Authors (including presenting author) :
Yeung SK(1), Lin LHG(1), Wong YND (1), Tong WCM (1), Lau KP (1)
Affiliation :
(1) Diabetes Mellitus and Endocrine Centre, Department of Medicine, North District Hospital
Introduction :
North District Hospital Endocrine and Diabetes team has joined the TAI programme since April 2018. All diabetic patients, who meet the inclusion criteria of TAI programme, will attend a Patient Empowerment session (TAIE) and two Interactive classes on Diabetic Kidney Disease (TAIG – DKD). The programme in NDH has been characterised by its extra dedicated effort in those with DKD as recent data suggested that there is an escalating prevalence of diabetic patients going into end-stage renal failure requiring dialysis due to long term poor glycaemic control while only 20% of DM patients aware of the linkage between glycaemic control and risk of developing DKD. The interactive classes are specifically designed by the team to provide culturally relevant education materials for the targeted local participants.
Objectives :
1) Empower patient to improve their diabetes self-management through interactive class and using of novel designed education materials.
2) Optimize glycaemic control and minimizing other atherosclerotic risk factors.
Methodology :
Patients are recruited, retrospectively, into intervention group if they have completed Complication Screening (TAIC), Patient Empowerment class (TAIE) and 2 Interactive classes on DKD, while patients who have only completed TAIC but defaulted subsequent interventions will be recruited into the control group. Furthermore, for both groups, they will only be selected if they met all the following criteria: 1) A1c>7.0%; 2) Blood result and physical assessment available pre and post intervention; 3) Post-intervention result at least 3 months from the start of TAI programme; 4) Aged 18-70; 5) eGFR 30-89.
Result & Outcome :
40 patients have met the criteria between November 2018 to March 2019. 29 patients are recruited into intervention group while 11 in control group. After completion of the programme, the result suggests that there is significant improvement in glycaemic control for patients in intervention group in comparison to the control group. There is a mean reduction of 1.4% in the HbA1c level in the intervention group while in the control group, the mean HbA1c level remain static. 45% of patients in the intervention group achieve good glycaemic control (HbA1c level < 7%) while there is no significant improvement in the control group. The post eGFR results remain static in the intervention group while there is a decrease in eGFR in the control group, signifying a deterioration in kidney function in the control group. There is no significant difference in BP control or lipids level between intervention and control group.
