Effectiveness of comprehensive diabetes care program in Taiwanese with type 2 diabetes

To assess continuing diabetic education in Taiwan, we evaluated the impact of comprehensive diabetes care program for Taiwanese people with type 2 diabetes.

211 diabetic patients were enrolled and followed up for 1 year at Kaohsiung Medical University Hospital. Patients were provided comprehensive care and their medications were not changed. Clinical and biophysical variables were collected and assessed at 0, 3, 6, 9, 12 months.

Metabolic control had improved significantly by 1 year: fasting plasma glucose (164.6+/-60.4 vs. 137+/-37.5mg/dl, p<0.001); total serum cholesterol (198.7+/-38.8 vs. 187.2+/-43.1mg/dl, p<0.001); high-density lipoproteins cholesterol (43.2+/-10.2 vs. 46.2+/-11.7 mg/dl, p<0.001); low-density lipoproteins cholesterol (121.1+/-32.9 vs. 113.1+/-29.6 mg/dl, p<0.005). In the male group, HbA1c level fell from 8.16+/-1.99% to 7.61+/-1.31% and 7.72+/-1.40% after 9 months and 1 year, respectively, p<0.05. There were also significant improvements in female group after 6 months and 9 months (7.89+/-1.62% after 6 months; 7.94+/-1.66% after 9 months vs. 8.22+/-1.70% at baseline). The change of HbA1c level was significant in male patients, patients whose duration of disease was shorter and in those with higher baseline HbA1c levels after multi-variable and age-adjusted analysis.

The comprehensive diabetes care program effectively improved glycemic and cholesterol control. The patients who were more likely to achieve better glycemic control were male, had diabetes for shorter periods of time and had high baseline HbA1c levels. Therefore, diabetic education should be offered to patients as close to the time of diagnosis as possible.