Effects of an Integrated Care Model (ICM) on People with Pre-Diabetes

Lin, Chiu-Chu

Purpose: This study aimed to develop an integrated care model (ICM) for people with pre-DM and to evaluate its effects on knowledge regarding pre-DM (K- pre-DM), dietary behaviors, health-promoting lifestyle, physical activity and pre-DM progression measures, including BW, BMI, fasting blood sugar, HbA1C, Tchol, HDL, LDL and TG.

Methods: In this single-group, longitudinal study, participants underwent baseline pre-testing (T₀) and post-testing at 3 (T₁), 6 (T₂), and 12 (T₃) months after a 4-week group ICM program.

Results: K- pre-DM was significantly increased (T₁vs. T_0,p=.01; T₂ vs. T_0,p=.00; T₃ vs. T_0, p=.01) throughout the 12-month period. Compared with T_0,dietary behavior was significantly better at T₁ (p=.01), and health-promoting lifestyle was significantly improved at T₂ (p=.02) and T₃ (p=.01). BW and BMI were significantly lower at T₁(p<.00, p=.00) and T₂(p<.00, p=.00) than at T₀. Fasting blood sugar was significantly lower than baseline at T₂ (p=.02) and T₃ (p=.02). The HbA1C level was significantly lower at T₁ (p<.00), T₂ (p<.00) and T₃ (p<.00) than at T₀. The HDL level was significantly higher at T₂ (p<.00) than at T₀. During the 12-month study period, physical activity was maintained at moderate intensity. In addition, Tchol, LDL, and TG were sustainably decreased throughout the study period.

Conclusion: The results of this study suggest that the ICM intervention is effective and may potentially prevent pre-DM progression.

Practice implications: This study provides evidence-based data to support the potential effects of a theory-driven protocol in preventing disease progression in people with pre-diabetes. Health care providers may apply it to people at high risk of developing diabetes in clinical and community care.