Authors (including presenting author) :
Lai SY, Tsang SW, Tong MH, Wong KM, Chan LS, Wong KY, Kwok CM, Lee K, Lee LS, Chim CK, Kwok ML Angela, Leung KW Maria
Affiliation :
Community Outreach Services Team, New Territories East Cluster
Introduction :
In 2021, the Hong Kong Hospital Authority (HKHA) data showed that 20% of Diabetes Mellitus (DM) patients aged over 65 are at risk of unawareness hypoglycaemia. Some had been hospitalized due to unawareness hypoglycaemia attack. In usual care, Self-monitoring blood glucose (SMBG) is generally recommended for DM patients. However, it has limitations including patients’ compliance, incomplete glucose profiles and limited static values (Hu.,et al,2017). Continuous Glucose Monitoring (CGM) devices offer 24-hour tracking for 10-14 days which are able to generate comprehensive profiles (Klonoff, et al., 2017). Therefore, NTEC COST has launched a CGM programme to provide specialty care for vulnerable DM patients in the community.
Objectives :
1. To detect unawareness hypoglycaemia
2. To prevent avoidable emergency admission
3. To enhance patients’ self-management skills for diabetes
Methodology :
• Patients aged ≥ 60 with type II DM under NTEC COST care were eligible for the program.
• Convenient sampling was adopted. CGM was set up for recruited patients in 4 weeks’ period. Community nurses provided regular visits to enhance DM self-management and arranged timely medical consultations based on CGM results. Pre- and post-intervention related to HbA1c and Patient Empowerment Scores of DM were measured.
Result & Outcome :
From 2020 to 2024, a total of 167 patients were recruited, mean age 78.4(range: 62-98); male 12%(n=56), female 88%(n=111). 454 hypoglycaemic episodes were detected. Pre-post intervention mean HbA1c dropped 7.2%(from 8.3% to 7.7%); Pre-post mean Empowerment Score improved 27.2% (from 13.2 to 16.8)
65% patients(n=108) required early interventions to improve glycaemic control. 97% patients(n=162) were no emergency admission related to DM within 28 days after recruitment.
