Authors (including presenting author) :
Chung WH, Lai ML, Leung SY, Leung KWM
Affiliation :
Department of Family Medicine, the New Territories East Cluster, Hospital Authority, Hong Kong
Introduction :
Early good risk factors control is paramount to prevent macrovascular and microvascular complications in young type 2 diabetic patients (YDM). However, as in March 2021, around 11% of YDM (age <55) followed up at General Outpatient Clinic of North District (ND GOPCs) couldn’t reach target in all three disease parameters (i.e. 3 Highs: Hemoglobin A1c (HbA1c) ≥7%, Low density lipoprotein cholesterol (LDL-C) ≥2.6, and Blood Pressure (SBP/DBP) ≥130/80mmHg).
Objectives :
To pilot an Intensive Diabetes management program (IDMP) at Fanling Family Medicine Centre (FLFMC) from 6th May 2021 which provide short term intensified care to the “3 Highs YDM”, aiming to treat all three disease parameters to target.
Methodology :
“3 Highs YDM” following up at ND GOPCs were identified by the Clinical Data Analysis and Reporting System (CDARS) and recruited to IDMP. They would be attended by a designated Family Medicine Specialist with longer consultation time (~ 20 minutes per case) and shorter follow-up interval (4 to 8 weekly). A colorful one-page record sheet would be issued to record disease parameters at intervals (0-month, 3-month and 6-month), as a mean of patient empowerment. An interim review was performed in Nov 2021 to compare between recruited patients and those patients on the waiting list (control).
Result & Outcome :
Total 119 “3 Highs YDM” were identified from CDARS. 77 had been invited with 72(93.5%) had attended IDMP. 42(35.9%) were yet to invite (control). Mean follow-up duration was 13.2 weeks. During the study period, 71(98.61%) IDMP vs 34(80.95%) control had blood test for HbA1c (p<0.001), and 69(95.83%) IDMP vs 27(64.29%) control had blood test for LDL-C (p<0.0001). At the end of the study period, HbA1c<7 was achieved in 32(44.4%) IDMP vs 14(33.3%) control (p 0.243); LDL-C<2.6 was achieved in 42(58.3%) IDMP vs 15(35.7%) control (p<0.05); SBP<130 was achieved in 31(43.1%) IDMP vs 11(26.2%) control (p 0.072); DBP<80 was achieved in 42(58.3%) IDMP vs 20(47.6%) control (p 0.268). Significantly more “3 Highs YDM” in IDMP had blood tests to review disease control, and LDL-C had been improved most significantly. More time would be required to review the effect in other parameters. Nevertheless, this highlights the importance of raising awareness of DM disease parameters among patients and timely intervention can make a difference.
