Prevention of Diabetes and Complications

Biography

Biography: Kisokanth G

Abstract

Diabetes Mellitus (DM) is a growing serious health problem and causing significant morbidity and mortality worldwide including in Sri Lanka. In many countries, the Nurse case management has become the keystone of self-management of DM which empowers patients to be informed about their disease, treatment modalities and preventive measures of complications for better outcomes. The peer support is also recognized as a promising approach for self-management of DM. The study was aimed to assess the effectiveness of self-management of DM through nurse case management and peer support intervention in improvement of glycemic control among patients with DM in the Teaching Hospital, Batticaloa, Sri Lanka. This was a single blinded randomised controlled trail. A total of 63 patients were randomized to one of three groups; a control group (n=21), an intervention group with nurse case management (n=21) and an intervention group with nurse case management with peer support (n=21). Glycosylate hemoglobin value (HbA1c) was measured as the primary outcome. At all phases the significance level was tested at 5%. After the 16 weeks of intervention, the HbA1c level declined by 1.92% in the nurse case management participants and by 1.76% in the nurse case management with peer support participants, but an increase of 0.13% was observed in the control participants (p=0.000). The secondary outcome measures, FBS, waist and hip circumferences, blood pressure have been significantly improved in nurse case management with peer support participants and followed by nurse case management participants compared to the control participants (p<0.05). Further, there was no statistically significant difference in body mass index (BMI) across the groups (p=0.071). However, these two groups were associated with a numerically greater decrease in BMI than control group [1.53 kgm2 (±2.42) vs. 1.53 kgm2 (±1.86) vs. 0.37 kg/m2 (±1.36)]. Assessment of the effectiveness of self-management of DM through intervention by nurse case management and peer support using intervention guide had revealed successful and positive outcomes on glycemic control among DM Tamils. It has revealed that peer support groups had more influence over better outcome. Peer support groups with nurses providing health education for the patients with DM based on the intervention guide could be incorporated into regular clinical care of patients.