Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

of 322, propensity score-matched subjects. Patients were

evaluated at baseline, one-year, 2-year and 3-year follow-up.

At follow-up, A1c significantly increased in both groups. Mean

A1c was 6.7 ± 0.6% at baseline. Mean A1c was 6.9 ± 0.8% at 3-

year follow-up. A1c was higher in the group of intensified

education than non-intensified education at the 1-year and 2-

year follow-up. However, the effect of education frequency on

A1c was insignificant over 3 years. Total cholesterol decreased

in both groups. In the group of non-intensified education, HDL

improved at 3-years follow-up.

Decrease of diabetic education frequency did not showed

impact on A1c and total cholesterol in patients who had

trained for coping with diabetes for more than two years.

Although A1c deteriorated, lipid profile improved over time in

those patients.

PG-34

Report of Conversation Map sessions held by a nephrologist

Tung-Huei CHANG

*, Akiko SUGAYA

Toshikazu YAMAMOTO

, Hiroyuki YOGI

, Moritake HIGA

Heart Life Hospital,

Heart Life Clinic,

Nanbu Hospital,

Tomishiro

Central Hospital, Japan

Background:

Diabetic patients need to learn methods of

controlling themselves. Controlling themselves needs power

for collecting their relevant information of improving their

health. Diabetic education would be more fruitful when they

are empowered with psychological approach. Conversation

Map is a one of decisive education tools and the number of

facilitators is increasing in Japan.

In the other hand, the number of diabetic nephropathy

patients also increasing and nephrologists confront same

healthcare problem. Psychological approach can be used with

the help of psychologists But not so many nephrologists are

interested in Conversation Map Now, we report the cases and

experience of a nephrologist facilitator.

Method:

After a training of Japan Association of Diabetes

Education and Care, the author got licensed for Conversation

Map and conducted participant sessions. Sessions were held

for admitted patients and their family, participants of

educative events for outpatients and lectures open to the

public. Patients who were CKD 4 or CKD 5 were excluded

because contents of Conversation Map are not partially fit for

CKD patients.

Result:

For 2 years, 30 sessions were held and approx. 50

persons have participated. At each ice breaking, they complain

about negative feelings for their own diabetes. After sessions

they asked questions like:

“

What shall I do to improve my

diabetic control?

” “

Is there any room for changing my daily

diet?

”

They tried to figure out their own relevant problems and

find its solutions.

And furthermore, they talked their bad health habit on the

condition that we keep it secret from the physician in charge.

And the facilitator himself was taught needs of patients who

can be candidates of department of nephrology.

Conclusion:

Conversation Map is amazing tool for educating

diabetic patients and can be used even by a nephrologist. It

also might be a good tool for educating healthcare providers

like a nephrologist.

PG-35

Effects and predictors of a STENO intensive multifactorial

intervention for HbA1c target achievement in Taiwanese

patients with type 2 diabetes

Jui-Yu HUNG

*, Yi-Yu CHEN

, Malcolm KOO

Hsin-Hung CHIANG

, Pin-Fan CHEN

Health Management

Center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical

Foundation,

Department of Medical Research, Dalin Tzu Chi

Hospital, Buddhist Tzu Chi Medical Foundation,

Division of

Endocrinology and Metabolism, Dalin Tzu Chi Hospital, Buddhist Tzu

Chi Medical Foundation, Taiwan

Purpose:

To investigate the effects and predictors of a STENO

Intensive Multifactorial Intervention on glycemic control in

Taiwanese patients with type 2 diabetes.

Methods:

Outpatients with type 2 diabetes and a glycated

hemoglobin (A1c) level of 7% or above were recruited from the

division of metabolism and endocrinology in a regional

hospital in southern Taiwan. These patients were invited to

enroll in a STENO Intensive Multifactorial Intervention, which

consisted of three in-person sessions over a period of 6 to 12

weeks. Data on A1c and fasting blood glucose (FBG) were

collected at baseline and post-intervention. Paired t-tests were

used to compare the changes in A1c and FBG levels between

baseline and post-intervention. Logistic regression analyses

were used to assess baseline factors associated with achieving

A1c < 7% post-intervention.

Results:

A total of 112 patients (52%males) with a mean age ( ±

standard deviation) of 57.9 ± 12.5 years completed the inter-

vention. The mean baseline and post-intervention A1c levels

were 8.6 ± 1.3 and 7.9 ± 1.2, respectively, with a significant

difference of 0.7 ± 1.0 (p < 0.001). The mean baseline and post-

intervention FBG levels were 169.1 ± 53.8 mg/dL and 149.3 ±

44.1 mg/dL, respectively, with a significant difference of 19.8

± 48.3 mg/dL (p < 0.001). At the end of the intervention, 25

patients (22.3%) achieved the desirable A1c goal of less than

7%. Results of the logistic regression analyses indicated that

patients who were under the age of 65 years at baseline were

less likely to achieve an A1c level of <7% post-intervention

(odds ratio = 0.37, 95% confidence interval = 0.15

–

0.92, p =

0.033). Sex, duration of diabetes diagnosis, educational levels,

and treatment type (oral antidiabetic therapy versus insulin

therapy) were not significantly associated with an A1c level of

<7% post-intervention.

Conclusions:

Completion of a STENO Intensive Multifactorial

Intervention was able to significantly improve the mean levels

of both A1c and FBG in Taiwanese patients with a baseline A1c

level of 7% or above. Nevertheless, less than a quarter of the

patients were able to achieve a desirable A1c level below 7% at

the end of the intervention. Further studies are needed to

identify predictors, in addition to age <65 years, for the

inability to achieve the desirable A1c goal.

PG-36

Improvements in the views of insulin therapy among

Taiwanese patients with type 2 diabetes participating in a

STENO multifactorial intervention

Jui-Yu HUNG

*, Yi-Yu CHEN

, Malcolm KOO

, Pin-Fan CHEN

Health Management Center, Dalin Tzu Chi Hospital, Buddhist Tzu

Chi Medical Foundation,

Department of Medical Research, Dalin Tzu

Chi Hospital, Buddhist Tzu Chi Medical Foundation,

Division of

Endocrinology and Metabolism, Dalin Tzu Chi Hospital, Buddhist Tzu

Chi Medical Foundation, Taiwan

Purpose:

To investigate the effects a STENO Intensive

Multifactorial Intervention on the views and perceptions of

insulin therapy, based on the Diabetes Attitudes, Wishes and

Needs (DAWN) instrument, in Taiwanese patients with type 2

diabetes.

Methods:

Outpatients with type 2 diabetes and a glycated

hemoglobin (A1c) level of 7% or above were recruited from

the division of metabolism and endocrinology in a regional

hospital in southern Taiwan to enroll in a 3-session STENO

Intensive Multifactorial Intervention. The views and percep-

tions of insulin therapy of the patients were assessed using the

22-item DAWN instrument at baseline and post-intervention.

Six subscales of the DAWNwere (A) benefits of insulin therapy,

(B) frustration and concerns about insulin therapy, (C)

inconvenience of insulin therapy, (D) impaired social relation-

ship, (E) discomfort of insulin therapy, and (F) side effects. A

lower score means a more positive view towards insulin

therapy. Non-parametric Wilcoxon signed-ranked tests were

used to compare the changes in the DAWN scores. Logistic

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

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