Authors (including presenting author) :
LEUNG SM (1), LEUNG HSS (2), MAK KP (2), WONG KK (2), CHAN SKE (1), YUEN YL (1), POON MY (1), YUEN CM (1)
Affiliation :
(1) Centre for Diabetes Education and Management, Our Lady of Maryknoll Hospital. (2) Department of Medicine & Geriatrics, Our Lady of Maryknoll Hospital.
Introduction :
A newly designed Multidisciplinary Caring Program-Dyslipidemia Management for Obese Diabetes (DMOD) had been launched from 11/2023. It adopted proactive approach with early assessment and identify those risk factors to prevent Metabolic-associated fatty liver disease (MAFLD) related complications in diabetes.
Objectives :
To estimate the local prevalence of Metabolic-associated Fatty Liver Disease (MAFLD) among diabetes patients. To deliver structural diabetes care to patients by multidisciplinary team approach.
Methodology :
All the eligible participants with aged 18-65, and met the inclusion criteria (Triglyceride (TG) >1.7mmol/L; Low-density Lipoprotein-Cholesterol (LDL-C) > 2.6mmol/L; Body Mass Index (BMI) > 25kg/m2) were invited to attend the program. Participants with adjusted lipid-lowering and diabetes medication regimen; established CVD/CHD; pace marker or metal implant; planned for pregnancy or pregnancy women; established Fatty Liver / deranged liver function; on weight reduction medication (e.g. GLP1-RA) and refused to join the program would be excluded. The VF and PBF changes were measured by a Body Composition Analyser called “Inbody”. These data facilitated to formulate a more effective treatment and prevention strategies for MAFLD. Two therapeutic education sessions were delivered by trained DM nurse at T0 and 3 months thereafter. The report findings were explained and a tailor-made exercise & dietary regimen were formulated with the related tele-information prescribed. Participants were referred to physiotherapist & dietitian for further management
Result & Outcome :
Outcome measurement included the changes in TG, LDL-C, BMI, HbA1c, Visceral Fat (VF) and Percentage Body Fat (PBF) at baseline (T0) and 6 months thereafter (T1). Paired Sample t Test was used to compare their mean differences. Total 13 eligible participants were recruited and received full dose of intervention (2 sessions of therapeutic education). The mean age was 56.1±13.8 (62% were male). Their mean duration of being diagnosed diabetes were 10.4±11.3. By the end of study, BMI (29.6±3.2 to 29.3±3.3); PBF (35.0±6.6 to 34.3±5.6); VF (12.2±4.4 to 11.4±3.3); and HbA1c (7.7±1.9 to 7.6±2.0) showed improvement. A compelling effect with statistically significant improvement (4.6±3.9 vs 3.7±1.4, p=0.04) was reflected in TG level. Feedback from majority of participants (77%) through post-intervention telephone interview after 4-5 weeks had experienced out-weighted benefits in improving their confidence in dietary modification and weight management.
