Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

Engaging women in a postnatal DPP is very challenging and

resource intensive. Despite substantive engagement effort, the

MAGDA-DPP experienced a low overall participation rate. The

improved recruitment and retention of older women, however,

suggests an intervention timed for post-GDM women with

older children may be more appropriate.

OL08-7

Clinical application of a self-reported diabetic-behavior

assessment computerized program in management of

patients with type 2 diabetes mellitus

Hui-Chun HSU

, Ling-Wang AN

, Yau-Jiunn LEE

Yu-Hung CHANG

, Der-Wei HWU

, Ruei-Hsia WANG

Lee

’

Endocrinology Clinic, Taiwan;

Beijing Ruijing Diabetes Hospital,

China;

Kaohsiung Medical University, Taiwan

Objective:

Diabetes self-management education/support

(DSME/S) is obligatory in long-term management of diabetes

because of a complex health intervention, is generally effective

at enhancing self-care behaviors. This study aimed to evaluate

the effectiveness of a self-reported diabetes-related behavior

dashboard computer program on clinical management of

patients with diabetes mellitus.

Materials and methods:

A Chinese version of computerized

assessment system was constructed to evaluate diabetes self-

management behaviors, including health eating, taking medi-

cation, exercise, blood glucose self-monitoring behaviors.

Furthermore, to assess the psychological stress, a short-form

Chinese version of PAID and WHO 5 well-being index

questionnaire were also build into the system. There were

3,404 patients with type 2 diabetes mellitus (T2DM) received

the behavior dashboard evaluation at baseline and re-evalu-

ated again 12-months later.

Results:

The computer program content validity index was

calculated by experts

’

ratings of item relevance. The CVI was

0.866

∼

1.0. The inter-rater reliability, involved the process of

inter-rater reliability assessment to test the rating consist-

ency among observational ratings was 0.816

–

0.965 (p <

0.001). The test-retest reliability of intra-class correlation

coefficient was 0.752 (p < 0.001). The baseline and 12-month

HbA1c, BMI, LDL cholesterol, and e-GFR levels correlated

well with the correspondent behavior scores of eating,

medication, exercise, self-blood glucose monitoring, the

PAID and WHO-5 scores, and the total scores. The difference

in baseline and 12-month HbA1C level was significantly

associated with the difference of baseline and 12-month

total score and a model predicting the 12-month HbA1C

level was also constructed.

Conclusion:

Diabetes behavior assessment program could be a

precise, convenient computer-based system to evaluate the

diabetes related behavior that associated with glycemic

control in patients with T2DM.

OL08-8

Fidelity: The missing dimension in structured diabetes

education around the globe

Deborah SCHOFIELD

, Helen MITCHELL

*, Sophie MCGOUGH

Timothy SKINNER

, Bernie STRIBLING

, Kamlesh KHUNTI

Melanie DAVIES

Diabetes WA, DESMOND Australia, Perth,

Charles Darwin University, School of Psychological and Clinical

Sciences, Darwin, Australia;

Leicester Diabetes Centre, DESMOND

UK, Leicester, United Kingdom

Background:

Client centred structured education programs

with focus on the quality development of facilitators are a

proven method to enable supported self-care in diabetes.

Group programs for type 2 diabetes are conducted worldwide.

However, few can be deliveredwith sufficient fidelity to ensure

client outcomes.

DESMOND is the collaborative name for a family of group self-

management education modules, toolkits and care pathways

for people with, or at risk of, type 2 diabetes. It breaks the

mould of the traditional train the trainer model with its focus

on measuring the quality of the facilitator of the program. In

doing so facilitators strongly orientated in a medical model are

moved along a pathway and provides them with the tools to

empower their patients. The DESMOND collaborative has

crossed international borders and is delivered in the UK,

Ireland, Qatar, Australia and New Zealand.

Aim:

Based on solid evidence, quality diabetes structured

education provides a blueprint to maximise time spent pro-

blem solving self-care behaviours among peers and ensuring

the development of personalised action plans under the

guidance of skilled facilitators.

Method:

There are agreed criteria on what constitutes quality

structured group education:

–

An underpinning philosophy

–

Evidence-based theories linked with outcomes

–

Using a structured curriculum

–

Delivered by trained educators

–

Quality assured, with an ongoing audit

DESMOND UK has worked with international partners to adapt

the program to enable translation into other countries.

Results:

DESMOND across the globe is building the diabetes

workforce beyond its traditional medical model by delivering a

consistent dose of quality education.

Aware of national health targets and messaging, the

DESMOND program has been adapted to reflect these differ-

ences, whilst maintaining the core elements of the program.

Cultural adaptions and modifications have been taking place

ahead of rolling out DESMOND in Qatar and in the Australian

Aboriginal and Torres Strait Islander Communities. The

changes include translating the participant resources into

Arabic as well as making the resources culturally acceptable.

The South Island of New Zealand has trained DESMOND

educators and the program is firmly embedded in their

diabetes care pathways.

Discussion:

DESMOND has demonstrated how international

collaboration can share best practice between countries to

improve health outcomes. It is possible to transcend cultural

and geographical barriers with an evidence-based structured

education program. The training and quality development

pathway for facilitators has maintained the fidelity of the

program and ensured that the same

“

dose of DESMOND

”

given across the globe.

Novel Treatment for Diabetes and

Diabetic Complications

OL09-2

GLP-1 action attenuates breast cancer growth and progression

Shiho KOMATSU

, Takashi NOMIYAMA

*, Chikayo IWAYA

Yasuteru YOSHINAGA

, Shinichi YAMASHITA

Takako KAWANAMI

, Yuriko HAMAGUCHI

Tomoko TANAKA

, Akinori IWASAKI

, Toshihiko YANASE

Fukuoka University, Japan

Incretin therapy has emerged as one of the most popular

treatment for type 2 diabetes. GLP-1R agonist, Exendin-4(Ex-4),

has received much attention, because of its tissue protective

effects beyond glycemic control, such as weight reduction and

vascular protection. We have previously reported vascular

protective effects (Diabetes 2010, BBRC 2011) and anti-prostate

cancer effect (Diabetes 2014, PLOS ONE 2015) of Ex-4. On the

other hand, breast cancer is one of the most popular cancers in

female with patients with type 2 diabetes and obesity. Then,

we next examined whether GLP-1 action could attenuate

breast cancer in the present study.

Oral Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S40

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S64

S60