years and 61% have family history of diabetes. 63% patients received secondary or above education. 42% of patients were working and 52% patients were either retired, housewife or students. 17.4% patients were smokers, 2.8% were drinkers. 47.9% patients were on oral anti-diabetic drugs (OAD), 39.2% patients were on both OAD and insulin, 5.5% on insulin while 7.4% on diet alone. Regarding diabetic complications, 12.9% has developed congestive heart disease, 8.8% and 5.3% and 45.2% patients have history of stroke, peripheral vascular disease and retinopathy respectively. Comparing the targets of optimal diabetic control at pre and post empowerment program, there was a significant improvement of HbA1c [8.4% (±SD1.61) versus 7.7% (±SD1.43, p <0.05)], systolic BP [131 mmHg (±SD22.8) versus 113 mmHg (±SD44.45, p <0.05)], Triglyceride [1.79 mg/mmol (±SD1.11) versus (1.62mg/mmol (±SD0.88), p <0.05)]. 165 patients filled in the pre and post program knowledge questions and satisfaction survey. Patients have increased knowledge of the target values of optimal diabetic control from 31.4% to 79.1%. Over 95% patients viewed that the program was practical, improved understanding on diabetes and own health, motivated in diabetes self-care. Conclusion The post diabetes complication screening empowerment program improved patients’ diabetic control, promote better adherence to self-care activities and lifestyle modification.
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