Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

importance is the increasing prevalence of diabetes through-

out the Pacific Region. In Tuvalu, the prevalence of diabetes is

about 14%, and chronic diseases accounted for 67% of all

deaths in 2002. The effective prevention and control of this

condition remains difficult. The purpose of this study was to

assess the diabetes and its co-morbidities status in Tuvalu as a

foundation to help health care providers and community

leaders to create culturally customized health promotion

interventions.

Methods:

A suitable sample of 150 (54.2%) from a total of 286

medical records of Princess Margaret Hospital adult out-

patients of non-communicable disease registration, 18 or

more years of age was evaluated in May to July, 2014.

Anthropometric data (body height, body weight, body mass

index (BMI), and waist circumference), and blood pressure

were measured. Biochemistry data (fasting blood glucose,

hemoglobin A1c (HbA1c), lipid profile (total-cholesterol, low-

density lipoprotein cholesterol, high-density lipoprotein chol-

esterol and triglyceride)) were measured.

Results:

This cross sectional survey consisted of a group of

mean age of 57.14 ± 10.12 years old, 63% were females. The

mean BMI and waist circumference were 32.30 ± 1.31 kg/m

and 220.68 ± 94.27 cm, respectively. Female patients had a

significantly higher mean BMI than males (P < 0.05). In regard

to ABC goal, only 18% of the patients had reached the glycemic

target (A1c < 7%), 24% achieved LDL-C < 100 mg/dL, and 62%

reached blood pressure goal. Large vessel disease (LVD) was

observed in 14% of patients, peripheral neuropathy in 44%.

Some of them were also with foot ulcer problems.

Conclusions:

Inadequate glycemic and lipid controls were

noticed in the majority of patients,which is probably due to

demographic transition to an ageing population, moderniza-

tion, lifestyle changes, non-compliance to medication, and a

relatively lower proportion of patient using insulin. A large

proportion of chronic diabetic complications also have signifi-

cant impact on health budget.

PC-02

Targeted Active Recruitment for Intervention (TARIN) for

patients with type 2 diabetes (T2DM) in general medical

specialist outpatient clinics

Siu Chan Veronica HUNG

*, Cheuk Man CHAN

, Yiu Yan HO

Hoi Fan NG

, Kit Ming Camille HUI

, Ka Ching WONG

Kwok Yip HO

, Man Yuk NG

, Pui Yee WU

, Cindy LAM

Department of Medicine & Geriatrics, Tuen Mun Hospital, Hong

Kong, Hong Kong

Introduction:

In general medical specialist outpatient clinics,

doctors are usually engaged with patients with multiple

medical problems within very short consultation time.

Referral rate of diabetes patients to structured management

is low. TARIN programme has been established in Tuen Mun

Hospital since January 2015 to fill the service gap.

Objective:

To evaluate the outcomes of patients recruited into

the TARIN programme.

Method:

Patients with T2DM, whose age <65, latest haemo-

globin A1c (HbA1c) >/=7% and plasma creatinine <200 umol/L

were identified from CDARS. Those who received structured

diabetes empowerment within two years were excluded.

A trained nurse went to target clinics to recruit patients. She

provided brief introduction on the programme and arranged

appointments according to patients

’

convenience. Patients

received metabolic risk assessment (MRA) and were invited

to attend an education class. A copy of MRA report was

distributed to each patient in the class. Patients with eyes and

feet complications were referred to podiatrist or ophthalmolo-

gist for timely interventions. In subsequent nurse clinic,

they were counselled on diet and lifestyle modification, self-

monitoring of blood glucose (SMBG) and had their anti-

diabetic medications intensified. Treatment plans were

reviewed with endocrinologists in weekly case conferences.

Results:

73 patients were recruited in January 2015 and the

outcomes were analyzed in January 2016. We recruited 45 men

and 28 women (mean age 56.7 ± 6.9 years; body mass index

28.3 ± 4.3 kgm

). Ten were newly diagnosed T2DM and 63 were

known diabetes with mean duration of disease 10 ± 5.2 years.

All of them had MRA done, of which 4% were referred to

podiatrist and 15%were referred to ophthalmologist. Mild non-

proliferative retinopathy was detected in 6% of patients and

they were offered follow-up MRA in 1 year to monitor the

progression. On entry to programme, 19% of patients were on

insulin and 19% were doing SMBG. After receiving structured

care, 55% of patients were performing SMBG. Mean number of

nurse clinic visits were 1.6. Thirty percent saw endocrinologist

for major treatment intensification. Mean baseline HbA1c was

8.2 ± 1.1% and post-intervention 7.1 ± 0.9% (Paired t-test, p <

0.0001). 53.4% of patients had HbA1c < 7% after completing the

programme. There was no emergency admission or death

during this period.

TARIN is effective in empowering patients with T2DM in self-

care and improving surrogate marker of T2DM in general

medical clinics up to one year.

PC-03

Results of the comprehensive care model for the care of

children with new-onset Type I diabetes

Shene-Fong YOU

*, Shao-Yin CHU

, Li-Xia TONG

Ya-Chun CHENG

, Yi-Hsuan WANG

, Chin-Ting WANG

Chen-Hua FANG

RN, Department of Nursing, Hualien Tzu Chi

Hospital,

Pediatric Genetic Endocrinologist, Department of

Pediatrics, Hualien Tzu Chi Hospital,

Division of Dietetics and

Nutrition, Hualien Tzu Chi Hospital,

Department of Nursing,

Hualien Tzu Chi Hospital,

Division of Endocrinology and

Metabolism, Hualien Tzu Chi Hospital,

Department of Psychiatry,

Hualien Tzu Chi Hospital,

Department of Social Service, Hualien Tzu

Chi Hospital, Taiwan

Introduction:

According to the International Diabetes

Federation statistics, the prevalence of Type I diabetes in the

world is 20 per 100,000 population and it is still gradually

increasing. According to the Taiwan National Health

Insurance database, the diabetes prevalence between 2003

and 2008 is 5.3 persons per 100,000. Thus, we can see that Type

I diabetes is a common chronic disease among children

worldwide. Therefore, it is also a very important topic for

diabetes care.

Objective/methods:

This study was aimed to investigate the

care results of a comprehensive care model for children and

adolescents inpatients with new-onset Type I diabetes. The

two groups

’

average hospital stay, glycated hemoglobin (A1C)

monitor rate, A1C improvement, and care satisfaction were

analyzed with SPSS.

Results:

The hospitalization duration prior and after the

implementation of the comprehensive care model was

8.8 ± 2.2 and 6.6 ± 1.7 days (p < 0.05), respectively. The A1C

monitor rate increased from 88.9% to 93.8%. The hospitaliza-

tion and 3

–

4 month after discharge A1C level difference prior

and after the implementation of the comprehensive care

model were 3.7 ± 2.9% and 5.6 ± 2.1% (p > 0.05). The nursing

team

’

s satisfaction, by utilizing this care model for preparing

the patient for discharge, increased from 77.1% to 84.0%. The

inter-team intervention immediacy increased from 77.1% to

87.0%, and the instruction content satisfaction increased from

80% to 87%.

Conclusion:

The use of the

“

comprehensive care model

”

can

significantly reduce the hospitalization duration for children

with Type I diabetes. Although, the A1C level difference did not

exhibit a significant, however, it did show an overall improve-

ment. Therefore, the implementation of the comprehensive

care model is beneficial for the care of these patients.

Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65

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