Diabetes self-management education on the sustainability of metabolic control in type 2 diabetes patients: Diabetes share care program in Taiwan
Background: Diabetes self-management education (DSME) improves glycemic and metabolic control. However, the frequency, duration and sustainability of DSME for improving metabolic control have not been well studied. Methods: The Diabetes Share Care Program (DSCP) stage 1 provided DSME every 3 months....
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664623003716 |
| _version_ | 1827339774020550656 |
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| author | Ying-Chuen Lai Yi-Shuan Chen Yi-Der Jiang Chiou-Shiang Wang I-Ching Wang Hsiu-Fen Huang Hui-Yu Peng Hui-Chuen Chen Tien-Jyun Chang Lee-Ming Chuang |
| author_facet | Ying-Chuen Lai Yi-Shuan Chen Yi-Der Jiang Chiou-Shiang Wang I-Ching Wang Hsiu-Fen Huang Hui-Yu Peng Hui-Chuen Chen Tien-Jyun Chang Lee-Ming Chuang |
| author_sort | Ying-Chuen Lai |
| collection | DOAJ |
| description | Background: Diabetes self-management education (DSME) improves glycemic and metabolic control. However, the frequency, duration and sustainability of DSME for improving metabolic control have not been well studied. Methods: The Diabetes Share Care Program (DSCP) stage 1 provided DSME every 3 months. If participants entering DSCP stage 1 ≥ 2 years and HbA1c < 7%, they can be transferred to stage 2 (DSME frequency: once a year). Three-to-one matching between DSCP stage 1 and stage 2 groups based on the propensity score method to match the two groups in terms of HbA1c and diabetes duration. We identified 311 people living with type 2 diabetes in DSCP stage 1 and 86 in stage 2 and evaluated their metabolic control and healthy behaviors annually for 5 years. Results: In the first year, HbA1c in the DSCP stage 2 group was significantly lower than that in the stage 1 group. In the first and the fifth years, the percentage of patients achieving HbA1c < 7% was significantly higher in the DSCP stage 2 group than the stage 1 group. There was no significant difference in other metabolic parameters between the two groups during the 5-year follow-up. Self-monitoring of blood glucose (SMBG) frequency was associated with a reduced HbA1c after 5 years (95% CI: −0.0665 to −0.0004). Conclusion: We demonstrated sustainable effects of at least 2-year DSME on achieving better glycemic control for at least 1 year. SMBG contributed to improved glycemic control. The results may be applied to the reimbursement strategy in diabetes education. |
| first_indexed | 2024-03-07T20:05:35Z |
| format | Article |
| id | doaj.art-f5df4385fb9842bdbf9eebdfc9c4bbc4 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-03-07T20:05:35Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-f5df4385fb9842bdbf9eebdfc9c4bbc42024-02-28T05:12:49ZengElsevierJournal of the Formosan Medical Association0929-66462024-02-011232283292Diabetes self-management education on the sustainability of metabolic control in type 2 diabetes patients: Diabetes share care program in TaiwanYing-Chuen Lai0Yi-Shuan Chen1Yi-Der Jiang2Chiou-Shiang Wang3I-Ching Wang4Hsiu-Fen Huang5Hui-Yu Peng6Hui-Chuen Chen7Tien-Jyun Chang8Lee-Ming Chuang9Department of Internal Medicine, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 100225, Taiwan, ROC; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Rm733, Bldg.Lab.Med., NTU Hospital, No.1, Chang-Te St., Taipei City 100229, Taiwan, ROC; School of Medicine, College of Medicine, National Taiwan University, No.1, Jen Ai Road Section 1, Taipei City 100233, Taiwan, ROCDepartment of Internal Medicine, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 100225, Taiwan, ROCDepartment of Internal Medicine, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 100225, Taiwan, ROCDepartment of Nursing, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 100225, Taiwan, ROCDepartment of Nursing, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 100225, Taiwan, ROCDepartment of Nursing, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 100225, Taiwan, ROCDepartment of Dietetics, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 100225, Taiwan, ROCDepartment of Dietetics, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 100225, Taiwan, ROCDepartment of Internal Medicine, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 