Trial of a New Diabetes Education Model: Closing the Gap in Health Disparity for People with Diabetes

2021 ◽  
pp. 193229682110014
Author(s):  
Thomas W. Martens ◽  
Janet S. Lima ◽  
Elizabeth A. Johnson ◽  
Jessica A. Conry ◽  
Jennifer J. Hoppe ◽  
...  

Background: Quality measures relating to diabetes care in America have not improved between 2005 and 2016, and have plateaued even in areas that outperform national statistics. New approaches to diabetes care and education are needed and are especially important in reaching populations with significant barriers to optimized care. Methods: A pilot quality improvement study was created to optimize diabetes education in a clinic setting with a patient population with significant healthcare barriers. Certified Diabetes Care and Education Specialists (CDCES) were deployed in a team-based model with flexible scheduling and same-day education visits, outside of the traditional framework of diabetes education, specifically targeting practices with underperforming diabetes quality measures, in a clinic setting significantly impacted by social determinants of health. Results: A team-based and flexible diabetes education model decreased hemoglobin A1C for individuals participating in the project (and having a second A1C measured) by an average of −2.3%, improved Minnesota Diabetes Quality Measures (D5) for clinicians participating in the project by 5.8%, optimized use of CDCES, and reduced a high visit fail rate for diabetes education. Conclusions: Diabetes education provided in a team-based and flexible model may better meet patient needs and improve diabetes care metrics, in settings with a patient population with significant barriers.

Author(s):  
Emina Hadziabdic ◽  
Sara Pettersson ◽  
Helén Marklund ◽  
Katarina Hjelm

Abstract Aim: To develop a diabetes education model based on individual beliefs, knowledge and risk awareness, aimed at migrants with type 2 diabetes, living in Sweden. Background: Type 2 diabetes is rapidly increasing globally, particularly affecting migrants living in developed countries. There is ongoing debate about what kind of teaching method gives the best result, but few studies have evaluated different methods for teaching migrants. Previous studies lack a theoretical base and do not proceed from the individuals’ own beliefs about health and illness, underpinned by their knowledge, guiding their health-related behaviour. Methods: A diabetes education model was developed to increase knowledge about diabetes and to influence self-care among migrants with type 2 diabetes. The model was based on literature review, on results from a previous study investigating knowledge about diabetes, on experience from studies of beliefs about health and illness, and on collaboration between researchers in diabetes care and migration and health and staff working in a multi-professional diabetes team. Findings: This is a culturally appropriate diabetes education model proceeding from individual beliefs about health and illness and knowledge, conducted in focus-group discussions in five sessions, led by a diabetes specialist nurse in collaboration with a multi-professional team, and completed within three months. The focus groups should include 4–5 persons and last for about 90 min, in the presence of an interpreter. A thematic interview guide should be used, with broad open-ended questions and descriptions of critical situations/health problems. Discussions of individual beliefs based on knowledge are encouraged. When needed, healthcare staff present at the session answer questions, add information and ensure that basic principles for diabetes care are covered. The diabetes education model is tailored to both individual and cultural aspects and can improve knowledge about type 2 diabetes, among migrants and thus increase self-care behaviour and improve health.


Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1239-P
Author(s):  
TEJASWI KOMPALA ◽  
MACKENZIE CLARK ◽  
SARAH KIM ◽  
LISA KROON ◽  
THOMAS A. PETERSON ◽  
...  

1989 ◽  
Vol 6 (8) ◽  
pp. 739-740 ◽  
Author(s):  
C. Dumitrescu ◽  
D. Cheţa

Author(s):  
Xia Lian ◽  
Rinkoo Dalan ◽  
Cherng Jye Seow ◽  
Huiling Liew ◽  
Michelle Jong ◽  
...  

AbstractSingapore currently has one of highest number of confirmed COVID-19 cases in Southeast Asia. To curb the further spread of COVID-19, Singapore government announced a temporary nationwide lockdown (circuit breaker). In view of restrictions of patients’ mobility and the enforcement of safe distancing measures, usual in-person visits were discouraged. Here we describe how diabetes care delivery was ad hoc redesigned applying a telehealth strategy. We describe a retrospective assessment of subjects with diabetes, with and without COVID-19 infection, during the circuit breaker period of 7th April to 1st June 2020 managed through Tan Tock Seng Hospital’s telehealth platform. The virtual health applications consisted of telephone consultations, video telehealth visits via smartphones, and remote patient monitoring. The TTSH team intensively managed 298 diabetes patients using a telehealth strategy. The group comprised of (1) 84 inpatient COVID-19 patients with diabetes who received virtual diabetes education and blood glucose management during their hospitalisation and follow-up via phone calls after discharge and (2) 214 (n=192 non-COVID; n=22 COVID-positive) outpatient subjects with suboptimal glycaemic control who received intensive diabetes care through telehealth approaches. Remote continuous glucose monitoring was applied in 80 patients to facilitate treatment adjustment and hypoglycaemia prevention. The COVID-19 pandemic situation mooted an immediate disruptive transformation of healthcare processes. Virtual health applications were found to be safe, effective and efficient to replace current in-person visits.


2004 ◽  
Vol 19 (12) ◽  
pp. 1167-1174 ◽  
Author(s):  
Russell E. Glasgow ◽  
Paul A. Nutting ◽  
Diane K. King ◽  
Candace C. Nelson ◽  
Gary Cutter ◽  
...  

2020 ◽  
Vol 20 (2) ◽  
pp. 107-112
Author(s):  
Jaya Pradhan ◽  
Satyan M Rajbhandari

Introduction: Structured diabetes education is a key element in the management of type 2 diabetes, but this is challenging to deliver in settings where resources are limited.Methods: We conducted a randomised evaluation of a single 90-minute session of structured diabetes education added to the local standard of diabetes care compared with a control group (standard diabetes care only) in 150 patients with recently diagnosed type 2 diabetes in Nepal. The level of knowledge about diabetes was low.Results: Follow-up 6 months after the intervention showed that the reduction in mean (SD) fasting plasma glucose was significantly larger in the education group (from 8.6 (2.9) mmol/L to 6.7 (1.2) mmol/L) compared with the control group (from 8.1 (1.8) mmol/L to 7.0 (1.8) mmol/L) (p=0.029 for comparison between groups). A significant reduction in postprandial plasma glucose also occurred in the education group (from 11.7 (3.7) mmol/L to 8.3 (1.2) mmol/L) compared with the control group (from 11.5 (4.0) mmol/L to 9.7 (2.3) mmol/L) (p=0.005 between groups). A trend to reduced HbA1c was seen for the education versus the control group at 6 months (p=0.06). There were no significant changes in lipids or blood pressure. Overall energy intake and the proportion of energy intake from fat was lower at 6 months compared with baseline for the education group but not for the control group, although there were no significant changes in anthropometric parameters.Conclusion: Our results suggest that a single session of structured diabetes education may provide glycaemic benefits in newly-diagnosed type 2 diabetes patients, and that this may be a pragmatic means of improving diabetes self-care in resource-limited countries such as Nepal.


Sign in / Sign up

Export Citation Format

Share Document