Journal List > Korean Diabetes J > v.32(5) > 1002251

Kim, Lee, Kim, Oh, Park, Park, Kim, Seo, Kim, Choi, Baik, Choi, and Kim: Effects of Comprehensive Support on Glycemic Control Using Community Networks in Low-Income Elderly Patients with Diabetes

Abstract

Background

Diabetes is common among elderly, and low-income is associated with poor adherence to treatment and increased mortality. We evaluated whether comprehensive support using community networks improves glycemic control among low-income elderly patients with diabetes.

Methods

A total of 49 low-income elderly patients with type 2 diabetes, mean age 73 years, were enrolled. For 1 year, study subjects underwent various lifestyle modification programs provided by community networks. The biochemical data including glycemic markers and anthropometric data were obtained at the baseline and at the end of the study. Also, the patients were asked to complete a questionnaire about their quality of life, self-confidence and self-care behavior.

Results

After lifestyle modification program, overall changes of fasting plasma glucose, HbA1c, blood pressure, body weight, and other biochemical markers were not significantly different. In a subgroup analysis of 21 patients with poorly controlled diabetes (fasting glucose > 140 mg/dL or HbA1c > 7.5%), fasting plasma glucose was significantly reduced (P = 0.030). Among patients with baseline HbA1c level ≥ 8%, HbA1c levels after intervention decreased from 9.33 ± 1.07% to 8.27 ± 1.15% (P = 0.092). The results of the questionnaires revealed significant increases in the scores of quality of life, self-confidence and self-care behavior (P < 0.05).

Conclusion

Among low-income, elderly patients with type 2 diabetes, lifestyle modification through community networks showed no significant changes in glycemic control markers. More intensive and precise interventions using community networks are needed for the glycemic control of low-income, elderly patients with type 2 diabetes.

Figures and Tables

Table 1
General baseline characteristics
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Table 2
Baseline characteristics associated with the management of diabetes
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Table 3
Characteristics associated with lifestyle
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Table 4
Comparisons of body weight, waist circumference, BMI, blood pressure, and biochemical markers before and after interventions among a total of 49 subjects
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Table 5
Comparisons of body weight, waist circumference, BMI, blood pressure, and biochemical markers before and after interventions among 20 subjects whose fasting glucose > 140 mg/dL or HbA1c > 7.5%
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Table 6
Comparisons of self-confidence, self-care behavior and quality of life before and after interventions
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