title: Impact of disease-management programs on metabolic control in patients with type 1 diabetes mellitus: A cohort study in Shantou, China.
abstract: The aim of this study is to evaluate the effect of diabetes disease management program (DMP) on glycemic control in type 1 diabetes mellitus (T1DM) patients in Shantou China.A sample of 240 participants recruited from 3C study Shantou subgroup was followed up in DMP for 3 years. The DMP provided self-management education, individualized therapy plan, diabetes complications screening, and laboratory examination periodical according to clinical practice guidelines. Primary outcomes were changes in hemoglobin A1C (HbA1c).Two hundred one of the participants completed the follow-up. There was a significant decrease in the HbA1c levels after DMP implemented. The mean (± SD) pre- and post-intervention HbA1c levels were 10.26% ± 3.30% and 8.57% ± 1.57% respectively with a P value <0.001. General linear mixed model analyse demonstrated that changes in glycemic control were associated with insulin treatment regimen, frequency of Self-Monitoring of Blood Glucose (SMBG), diabetes diet adherence, physical activity, and duration of diabetes.DMP helped to improve glycemic control and should be general implemented in China's T1DM. Individuals with basal-bolus regimen (multiple daily injections or pump therapy), more frequency of SMBG, following a diabetes diet, more physical activity, shorter diabetes duration may derive greater benefits from DMP.
authors.affiliation: Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College Shantou University Medical College Department of Endocrinology, Shantou Chaonan Minsheng Hospital Department of Endocrinology, Shantou Central Hospital, Shantou Department of Endocrinology, Jieyang People's Hospital, Jieyang Department of Endocrinology, Chenhai District, Shantou City People's Hospital, Shantou, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Lin
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Yang
authors.forename: Yixi
authors.initials: Y
authors.lastname: Wu
authors.forename: Shuru
authors.initials: S
authors.lastname: Chen
authors.forename: Guoshu
authors.initials: G
authors.lastname: Yin
authors.forename: Jianjun
authors.initials: J
authors.lastname: Zhan
authors.forename: Chujia
authors.initials: C
authors.lastname: Lin
authors.forename: Wencan
authors.initials: W
authors.lastname: Xu
authors.forename: Yongsong
authors.initials: Y
authors.lastname: Chen
authors.forename: Dan
authors.initials: D
authors.lastname: Lin
authors.forename: Peiwen
authors.initials: P
authors.lastname: Xie
authors.forename: Yishan
authors.initials: Y
authors.lastname: Fang
authors.forename: Qiuqiang
authors.initials: Q
authors.lastname: Lin
authors.forename: Shaoda
authors.initials: S
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D015190:Blood Glucose Self-Monitoring; D002648:Child; D002681:China; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000628:therapy*; D004032:Diet; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D010353:Patient Education as Topic; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human