Diabetes Research and Clinical Practice - Volume 120 - Supplement 1 - October 2016

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PC-04
Dietary intake in elderly type 2 diabetes subjects in Taiwan
Hsiu-Yueh SU 1*, Min-Su TZENG2, Shu-Ti CHIOU3,
Neng-Chun YU4, Wayne H-H. SHEU5. 1Department of Dietetics,
Taipei Medical University Hospital, 2Department of Nutritional
Science, Fu Jen Catholic University, 3Health Promotion
Administration, Ministry of Health and Welfare, 4Yu Neng-Chun
Diabetes Clinic, I-Lan County, 5Division of Endocrinology and
Metabolism, Department of Internal Medicine, Taichung Veterans
General Hospital, Taichung, Taiwan
This was a cross-sectional survey commissioned by Health
Promotion Administration, Ministry of Health and Welfare,
and conducted by Taiwanese Association of Diabetes
Educators in year 2011. In brief, type 2 diabetic subjects who
regularly visited the same Diabetes Health Promotion Institute
for at least one year were invited by amethod of one per every 5
consecutive visitors. Every 5 enrolled subjects were asked to fill
the semi-quantitative food frequency questionnaire (FFQ). The
categories listed in FFQ included a total of 10 food categories
and 83 types of food. We compared elderly group ( ≧65 years
old, n = 285, with age 72.6 ± 5.1 years (mean + SEM), and the
adult group (<65 years old, n = 392, with age 54.4 ± 8.0 years).
The body mass index of the elderly group was lower than the
adult group (25.3 ± 3.7 vs. 26.4 ± 4.4 kg/m 2, p < 0.05). Values of
SBP, DBP, fasting glucose, PPG, HbA1c, total cholesterol, LDL-
cholesterol and triglyceride were not different between elderly
and adult diabetes. There were no differences between calorie
intake (1856 ± 631 vs. 1965 ± 619 kcal/day, p = 0.80) and protein
intake (60 ± 25 vs. 65 ± 24 gm/day, p = 0.47) while cholesterol
intake were significantly lower in elderly diabetes subjects
(159 ± 124 vs. 206 ± 157 mg/day, p < 0.01) than adults diabetes.
In general, nutrients intake were lower in women than men
with the cholesterol intake reached statistically significant.
The percentages of those who attained the ABC goals in the
elderly group were 12.3% compared with 8.6% in the adult
group (p = 0.413). In conclusion, nutrients intake of the elderly
diabetic group are lower than the adult group. Further careful
monitoring and ensure adequacy nutrients intake while
maintain good diabetes control in elderly patients are clearly
needed.
PC-05
Utilizing diet behavior and knowledge for improving the
nutritional care of type II diabetes patients
Mei-Yu TU 1*, Mei-Yuan LIU1. 1Department of Nutritional Services,
Taiwan
Objective: This goal of this project is to utilize a diabetes diet
behavior and diet adjustment knowledge questionnaire
assessments, twice, for motivating and improving the partici-
pants ’ diet behavior and knowledge. The result from this study
can be utilized for educating the participant on the monitoring
of fasting and postprandial blood glucose (FBG; PBG) for the
improvement of blood glucose management and living
qualities.
Methods: The consulting health education including the
knowledge of low glycemic index foods, the use of a healthy
food plate, the correct assessment of macronutrients and
calories, the use of a health diary, and diabetes diet behavior
and diet adjustment knowledge assessment were provided by
a nutritionist to inpatients. The participant consisted of
diabetic inpatient with stable conditions. The participants
were enrolled from the hospitalization period until three
month after discharge.
Results: The FBG and PBG levels and types of food were
analyzed by a two-factor analysis of variance (ANOVA). The
ANOVA analysis indicated that there is no significant blood
glucose difference between the types of food. However, the
blood glucose levels were determined to be significantly
different between the FBG and PBG, and the types of food
has an interaction with the FBG levels (p = 0.001). Furthermore,
the glycated hemoglobin index for the control and experi-
mental group were also analyzed by two-factor ANOVA, which
exhibited significant difference between the FBG and PBG.
Finally, the diabetes diet behavior and diet adjustment
assessments showed an improvement in patient diet
behaviors.
Conclusion: Individualized diet education and continual
follow-up after hospital discharge were able to convey the
importance of FBG and PBG management to the patients for
improving their diet behavior and knowledge.
PC-06
Metabolic outcome for pay for performance for diabetes care –
An example from a regional teaching hospital in Taiwan
Yu-Chen LAI1*. 1Feng Yuan Hospital Diabetes Education
Department, Taiwan
Backgrounds: Taiwan’s National Health Insurance (NHI)
Program implemented a diabetes pay-for-performance pro-
gram (P4P) based on process-of-care measures in 2001. This
research is directed primarily to those outpatients with
diabetes from the Division of Endocrinology and Metabolism
at Feng Yuan Hospital who have joined the “Diabetes Shared
Care Model” management since 2002. We want to study the
metabolic outcome among the patients.
Methods: An observational method was adapted in this
research. The research was performed from 2012 to 2015. The
study participants were all outpatients from the “Diabetes
Shared Care” in Feng Yuan Hospital. The health education
content was provided by a specialized center offering
team-based care (including endocrinologist, dietitian, nurse-
certified diabetes educator). The patients’ baseline character-
istics, annual metabolic indicators, the improvement of
annual metabolic indicators were monitored and analyzed.
Multifaceted efforts were arranged to maintain the quality
including 1: Encourage more certified physicians to join the
Diabetes Shared Care program (number increased from 9 to
12); 2: Using digital health technology in the case manage-
ment; 3: Diabetes health education to enhance the knowledge
of self management and enhancing the usage of waiting times.
Results: The patients number of the “Diabetes Shared Care”
program increased by 15% from56% to 71%. The percentages of
subjects who had HbA1c lower than 7% increased by36.3%
(from 35.22% to 71.52%), both SBP and DBP lower than 130/
80 mmHg (B), and LDL cholesterol lower than 100 mg/dL
increased by 38.42% from 43.99% to 82.41%) respectively.
Conclusion: The “diabetes shared care model” case manage-
ment system is a system that is worth popularizing in the
regional teaching hospital and it should be offered to patients
to strengthen and improve diabetic knowledge and self-care
skills which can be helpful to improve the life quality and to
reduce the severity of the chronic complication.
PC-07
The correlation with continuity of care and diabetic foot in
Taiwan
Su-Chen WU1, Yi-Chien YAO3, Ying-Chun LI 2*. 1Taiwan
Association of Diabetes Educator, 2Taiwan Sociaty of Health
Economics, 3NIL, Taiwan
Objective: The expense of treating Diabetes Mellitus and its
complication is the 4th largest part of all in Taiwan Health
insurance system. Since continuously multidiscipline team
service is the best strategy for Diabetic care. This study is
aimed to investigate the relationship between COC (continuity
of care) and risk of diabetic foot in Taiwan.
Method: We used Taiwan National Health Insurance database
to make a longitudinal study during 2001–2007. Only adult
diabetes patients who had more than 4 times ambulatory
records in 2001–2002 were enrolled. The outcomes from 2003
to 2007 were analyzed as following: risk of amputation, re-
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S88