Team-based multicomponent care improved and sustained glycaemic control in obese people with type 2 diabetes (T2D) in a Diabetes Centre setting: A quality improvement program with quasi-experimental design
Objective: To evaluate the effect of a team-based multi-component intervention care (MIC) program in obese patients with type 2 diabetes (T2D) and poor glycemic control. Methods: Patients with T2D and HbA(1c) >= 8 % and body mass index (BMI) >= 27 kg/m(2) and/or waist circumference > 80 cm...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
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Elsevier
2022
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| Subjects: | |
| Online Access: | http://eprints.um.edu.my/40328/ |
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| Summary: | Objective: To evaluate the effect of a team-based multi-component intervention care (MIC) program in obese patients with type 2 diabetes (T2D) and poor glycemic control. Methods: Patients with T2D and HbA(1c) >= 8 % and body mass index (BMI) >= 27 kg/m(2) and/or waist circumference > 80 cm in women and > 90 cm in men were recruited. The intervention in Diabetes Centre included 1) nurse-led, group-based workshops; 2) review by endocrinologists; 3) telephone reminders by healthcare assistants and 4) peer support during visits. The usual care (UC) group received consultations at outpatient clinic without workshops or peer support. The MIC group received UC after 1-year of intervention. The primary outcome was change of HbA(1c) from baseline at 1- and 3-year. Results: Of 207 eligible patients age (mean +/- standard deviation): 56.9 +/- 8.8 years, 47.4 % men, disease duration: 13.5 +/- 8.2 years, HbA(1c): 9.6 +/- 1.3 %, BMI: 28.8 +/- 4.3 kg/m(2), waist circumference: 101.5 +/- 9.9 cm (men), 95.3 +/- 9.8 cm (women)], 104 received MIC and 103 received UC. 95 % patients had repeat assessments at 1- and 3-year. After adjustment for confounders, MIC had greater HbA(1c) reduction (beta-0.51, 95 % confidence interval CI] -1.00 to -0.01; P = 0.045) than UC at 1-year, with sustained improvement at 3-year (beta-0.56, CI -1.10 to -0.02; P - 0.044). Conclusion: Team-based MIC for 1 year improved glycemic control in obese T2D which was sustained at 3-year. |
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