Author : Yeung Theresa Hoi-Ming
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)
Book Synopsis Optimization of Glycemic Control for Newly Insulin Initiation Patients U2013 a Patient Partnership Approach by : Yeung Theresa Hoi-Ming
Download or read book Optimization of Glycemic Control for Newly Insulin Initiation Patients U2013 a Patient Partnership Approach written by Yeung Theresa Hoi-Ming and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Optimisation Of Glycaemic Control For Newly Insulin Initiation Patients u2013 A Patient Partnership ApproachYeung THM, Chik MY, Choy WY, Chan WS, Lee KY, Lau LW, Wong RYM, Loo KM, So TTY, Ozaki R, Cheung KKTDiabetes and Endocrine Centre, Prince of Wales HospitalIntroductionType 2 diabetes mellitus is characterized by insulin resistance and progressive beta cell failure. Most patients will eventually require insulin therapy; which will need adjustment over time to maintain good glycemic control. However, with limited resources, physicians can only follow up these patients every 4-6 months, resulting in delay in insulin titration to achieve glycemic targets. The Diabetes and Endocrine Centre, Prince of Wales Hospital ran a pilot program on u201cInsulin Titration Program For Patient With Type 2 Diabetesu2019u2019 to empower patients in achieving and maintaining good glycemic control within a shorter period of time.ObjectivesTo develop a structured insulin titration program to empower and engage patients to better understand and be more involved in their diabetes careTo educate and encourage patients to self-titrate their insulin dosage according to a structured insulin titration algorism MethodologyPatients (aged 18 to 75) newly initiated supplementary bedtime insulin were invited to join the program. In the program, patients learned the technique of self-injection, blood glucose monitoring, hypoglycemic management, healthy lifestyle modifications. Self-adjustment of insulin dose was encouraged, based on 3 consecutive home fasting blood glucose (FBG) readings, and a weekly fine-tuning titration of +/- 1-2 units. Patients were phone contacted on their progress at Week 1 and 2, and their insulin titration ability assessed using a standardized assessment form at Week 3. Patients who passed the evaluation would self-titrate their insulin dose with the support of diabetes nurses. If they failed the assessment, diabetes nurses would lead the insulin adjustment accordingly. Phone interviews continued until patients achieved their target FBGs. Result & Outcome33 patients (male=22; female=11; mean age 60.5 u00b1 10.8 years) completed the program. At Week 0, mean baseline HbA1c was 9.5 u00b1 1.2%. At 5 months, HbA1c was lowered to 8.0 u00b1 0.7%. 19 patients (57.5%) had adjusted insulin dose according to the prescribed algorithm. There were a total of 119 insulin titration episodes with few episodes of mild hypoglycemic event during the study period: titration by nurse=56.3% (n=67); by patients = 33.6% (n=40); by doctor = 10.1%(n=12). 6 patients did not require insulin titration as home FBGs were optimized by the prescribed starting dose of insulin therapy. Conclusion Empowering patients to take greater control of their diabetes, through education and patient-oriented insulin titration algorithms, can achieve targeted FBGs at a faster and more effective manner.
