Impact of the Structured, Comprehensive Clinic-Led, Population-Targeted Diabetes Intervention Program as Compared with the Standard Care Approach

We implemented a structured comprehensive Diabetes Management Plan (DMP) which includes monthly diabetologist counselling, pharmacological interventions, dietician review and education, follow-up through face to face and mobile technology, exercise motivation and periodic investigations, at a onetime enrolment cost. ANOVA, Chi-Square test were used for the statistical analysis. We conducted a retrospective analysis of the glycemic measures of effectiveness in patients enrolled with DMP (n=47, males= 32, females = 15; mean age (years) 50.4 ± 9.4, min 27, max 72) compared to the group receiving the conventional Standard Of Care (SOC) over one year (n=47, males= 24, females = 23; mean age (years) 54.3 ± 13.9, min 24, max 78); (p=0.116) from Jan- Dec 2017. At end of one year of follow-up, DMP group (baseline HbA1c 9.1±1.57%) demonstrated higher HbA1c reductions of 1.86±1.10% as compared to the SOC group (baseline HbA1c 8.59±1.5%), which was statistically significant (p=0.046). DMP group (baseline Fasting Blood Glucose (FBG) 167.5±59.32 mg/dl) demonstrated higher FBG reductions of 34.89 ± 36.71 which was highly statistically significant from baseline (p=0.001). However, FBG was not statistically significant as compared to the baseline within the SOC group (baseline 147.25 ± 52.11 mg/dl, (p=0.602); the differences were statistically significant (p=0.005). The dyslipidemia parameters reveal that there was no significant difference in the groups for the change in LDL-C (p=0.36), total cholesterol (p=0.16) and HDL-C (p=0.11). The DMP group had significant elevation in HDL-C (11.8%, p=0.001). DMP with compulsory periodic interventions is useful as a better glycemic management tool and resource optimisation, as done in DMP, in an emerging economy would be useful model to emulate even for the developed world to manage the cost of diabetes care. Disclosure I. Kuberan: None. S. Rao: None. N. Wadhwa: None.