Efficacy of telling blood test with a trend graph to decrease levels of HbA1c and direct LDL in diabetes patients
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Abstract
BACKGROUND: Uncontrolled diabetes is a significant contributor to high annual mortality rates. In Thailand, physicians typically inform patients of their HbA1c and direct LDL levels through verbal communication. However, a review of the literature found no clinical trials comparing the effectiveness of traditional verbal communication and trend graph communication in reducing HbA1c and direct LDL levels among patients with diabetes.
OBJECTIVE: To compare the efficacy of traditional verbal communication versus trend graph communication in conveying blood test results for reducing HbA1c and direct LDL levels in patients with type 2 diabetes.
METHODS: Patients with type 2 diabetes mellitus at subdistrict health promoting hospital in Chiang Rai were randomized in an open-label design into two groups: a control group that received blood test results through traditional verbal communication and an intervention groupthat received blood test results through trend graph communication. Each group will receive treatment and be provided with their blood test results twice: on the first day of study enrollment and at the 3-month follow-up. HbA1c and direct LDL levels will be monitored at 3 and 6 months after the study begins. The efficacy will be compared within and between groups using the mean differences in blood test results from 0 to 3 months and from 0 to 6 months, analyzed with paired t-test and independent t-test.
RESULTS: A total of 120 patients were included, and 98 patients met the criteria. The baseline characteristics, including initial HbA1c and direct LDL levels, were not statistically different between the two groups. At the end of 6 months, the mean differences in the reduction of HbA1cand direct LDL between the trend graph communication group and the traditional verbal communication group were not statistically significant [HbA1c: mean difference -0.04 (95% CI -0.25 to 0.16), p=0.661; direct LDL: mean difference 4.33 (95% CI -4.76 to 13.41), p=0.347]. However, within the trend graph communication group, HbA1clevels showed a statistically significant reduction from baseline [mean change -0.14 (95% CI -0.25 to -0.04), p=0.010].
CONCLUSIONS AND RECOMMENDATIONS: Both groups were able to reduce HbA1c and direct LDL levels over 6 months, with no significant difference in efficacy. However, trend graph communication demonstrated a slightly greater reduction in HbA1clevels. This approach may serve as an additional tool to support patients with type 2 diabetes in better managing their HbA1c and direct LDL levels.
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