The Medical Nutrition Therapy in Diabetes Quality Improvement Program in the Community Primary Care Clinics, Taichung City - Based on the Diabetes Case Management Program 2001, Taiwan
Martin M-T Fuh, HY Chang, HY Su, CT Chang, RH Chen, CC Chen, LW Hsieh, CC Lee, CC Lin
Affiliation : China Medical University Hospital, Taichung, Taiwan
Background and Aims. In order to assess the nutritional status of a diabetes cohort following by the MNT
intervention and ensuing demonstration of quality of diabetes care, a nationally standardized, multi-profes-
sionally integrated, and patient-center healthcare program – Diabetes Case Management Program ( DCMP
) 2001 was implementing at the community primary care clinics, Taichung City.
Materials and Methods. From Jul. 2003 to Jun. 2005, around 1400 diabetes beneficiaries were randomly and
cumulatively recruited in DCMP 2001 via monthly outpatient visits in 24 community primary care firms at
Taichung City, Mid-Taiwan. Accordingly, the diabetes should tri-monthly be able to have dietary consultation
after seeing physician. The nutritional assessment and medical nutrition therapy ( MNT ) intervention were
individually recommended after adequate record of personal dietary history. All data were presented as
mean±SEM. Comparison between sexes, Student’s t test was used for continuous variables, and Chi-Squre test
was used for categorical variables. The significant level was set at P<0.05.
Results. The dietary consultation has been conducting within the community computerized primary care
settings with partially–designed IT and database depository in the Primary Diabetes Care Association (
PDCA ), Taichung City. The distributions of the differences ( A-R ) between actual ( A ) and recommendatory
( R ) total daily caloric intakes indicated patients’ adherence of eating habits to MNT ( Fig. 1 ). The distribu-
tions of percentage of macronutrients in daily caloric intakes in this community diabetes cohort demonstrated
the eating styles as well ( Fig. 2 ). The actual total daily caloric intakes were significantly different in both
sexes at different ranges of age . Furthermore, the gender differences of distributions of A-R and percentages of
macronutrients in daily caloric intake were also shown significant statistically .
Conclusion. Based on these cross-sectional data, the results shown that there were more than 40% of total
cases in this community diabetes cohort had their A-R daily caloric intakes either above the level of + 200
kcal or below the level of -200 kcal of the MNT recommendation. As a matter of fact, the distribution of
percentages of macronutrients in daily caloric intakes, however, clearly indicated that a considerable oppor-
tunity existed for dieticians to improve the quality of nutritional care after implementing DCMP 2001. More-
over, the relationship between eating habitudes and metabolic control needs to be further elucidated at the
community primary care level.
Keywords :
