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

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regression analyses were used to assess baseline factors
associated with a decrease (improvement) in DAWN with the
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. At the baseline, 37 patients (33%) were on oral
antidiabetic therapy and 75 patients (67%) were on insulin
therapy. After the intervention, 19 patients had changed from
oral antidiabetic therapy to insulin therapy and 10 patients
had increased their frequency of insulin injections. The overall
DAWN score and the scores of all 6 subscales except subscale F
were significantly decreased with the intervention, indicating
that the patients had a more positive view towards insulin
therapy with the intervention. Seventy-nine patients (71%)
had a more positive view towards insulin therapy with the
intervention. Results of the logistic regression analyses of the
subscales indicated that patients whowere 65 years or above at
baseline were significantly more likely to show improvement
in subscale A of DAWN post-intervention (odds ratio = 3.03,
p = 0.009). Moreover, patients who were on oral antidiabetic
therapy at baseline were more likely to show improvement in
subscale E of DAWN post-intervention (odds ratio = 2.08,
p = 0.073).
Conclusions: Completion of a STENO Intensive Multifactorial
Intervention was able to significantly improve the views and
perceptions of insulin therapy in Taiwanese patients with type
2 diabetes. Further studies are needed to identify the reasons
for patients who did not show improvements.
PG-37
Impact of drama-based educational program, diabetes theater,
on healthcare professionals ’ attitudes toward diabetes care: a
mixed method evaluation
Kentaro OKAZAKI 1*, Hiroshi OKADA2, Ken OHASHI 3,
Toshikazu YAMAMOTO 4, Takayuki ASAHINA 5. 1Nagoya
University Graduate School of Medicine, 2Kyoto Medical Center,
3 National Cancer Center Hospital, 4Heartlife Clinic, 5Asahina Clinic,
Japan
Background: Patient empowerment is considered to be crucial
for healthcare professionals (HCPs) in diabetes. However, how
to learn this concept is yet unclear. Thus we developed a
drama-based educational workshop, Diabetes Theater (DT),
to teach HCPs the philosophy of patient empowerment.
Participants reflect on their own practice by watching a play
based on common misunderstandings between patients and
HCPs in a clinical practice, and then discussing by focusing on
the good points and areas for practice improvement in the
drama.
Aims: The aim of our study was to investigate the effect of DT
on participants ’ attitudes toward diabetes care using a mixed
method.
Method: The study design utilized both quantitative and
qualitative methods (mixed-method). Participants in DT held
at the 57th annual scientific meeting of the Japanese Diabetes
Society in 2014 were requested to answer a questionnaire
before and after the program. To compare the scores before
and after, a paired t-test was performed with a significance
level of alpha = 0.05. Attitudes were measured by four items
from the Diabetes Attitude Scale, using an eleven-point Likert
scale ranging from 10 = strongly agree to 0 = strongly disagree.
Free descriptions for the open-ended questions were analyzed
qualitatively.
Results: We analyzed data from 131 respondents (male 15,
female 116); nurses 54%; dietitians 16%; doctors 11%; pharma-
cists 11%; and others 8%. HCPs ’ attitude scores increased
significantly in each item. In detail, “HCPs should be trained
how to communicate with their patients ” (from 8.1 ± 2.0 to
9.1 ± 1.5); “HCPs should learn counseling skills” (from 8.0 ± 1.9
to 9.2 ± 1.4); “HCPs should learn how to set goals with patients”
(from 8.5 ± 1.6 to 9.4 ± 1.3); “people with diabetes have the right
not to take good care of their diabetes” (from 6.2 ± 2.5 to
7.4 ± 2.5) (from before to after, mean ± SD, all p < 0.05). What
participants learned from the program were summarized: (1)
HCPs should wait till the time is ripe; (2) Two-way communi-
cation between patients and HCPs is important.
Discussion: In conclusion, HCPs who participated in DT
changed their attitudes toward diabetes care positively. They
put more focus on the importance of special training in key
elements of patient empowerment, such as communication,
counseling, and collaboration with patients. These results
suggest that DT could be useful to improve the attitudes of
HCPs in diabetes care in terms of patient empowerment.
PG-38
A 6-month nutritional education program for patients with
diabetes mellitus is effective to improve HbA1C
Masayo KOMEDA1*, Masashi ADACHI2, Takao SHIMIZU2,
Mami UTSUNOMIYA3, Shin HASEGAWA4, Ayumi NAKAI4,
SusumuNISHIKUBO5, Yoshie AKISUE 5.1 Department of Nutrition,
Maki Hospital, 2Department of Medicine, Maki Hospital,
3Department of Nursing, Maki Hospital, 4Department of Pharmacy,
Maki Hospital, 5Department of Clinical Laboratory, Maki Hospital,
Japan
Background: It is important to prevent and treat diabetes
mellitus with lifestyle as an important component. However,
the best form of education program to control and correct
lifestyle measures of people with diabetes is not always
performed. Continuous nutrition education was performed
individually to support patients with diabetes and the
effectiveness of this education was assessed.
Subjects and methods: Thirty four patients took part in the
education program for six months from May 2013 to October
2014. The program was performed at four discrete timepoints:
baseline, one month, three months, and six months. Also the
program was provided four to six times. It was individually
targeted based on HbA1c level and duration of treatment. In
patients with dementia, the education program was provided
mostly to the patient’s family. At baseline the personal
information of patients was collected and education was
provided about diabetes mellitus. At the second timepoint,
education was provided about a well-balanced diet. The third
timepoint involved education regarding appropriate snacks
and drinking alcohol, and at the final 6-month timepoint, a
review of all the education components was provided together
with education on achieving the target goals for diabetes
mellitus. HbA1C, body weight, abdominal circumference, diet,
medication and activity level were compared and investigated
before and after the nutritional education program.
Results: HbA1C decreased by 0.8%, from 8.1 ± 1.8% to 7.3 ± 1.2%
(p < 0.01). In patients with HbA1C > 8.0% (n = 13), the value
decreased by 1.7% from 10.0 ± 1.4% to 8.3 ± 1.4% (p < 0.01). On
the other hand, in patients with HbA1C < 7.9% (n = 21), it
dropped by 0.1%, from 6.9 ± 0.5% to 6.8 ± 0.6%. Body weight
decreased by 0.8 kg, and abdominal circumference decreased
by 1.2 cm (not statistically significant). There were thirteen
patients whose medication was changed during the six
months period. Analysis of activity found that, the step
counts changed from 4,249 to 3,891 steps, and activity levels
changed from 2.1METs to 2.3METs. These changes are not
statistically significant.
Conclusion: The use of a 6-month education program for
diabetes was able to significantly reduce HbA1C by 0.8
percentage points. A greater benefit was seen in patients
with a higher baseline of HbA1C > 8.0%. However, our educa-
tion program performed only by dietitians could not improve
physical activity levels. A potential team consisting of
dietitians, pharmacists, rehabilitation therapists, nurses and
doctors should continue to support these patients with
diabetes to improve their lifestyles.
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S171