Abstract
Background: The Tallaght Community Integrated Care Hub is one of 30 integrated care hubs in the Republic of Ireland. These hubs aim to provide preventative, management and support services to patients with chronic diseases. The dietetic team within the hub have successfully delivered six 12-month Diabetes Prevention Programme’s (DPP) since July 2022, with two completed and four still in progress. International evidence has shown that those living with pre-diabetes who follow a structured education programme (similar to the DPP) can reduce their risk of developing type 2 diabetes mellitus (T2DM) by approximately 60% (1, 2). The effectiveness of these self-management education and support (SMES) programmes delivered by the hub in reducing patients’ risk of developing T2DM to date has been evaluated.
Aims and objectives: The dietetic team aimed to establish a service within the local community, to deliver SMES in the form of the DPP, with an aim to prevent T2DM in people diagnosed with pre-diabetes (hbA1c: 42-47 mmol/mol). The DPP is a nationwide programme in Ireland that was commissioned and developed under the Health Service Executive Slaintecare chronic disease team (3). The programme supports participants to make sustainable lifestyle changes by adopting a progressive approach to diet, physical activity, weight and changes for health. The dietitians aim to deliver this programme on a continuous basis, both online and in-person, at local health centres closer to home. The outcomes of the programme are evaluated upon completion.
Project design: Initially, general practitioners within the local community were contacted to create a waitlist for the DPP. The recruitment phase, which involves a 45-60 minute 1:1 assessment with the dietitian, commenced in April 2022. Suitable participants were then enrolled on the first DPP at the hub in July 2022. The dietitian led programme delivers SMES with 14 group sessions and three 1:1 assessments over a 12 month period. Since July 2022 two programmes have been completed, four are ongoing with a total of 106 participant’s enrolled and 72 group sessions delivered. Data such as weight, body mass index and serum HbA1c are collected and analysed initially, at 6 months and upon completion of the programme. Verbal progress and feedback from participants is also collected throughout.
Results: Our statistics have shown that 93% of participants (n=14) who completed the programme have avoided developing T2DM with 43% now below the pre-diabetes range. Data available on those currently enrolled on programmes (n=21), shows 100% have avoided developing T2DM with 15% now below pre-diabetes range before programme completion. 73% of participants (n=15) who completed the programme have lost weight, with an average weight loss of 7.3%. However not all participants enrolled onto the programme will have weight loss goals as part of their individual plans.
Conclusion: The dietitians working at The Tallaght Community Integrated Care Hub demonstrate that preventative care can be successfully implemented and delivered within the community setting. The ongoing delivery of the DPP at this hub has shown to be successful in preventing T2DM for those with pre-diabetes, reducing weight and improving lifestyle behaviours.