Authors (including presenting author) :
Lam YH,Cheung SM,Liu WSA,Huang HY,Ho SY
Affiliation :
Diabetes Ambulatory Centre, Department of Medicine, Pamela Youde Eastern Nethersole Hospital
Introduction :
An important goal in diabetes management is to prevent the development of diabetic complications by achieving optimal glycaemic control. In order to achieve this goal, diabetes nurses play an important role in empowering patients daily diabetes self-care. In 2020, the Hospital Authority (HA) provided funding to support diabetes nurse to educate and teach patients the use of CGMS for achieving better glycaemic control.
Objectives :
To empower patients in diabetes self-care management skill for better glycaemic control.
Methodology :
Patients with diabetes were recruited to use 1 out of 3 types of CGM devices under selection criteria from July 2020 to March 2021 by referral from endocrinologist or diabetes nurses. Selected patients would attend diabetes nurse clinics for education on correction of injectables technique, carbohydrate counting and reinforcement on drug compliance before CGMS installation. The completed CGMS report would be analysed by diabetes nurses, and then discussed with endocrinologists. Patients would be informed of the actionable treatment plan or regimen changes by phone immediately. Following this, patients would see diabetes nurses for explanation of the CGM report and decide on their desired treatment plan. Glycaemic control by haemoglobin A1c (HbA1c) and fasting blood glucose (FG) were assessed, and results were compared at baseline, 6-months, and 12-months after CGMS.
Result & Outcome :
There were 100 eligible patients recruited including: 27 with Type 1; 68 with Type 2; 2 with Type 1 pregnant; and 3 with Type 2 with pregnancy. Their average ages were 52.18 ± 17.14 years old and the average duration of DM was 15.93 ± 11.50 years. 47 were males and 53 were females. HbA1c showed significant improvement from baseline 9.21 ± 1.84% to 8.46 ± 1.69% (p<0.001) after 6-months. The significant improvement was sustained and improved to 8.50 ± 1.85% (p=0.027) after 12-months. FG was also significantly improved from 9.51 ± 3.42 mmol/L to 8.47 ± 3.61 mmol/L (p=0.046) after 12- months. The results suggest that diabetes nursing intervention with the use of CGMS could significantly help to improve glycaemic control with sustainability. The CGMS is a useful tool for optimizing glycaemic control and empower their diabetes self-care. Improving diabetic control could reduce financial burden and prevent diabetic complications.
