Implementing a localized health promotion model in diabetic patients: a field trial

Abstract

Objectives: Diabetes mellitus, a major cardiovascular risk factor, is a leading non-communicable disease globally. Self-management education can effectively prevent and control diabetes. We evaluated a localized health promotion model for diabetic patients through a field trial in a general hospital.

Methods: We enrolled 452 diabetic patients who visited our hospital's cardiology and internal medicine wards and randomly assigned them to two equal groups: intervention and control. The intervention group received initial and periodic education on diabetes management and lifestyle modification, as well as educational materials. The control group received only initial education and phone follow-ups. We measured the following outcomes after 6 and 12 months of discharge: glucose and lipid levels, smoking status, diet quality, rehospitalization rate, treatment cost, quality of life, and work absenteeism. The groups were then compared using chi-square, student t-test, and two-way repeated-measures analysis of variance.

Results: We enrolled 452 patients, randomized into two equal groups, and followed them for one year. Baseline demographic and clinical variables were similar between groups. The intervention group showed a significant reduction in BMI (P = 0.027), fasting blood glucose (P < 0.001), and HbA1c levels (P = 0.002) compared to the control group. The prevalence of hypertension, smoking, sedentary lifestyle, and inappropriate diet was significantly higher in the control group (P = 0.001 for all). The intervention group had fewer hospitalizations, work absences, and medical costs (P < 0.001, P = 0.001, and P < 0.001, respectively). No significant difference was observed in satisfaction rates between the groups.

Conclusions: Health promotion interventions could improve glucose control and other health indicators and reduce costs for diabetic patients.

Keywords: Diabetes mellitus; Field trial; Health education; Health promotion; Healthy lifestyle.