Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors (including presenting author) :
LEUNG SM (1), LEUNG HSS (2), MAK KP (2), WONG KK (2), FONG L (2), CHAN SKE (1), YUEN YL (1), POON MY (1)
Affiliation :
(1) Centre for Diabetes Education and Management, Our Lady of Maryknoll Hospital.
(2) Department of Medicine & Geriatrics, Our Lady of Maryknoll Hospital.
Introduction :
Tele-diabetes Nurse Clinic (TDNC) in OLMH was newly established from 1/9/2023, and it facilitated diabetes nurses to timely discuss the Continuous Glucose Monitoring (CGM) findings with patients. Those physiologic and behavioral problems causing irregular glucose variability could be easily identified (e.g. loose dietary control, inappropriate injection-meal intervals, missed medication doses), and adjusted accordingly.
Objectives :
To evaluate the synergistic effects of advance technologies on glycemic control and safety of diabetes patients with CGM.
To outline the delineation of a new treatment modality for further promulgation.
Methodology :
Participants with no treatment modification at 3-month prior the CGM were recruited from 6/2023 to 11/2023. Those participants cared by usual practice were categorized into Group 1, whereas the others were monitored by telecare on 5 to 10 days after CGM application in Group 2. Outcome evaluation included Time-in-Range (TIR), number of hypoglycemic attacks detected (%) and the change of HbA1c at baseline (T0) and 2-3 months thereafter (T1). TIR has an accurate predictive value for glycaemia, and the target is > 70%. The goals of diabetes management are to enhance TIR and minimize the risk of hypoglycaemia. Paired Sample t Test was used to compare their mean differences.
Result & Outcome :
Total 15 eligible participants were recruited. All of them were monitored by intermittent scanned CGM. Ten of them were cared by usual practice (Group 1), and the others were monitored by telecare on 5 to 10 days after the application of CGM sensor (Group 2). The mean age of Group 1 and Group 2 were 49±14.6 (20% were male) vs 39 ±10.2 (20% were male). Their mean duration of being diagnosed diabetes were 18.7±10.9 (Group 1) vs 12.2±6.3 (Group 2). The baseline HbA1c level in Group 2 was slightly higher (Group 1: 8.6±1.6 vs Group 2: 8.9±1.1, p=0.260). There was no significant difference in all the baseline outcome variables between two groups.
By the end of study, Group 2 had showed statistically significant improvement in HbA1c level (Group 1: 8.6±1.6 vs 8.0±1.4; Group 2: 8.9±1.1 vs 8.1±0.4, p=0.011). Also, inter-group comparison reflected some compelling effects with significant improvement in TIR (65.6±11.1 vs 74.9±10.3) and hypoglycemia (3.0±4.6 vs 2.7±2.8) in Group 2 only.
Feedbacks from Group 2 through post-intervention telephone interview had demonstrated out-weighted benefit in improving their confidence in dietary modification and management of glucose variability. Majority of participants (80%) rated the highest level of satisfaction to support this telecare service in future.