100225, Taiwan, ROC; School of Medicine, College of Medicine, National Taiwan University, No.1, Jen Ai Road Section 1, Taipei City 100233, Taiwan, ROC; Corresponding author. Department of Internal Medicine, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 100225, Taiwan.Department of Internal Medicine, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 100225, Taiwan, ROC; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Rm733, Bldg.Lab.Med., NTU Hospital, No.1, Chang-Te St., Taipei City 100229, Taiwan, ROC; School of Medicine, College of Medicine, National Taiwan University, No.1, Jen Ai Road Section 1, Taipei City 100233, Taiwan, ROC; Institute of Epidemiology and Preventive Medicine, National Taiwan University, Room 501, No.17, Xu-Zhou Road, Taipei City 100025, Taiwan, ROCBackground: Diabetes self-management education (DSME) improves glycemic and metabolic control. However, the frequency, duration and sustainability of DSME for improving metabolic control have not been well studied. Methods: The Diabetes Share Care Program (DSCP) stage 1 provided DSME every 3 months. If participants entering DSCP stage 1 ≥ 2 years and HbA1c < 7%, they can be transferred to stage 2 (DSME frequency: once a year). Three-to-one matching between DSCP stage 1 and stage 2 groups based on the propensity score method to match the two groups in terms of HbA1c and diabetes duration. We identified 311 people living with type 2 diabetes in DSCP stage 1 and 86 in stage 2 and evaluated their metabolic control and healthy behaviors annually for 5 years. Results: In the first year, HbA1c in the DSCP stage 2 group was significantly lower than that in the stage 1 group. In the first and the fifth years, the percentage of patients achieving HbA1c < 7% was significantly higher in the DSCP stage 2 group than the stage 1 group. There was no significant difference in other metabolic parameters between the two groups during the 5-year follow-up. Self-monitoring of blood glucose (SMBG) frequency was associated with a reduced HbA1c after 5 years (95% CI: −0.0665 to −0.0004). Conclusion: We demonstrated sustainable effects of at least 2-year DSME on achieving better glycemic control for at least 1 year. SMBG contributed to improved glycemic control. The results may be applied to the reimbursement strategy in diabetes education.http://www.sciencedirect.com/science/article/pii/S0929664623003716Pay-for-performanceDiabetes self-management educationSelf-monitoring of blood glucoseDiabetes educationGlycemic controlDiabetes share care program |
| spellingShingle | Ying-Chuen Lai Yi-Shuan Chen Yi-Der Jiang Chiou-Shiang Wang I-Ching Wang Hsiu-Fen Huang Hui-Yu Peng Hui-Chuen Chen Tien-Jyun Chang Lee-Ming Chuang Diabetes self-management education on the sustainability of metabolic control in type 2 diabetes patients: Diabetes share care program in Taiwan Journal of the Formosan Medical Association Pay-for-performance Diabetes self-management education Self-monitoring of blood glucose Diabetes education Glycemic control Diabetes share care program |
| title | Diabetes self-management education on the sustainability of metabolic control in type 2 diabetes patients: Diabetes share care program in Taiwan |
| title_full | Diabetes self-management education on the sustainability of metabolic control in type 2 diabetes patients: Diabetes share care program in Taiwan |
| title_fullStr | Diabetes self-management education on the sustainability of metabolic control in type 2 diabetes patients: Diabetes share care program in Taiwan |
| title_full_unstemmed | Diabetes self-management education on the sustainability of metabolic control in type 2 diabetes patients: Diabetes share care program in Taiwan |
| title_short | Diabetes self-management education on the sustainability of metabolic control in type 2 diabetes patients: Diabetes share care program in Taiwan |
| title_sort | diabetes self management education on the sustainability of metabolic control in type 2 diabetes patients diabetes share care program in taiwan |
| topic | Pay-for-performance Diabetes self-management education Self-monitoring of blood glucose Diabetes education Glycemic control Diabetes share care program |
| url | http://www.sciencedirect.com/science/article/pii/S0929664623003716 |
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