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>100 mg/dL. Cardiovascular disease is the primary cause of
death among T2DM patients. Hyperglycaemia, dyslipidaemia
and hypertension are the most critical risk factors for CVD.
After additional adjustments for BMI, the ADA dietary
score was still significantly inversely associated with SBP,
serum LDL-C, HbA1c and 10-year risk of CHD. Previous studies
have reported that the dietary composition of the ADA dietary
score was associated with reduced CVD risk factors, and
the association was independent of BMI. Conclusions: Patients
with T2DM who adhere to the ADA dietary recommenda-
tions or with higher AHEI-2010 scores exhibited signifi-
cantly reduced CVD risk factors, including lower central
obesity, hypertension, poor control of blood glucose and
dyslipidaemia. Effects other than BMI contributed to the
beneficial effects of the ADA dietary recommendations on
CVD risk in the present study. ADA dietary score and AHEI-
2010 score might both exhibit reduced risk factors of CVD in
T2DM patients.
Diabetes Education: Patient Centered
Approach
S29-1
Personalised diabetes care: What is it, and does it
‘
work
’
?
Trisha DUNNING
1
.
1
School of Nursing and Midwifery, Deakin
University, Australia
Personalised care requires effective relationships among
people with diabetes, communities and the individual
’
s sup-
port people. It can help people set relevant care goals and gain
control over their care, which improves satisfaction, physical,
psychological and other outcomes, and can reduce costs and
unnecessary presentations to health services.
Health professionals require specific knowledge and compe-
tencies to deliver effective personalised care including how
to recognise the assets and values individuals bring to
consultations about their care. Personalised care is delivered
in different ways, but productive conversations about what
matters to the
individual
and the supportive and inhibitory
factors that could affect their preferences is essential to
developing personalised care plans and goals. Effective
personalised diabetes care should encompass proactive con-
versations about changing needs, be coordinated, clearly
documented and communicated to relevant care providers.
The presentation will discuss the intended outcomes of perso-
nalised care, the factors that affect decision-making, values
and preferences such as experience, culture, health literacy
and risk perception. The core skills and knowledge health
professionals need to cogenerate personalised care plans with
individuals with diabetes, will be outlined. It will touch on
factors such as the human Genome studies, epigenetics, pre-
and probiotics and the role these initiatives might play in
future understandings and application of
“
personalised dia-
betes care.
”
S29-2
Going even further, from counselling to motivating: a
universal patient-centered approach to provoke behaviour
modifications in your patients
Jacques BEDARD
1
.
1
Internal Medicine, Faculty of Medicine,
University of Sherbrooke, Quebec, Canada
Behaviour change: Behavioural changes (physical activity,
diet, medication adherence, smoking cessation
…
) are funda-
mental for prevention and active treatment of diabetic
patients.
The traditional approach identifies the behaviours that (
we
think) the patient should change, aim to convince about
the Why and give instructions on the How to change (a
Professional-Oriented directive approach).
Patients, however, don
’
t change!
In response to this problem, we present a practical universal
(Patient-Centered) intervention tool (identical for all profes-
sionals and all behaviours) that leads to behavioural change.
This targeted intervention uses recognition of the apparent
Stage of Change (Prochaska
’
s model), confirmed by the
Conviction level, to develop one of three specific intervention
scenarios with the proper closing technique for each scenario.
It uses a variation of the
“
Motivational Interviewing
”
commu-
nication technique. Through the skilful use of open questions,
it provokes, reinforces and accelerates progress along the path
to change rather than directing it.
Used by different members of the same therapeutic team
(physicians, nurses, pharmacists, nutritionists
…
), it creates a
synergy that increases the acceleration of patient progress as
they move from one professional to the next.
Across the spectrum of medical interventions, we have spent
more than 30 years focusing on the WHY of changing patient
behaviours
–
the time has now come to promote the HOW!
Peer Leaders in Diabetes Management
S34-2
Effectiveness of peer leaders in diabetes self-management
support
Juliana C.N. CHAN
1
.
1
Department of Medicine and Therapeutics,
Hong Kong Institute of Diabetes and Obesity, The Chinese University
of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
Diabetes is a chronic andmultisystemdiseasewhich can affect
physical and psychological health. There is growing evidence
showing the bidirectional associations between depression
and diabetes which is associated with reduced adherence
and increased risk of complications. Leaving aside possible
biological links between diabetes and depression, miscon-
ceptions and anxiety about the nature of diabetes and its
possible complications, side effects of medications, demands
on self-discipline in changing lifestyle, regular medical visits
and long term medications are some of the factors that can
cause distress, anxiety and depression in peoplewith diabetes.
With the onset of complications anddisabilities, thesenegative
emotions can further intensify. Given the interlinking nature
between cognition, psychology and behavior, education and
empowerment aiming to increase self-efficacy can reduce
negative emotions and promote positive behaviors. However,
time contact is one of the most important determinants in
patient education. Here, knowledge transfer from doctors to
other personnel including nurses, dietitians, care assistants
and community workers are effective measures to engage and
empower patients. Supported by the medical team, the
paramedical personnel can identify and train peer leaders
who can provide practical tips to their peers on daily livingwith
diabetes, such as food choices, interpretation of results of
self-monitored blood glucose and ongoing social support.
Research studies have supported the benefits of peer support
on metabolic risk factors, psychological and behavioral factors
as well as health care utilizations, especially in settings where
health care provision is less well-coordinated. Furthermore, by
supporting their peers, peer leaders may also improve by being
more positive and engaged with stable glycemic control. That
said, more studies are needed to define the attributes of peers
and peer leaders and dynamics between peer and peer leaders
to increase the impacts of these holistic programs. Pending
such results, establishing infrastructures such as community-
basedDiabetesCentres or Patient-CentredHomesmay improve
the efficiencyand effectiveness of these complex interventions
Speech Abstracts / Diabetes Research and Clinical Practice 120S1 (2016) S1
–
S39
S28