533-P: The Physiological Effects from Type 2 Diabetes Self-Management Program in a Municipal Setting

There is a lack of knowledge showing the real-life effects of person-centered type 2 diabetes (T2DM) Management programs offered in a municipal setting. The aim of this study is to determine the effectiveness of individualized T2DM management programs for patients with T2DM in a municipal setting on HbA1c and blood pressure (BP). Based on a person-centered and differentiated approach, the intervention consists of education, physical training, cooking classes and/or individual consultations.

Methods: The study was conducted during 2018 to 2021 with citizens referred consecutively for T2DM management programs. A total of 308 patients were included. Of these 308, 172, and 131 completed questionaries and physiological measurements at baseline, at end of the program and at 6 months follow-up, respectively. All physiological data was collected by selected health care professionals trained in standard operations procedures. Results: Respondents consist of 60% men, age range primarily from 55-79, 57% have a short education level. At baseline mean HbA1c was 58.5 mmol/mol (IQR: 48.0-64.0). At end of the program, a statistically significant decrease of −6.5 mmol/mol (95% CI: −9.0; −4.1, p<0.001) was observed. At 6 months follow-up this decrease was unchanged as it was showing a decrease of −5.8 mmol/mol (95% CI: −8.8; −2.8, p<0.001) compared to baseline. At baseline mean systolic and diastolic BP was 147.5 mmHg (IQR: 134.2-158.0) and 86.2 mmHg (IQR: 79.6-93.3), respectively. At end of the program and at 6 months follow-up a significant decrease of −10.7mmHg (95% CI: −15.0; −6.3, p<0.001) and −11.8 mmHg (95% CI: −16.4; −7, 2, p<0.001), respectively, was observed for systolic BP when compared to baseline.

Conclusion: Person-centered T2DM management programs in a large municipal setting significantly reduce HbA1c and BP on long and short term. These results may be caused by person-centered care and a holistic approach.