Diabetes Care Programme for Type 2 Diabetes Mellitus in Primary Care Setting
Diabetes Care Programme for Type 2 Diabetes Mellitus in Primary Care Setting
Uncontrolled metabolic parameters and co-morbidity risk factors cause Diabetes Mellitus as
 the leading cause of a multitude of micro-/macro-vascular complications. According to the
 International Guidelines and Recommendations, people with Type 2 Diabetes Mellitus (T2DM)
 should attend diabetes educational programmes periodically and optimize the metabolic index
 of control. In Hong Kong, General Practitioners with solo-practice (GP-SP) have the least
 availability of resources and support in DM management. A discrepancy of diabetes care
 between public and private settings and a gap of clinical practice between public-private
 healthcare settings is identified. In relation to the big population of T2DM is caring by
 GP-SP but no structured Diabetes Care Programme (DCP) is in place. A structured DCP for T2DM
 is in need to fill up the clinical gap and make beneficial to the target subjects.

 The aim of this study is to evaluate the effectiveness of a DCP for people with T2DM in
 primary care settings. It is a multi-center, single-blind randomized controlled trial with
 parallel groups pre-test and post-test design. The evidence-based intervention (DCP) will be
 carried out in a private primary care setting. People with T2DM attending the GP-SP who meet
 the study criteria will be randomly assigned into one of the two study groups, either "DCP in
 addition to usual medical care" or "Usual medical care only" as a control group. The
 intervention group can beneficial in clinical and psychosocial outcomes after the completion
 of the 20-week structured DCP with a greater improvement of HbA1c level, Self-Efficacy in
 diabetes management, Diabetes Empowerment level, Diabetes Knowledge, and Quality of Life than
 those who only received usual medical care at the GP-SP.
This study is to implement an evidence-based develop Diabetes Care Programme (DCP) for 152
 adults with Type 2 Diabetes Mellitus (T2DM) in a few clinics of a general practitioner with
 solo-practice (GP-SP) in community, and evaluate its effectiveness by comparing the outcomes
 between study group (DCP with the usual medical care) and control group (Usual medical care
 only). It is believed that a structured DCP can promote greater clinical outcomes improvement
 and behavioral changes in the study group as evidence showed in literature. The primary
 outcomes are glycemic control (HbA1c level) and Self-Efficacy in diabetes management; whereas
 Diabetes Empowerment level, Diabetes Knowledge and Quality of Life are the secondary
 outcomes.

 The DCP consists of two parts, conduct 3 interactive group education with an innovative
 educational tool "Diabetes Conversation Map™" sessions by dietitian and diabetes
 educator/nurse. Then it followed by another 8 weeks for delivering two 15-30 minutes
 teleconsultations for patient empowerment and follow-up of "Action Plan" by a diabetes
 educator/nurse. Evaluation of outcomes will be done before the DCP (baseline), at week-8
 (right after the group sessions), and at week-20 (4 weeks after the last teleconsultation).

 In addition, a focus group interview will be carried out after the completion of the whole
 intervention. It purposes to explore and get valuable descriptive information and feelings
 from participants about the intervention and diabetes self-management.
Inclusion Criteria:

 1. People with T2DM and follow up at private general practitioner

 2. Age 18-75

 3. Haemoglobin A1c (HbA1c) >7.0%

 4. Can communicate in Cantonese

 Exclusion Criteria:

 1. Insulin users

 2. Unstable emotional and/or mental status

 3. Cognitive impairment and/or learning disabilities

 4. Recruited in other research and/or diabetes educational programme during the study
 period