Objective: Previous studies showed that integrated care models by multidispline professionals were effective in management of clinical metabolic indicators and prevention of diabetes mellitus-related complications. The objective of this study was to investigate the effect of “the Improvement Program of National Health Insurance Payment for Diabetes Medical Treatment” (the Improvement Program) on metabolic indicators of type 2 diabetic patients in Taiwan.
Methods: A total of 885 patients were enrolled in this study from a tertiary teaching hospital (1,300 beds) in Taichung, Taiwan, 2002-2012. The Improvement Program included multi-displine professionals (physicians, nurses, and dietitians) as an integrated care team and provided continuous care with regular follow-up (Ref: https://www.nhi.gov.tw/Resource/webdata/19248_2_糖尿病醫療 給付改善方案.pdf). Anthropometric indicators including body weight (BW), waist circumference (WC), and body mass index (BMI) were measured using standard protocols. Biomarkers including total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglyceride (TG) were measured in central laboratory of this hospital.
Results: After the Improvement Program, total cholesterol (199.52 ± 42.69 mg/dL vs 189.81 ± 49.70 mg/dL; p = 0.009), LDL-C (110.33 ± 34.21 mg/dL vs 103.63 ± 31.96 mg/dL; p = 0.01), and TG (162.12 ± 126.90 mg/dL vs 145.15 ± 106.04 mg/dL; p = 0.001) were significantly decreased. However, BW, WC, BMI, and HDL-C showed no statistical significant difference.
Conclusion: The Improvement Program may be beneficial for metabolic control in type 2 diabetic patients.