Authors: (including presenting author): :
Wong WM(1)(2), Wong TW(1)(2), Leung HT(1)(2), Chong YC(1)(2), Kwok KP(1)(2), Chan WS(1)(2), Wong WM(1)(2), Ip ML(1)(2), Au KY(1)(2), Leung YYJ(1)(2)
Affiliation: :
(1) Diabetes & Endocrine Centre, Ruttonjee & Tang Shiu Kin Hospital (2) Department of Medicine and Geriatrics, Ruttonjee & Tang Shiu Kin Hospitals
Keyword 1: :
Diet Declaration
Keyword 2: :
behavioral couselling
Keyword 3: :
patient self-efficacy
Keyword 4: :
glycemic improvement
Keyword 5: :
dietary change
Introduction: :
Lifestyle modification is the cornerstone of diabetes management, yet traditional consultations often struggle to bridge the gap between clinical advice and sustainable behavioral change. Evidence suggests that collaborative goal-setting focusing on incremental "baby steps" can significantly improve patient self-efficacy and glycemic control (DeWalt et al., 2009). However, translating this into a busy clinical workflow requires a structured approach that integrates behavioral coaching into routine visits.
Objectives: :
This project aimed to: 1.Improve care delivery efficiency through a structured, nurse-led behavioral framework. 2.Enhance patient self-efficacy by introducing a "Diet Declaration" initiative for new case referrals attending a specialist Diabetes Clinic (DMC).
Methodology: :
Our diabetes team collaborated to design a "Diet Declaration" form that provides a menu of diet-related habit-change options. During the initial appointment, the diabetes nurses engaged patients in committing to quitting "bad habits" and building "good habits." Follow-up was conducted by telephone at 3-5 months, and some patients also attended interim nursing clinic visits at 1-2 months for progress assessment. Clinical data (HbA1c, LDL-C, BW, BMI and BP) were collected pre- and post-intervention.
Result & Outcome: :
This project sought to streamline the behavioral counselling process, ultimately achieving measurable improvements in glycemic control. The pilot cohort consisted of 10 patients (mean age 59.4 ± 17.7 years; 80% male) with a mean diabetes duration of 17.6 ± 7.6 years. Analysis showed high levels of patient engagement, with mean adherence to habit change of 69%. Qualitative feedback indicated that the “Diet Declaration” habit-change menu provided clear instructions, enhanced self-efficacy, and made lifestyle targets easier to follow, although dining out remained a persistent challenge. Among 7 patients with complete data, mean HbA1c decreased from 8.73 ± 1.71% to 7.04 ± 0.89% (mean change of -1.69 ± 1.77%, p=0.045), while other metabolic markers (LDL-C, BW and BP) showed no significant changes. Overall, patients’ satisfaction rate was high, with a mean score of 4.3 out of 5. The "Diet Declaration" behavioral model demonstrated that a simple, low-cost, and effective intervention can support patients in making dietary changes and improving diabetes control.
