Authors: (including presenting author): :
Cheng HC, Wong YSF, Ko WYD, Wong SC, Ko YTP, Chan YYR
Affiliation: :
Department of Medicine & Rehabilitation, Tung Wah Eastern Hospital
Keyword 3: :
Self-Management Education
Keyword 4: :
Glycaemic control
Keyword 6: :
Nurse support program
Introduction: :
Suboptimal glycaemic control in diabetes mellitus (DM) can lead to various complex health complications. Diabetes self-management education and support (DSME/S) equips patients with the knowledge and skills necessary for effective self-management, ultimately leading to improve clinical outcomes.
Objectives: :
- Evaluate the effectiveness of a nurse-led DSME/S program on glycaemic control in patients with suboptimal diabetes control,
- Assess lifestyle factors of diabetic patients to facilitate the development of a tailored education program.
Methodology: :
Patients aged 18–74 years with HbA1c >7% were recruited during diabetic complication screening (MRAM). Self-management behaviours and lifestyle factors were assessed at MRAM. All participants received the nurse-led DSME/S program, and HbA1c was measured at baseline, 3–6 months, and 12 months after program completion. Changes in HbA1c were analysed using paired sample t-tests. Subgroup analyses were performed for patients with and without subsequent medication adjustment.
Result & Outcome: :
Results:
By the end of August 2025, a total of 286 participants were analysed (56.6% male; mean age 63.7 years; mean Diabetes duration 17 years). Among them, 24.8% used insulin, 68.8% performed SMBG/CGM, 77.3% had central obesity, 46.5% reported no exercise, 21.3% dined at home regularly, and 29.7% dined out ≥2 meals/day. Mean HbA1c decreased from baseline (7.83 ± 0.64%) to 3-6 months (7.64 ± 0.79%, p < 0.001) and was maintained at 12 months (7.65 ± 0.87%, p < 0.001). The proportion of participants achieving HbA1c < 7% increased to 17.1% at 3-6 months and 20.3% at 12 months, both p < 0.001. Among the 96 participants without medication changes, the target achievement rate was 22.9% and 21.9%, compared to 14.2% and 19.5% in the 190 participants with medication adjustments. Conclusions:
The nurse-led DSME/S program was effective in improving glycaemic control, including among patients without pharmacologic changes. Benefits and Implications:
Nurse-led DSME/S can play a pivotal role in delivering sustainable patient care. Lifestyle assessment enables targeted interventions, and addressing identified barriers may further enhance outcomes.
