Scientific Programme
Abstract
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Abstract
Year 2021
October 2021

SHBC1141

Abstract Title
Lifestyle intervention counselling in newly diagnosed prediabetes patients in the primary care setting leads to increased appropriate follow-up glycaemic monitoring
Authors

Y.Z.P. EE1, S.E. NG1, C.Y.J. LEE1, N.M.J. GOH1, M. MOHAN1, N.D. CADWISING2, Z.H. TEO1 

Institutions

NHG Polyclinics1, NHG Diagnostics2

Background & Hypothesis

The rising burden of diabetes in Singapore necessitates screening in at-risk groups to identify patients with prediabetes – impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Lifestyle interventions can reduce progression to diabetes, with pharmacotherapy recommended if glycaemic control worsens. 6-monthly glycaemic monitoring is recommended in the 2017 Appropriate Care Guide, but is not routinely performed. This study hypothesised that lifestyle intervention counselling by Nursing Care Managers in a polyclinic would increase appropriate follow-up glycaemic monitoring in newly diagnosed prediabetes patients.

Methods

1439 prediabetes patients (479 control, 960 intervention) in a polyclinic were identified over 2 years using 2-hour oral glucose tolerance test. The control group (1 June – 11 November 2018) received usual care; the intervention group (12 November 2018 – 31 July 2020) underwent lifestyle intervention counselling by a Care Manager. The primary outcome measured was the percentage of patients in control and intervention groups with follow-up glycaemic monitoring performed within 6 months.

Results

Baseline characteristics – age, gender, body mass index, and proportion of IFG and IGT – were similar in both groups. The percentage of patients in the control and intervention groups with follow-up glycaemic monitoring performed within 6 months was 56% and 65% respectively (17% increase), which was statistically significant (p=0.001).

Discussion & Conclusion

Lifestyle intervention counselling by a Care Manager for prediabetes patients led to a 17% increase in appropriate follow-up glycaemic monitoring. More frequent glycaemic monitoring will aid identification of prediabetes patients who would benefit from more aggressive management, including pharmacotherapy, to reduce progression to diabetes.

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