Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

education provided through professional teams. The imple-

mentation of patient-centered care in diabetes can include

diet and exercise, treatment-taking, psychological stress,

self-monitoring of blood glucose, and sick-day management

to reduce the risk of long-term complications, such as kidney

disease, coronary artery disease, stroke, blindness and

amputation. Diabetes self-management education/support

access to a multidiscipline team, care planning discussions,

reminding, informatics and annual checks are important

procedures to identify necessary changes to treatment

regimens and refer to specialist services. Integrated diabetes

care is both integration of a health care system and co-

ordination of services around a patient. Integration of

services around the patient and across the community

becomes more robust and effective as evidenced by many

scientific reports. Our polyclinic specific on diabetes care

constitute of diabetologist, neurologist, ophthalmologist,

nephrologist, hepatologist, psychologist, and certified dia-

betes educators that serving over 5,000 patients with

diabetes. Our experience on integrated care specific on

diabetes management may suggest higher quality of man-

agement would be observed if patients are managed under

the system. However, challenges and barriers of quality

improvement in diabetes care still exist and need to be

conquered by wisdom and encouragement.

Self-Management of Diabetes Education

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The role of shared decision making in diabetes education

Mei Chang YEH

School of Nursing, College of Medicine, National

Taiwan University, Taipei, Taiwan

Patient-centered care has been found to be associated with

improved patient outcomes, including improved self-manage-

ment, patient satisfaction, and medication adherence. A

patient-centered care is defined as: providing care that is

respectful of and responsive to individual patient preferences,

needs, and values and ensuring that patient values guide all

clinical decisions. Shared decision making is one of practical

and well-described methods to accomplish patient-centered

care.

Shared decision making has been defined as:

“

an approach

where clinicians and patients share the best available

evidence when faced with the task of making decisions,

and where patients are supported to consider options, to

achieve informed preferences

”

. In shared decision making

the clinicians

’

role is to help patients understand what the

reasonable options are, clarify treatment options, and

integrate patients

’

informed preferences as they relate to

the available options. Usually a patient has more than one

reasonable treatment option, informed preferences are an

optimal goal because the decisions made will be better

understood, based on more accurate expectations about the

negative and positive consequences and more consistent

with personal preferences. In other words, individual self-

determination is a desirable goal and clinicians need to

support patients to achieve this goal.

The model of how to do shared decision making is based on

choice, option and decision making. Three key domains of

shared decision making are (1) Information-Sharing, Clini-

cians help patients participate by providing high quality

information and also need to elicit what patients already

know, and whether it is correct. (2) Deliberation, Clinicians

support patients to full disclosure of treatment options, and

explore their reactions to information. (3) Decision-making/

implementation, Clinicians support patients to consider

preferences and decide what is best. Patients and clinicians

arrive at a treatment plan. Barriers and facilitators to shared

decision making in diabetes education also will be mentioned.

S40-2

A diabetes self-management education/support structured

program built for patients with poor glycemic control

Hui-Chun HSU

, Yu-Hung CHANG

, Yau-Jiunn LEE

Ruey-Hsia WANG

Department of Internal Medicine, Lee

’

Endocrinology Clinic, Pingtung,

Department of Nursing, School of

Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan

Diabetes self-management education/support (DSME/S)

refers to the education and support that is required for

implementing and sustaining coping skills and behaviors

needed to self-manage on an ongoing basis. It is well esta-

blished that diabetes self-management education (DSME), a

complex health intervention, is generally effective at enhan-

cing self-care behaviors, improving glycemic control, lowering

health care costs, and improving quality of life. We thought

that the theoretical basis and framework of the behavior

change approach for the structured educational intervention

among patients with type 2 diabetes (T2DM) in poor glycemic

control is essential.

Focus group education approach such as Conversation Map

™

(CM), an innovative visual tool grounded in several learning

and behavior change theories, may be a promising toolkit for

DSME. In contrast to traditional DSME provided by a one-to-one

didactic method, CM is performed in a small group and allows

patients to learn about key concepts through interactive

discussion and choose what they can change in their daily

diabetes care. In the meantime, instead of as inculcators, dia-

betes educators can work as facilitators by providing informa-

tion to participants and helping patients to set personalized

action goals to improve their diabetes care. To date, the content

of CM has been recognized by several professional societies (e.

g., the American Diabetes Association (ADA), International

Diabetes Federation (IDF), Canadian Diabetes Association and

Taiwan Association of Diabetes Educators (TADE).

Despite CMhaving been distributed worldwide for the past few

years, scientific evidence is limited and its clinical value may

also be challenged. We thought it should be noted that the

delivery of DSME largely depends on the resources of the

healthcare system and the clinical scenario. Hence, we design

the program with CM in in our routine focus group education

every Tuesday afternoon and share the experience to you.

Lunch Seminar

–

LG Life Science

LN02-1

Optimizing glucose control with gemigliptin in type 2 diabetes

Jeong Hyun PARK

Division of Endocrinology and Metabolism,

Department of Internal Medicine, Inje University Busan Paik

Hospital, Inje University College of Medicine, Busan, Korea

Type 2 diabetes is a complex and progressive disease which

requires continuous medical care with multifactorial risk

reduction. Glycemic variability and chronic sustained hyper-

glycemia are themain components of dysglycemia in diabetes.

Because even short periods of hyperglycemia increase the risk

of micro- and macrovasular complications, a more proactive

approach is required to get patients to achieve their glycemic

goals sooner.

DPP-4 inhibitors are well suited for the use in a wide range of

patients with T2DM, due to their ease of use, low risk of

hypoglycemia, weight neutrality and favorable tolerability.

However, they differ widely in their binding to the DPP-4

enzyme, potency, and selectivity as well as their pharmaco-

kinetics profiles because the class is heterogeneous regarding

chemical structure.

Speech Abstracts / Diabetes Research and Clinical Practice 120S1 (2016) S1

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