The Development of a Care Model to Promote Diabetes Remission in Tha Bo District, Nong Khai Province

Abstract

This research and development project aimed to develop and evaluate the effectiveness of a care model for type 2 diabetes (T2DM) patients to achieve remission through a fourteen-member multidisciplinary team. The process consisted of four steps: 1) investigating the self-care problems affecting blood sugar control using a self-care behavior questionnaire; 2) developing a care model based on Orem’s self-care theory and Bandura’s self-efficacy theory for T2DM patients to achieve remission with the participation of a multidisciplinary team and conducting a pilot test before actual implementation; 3) implementing the developed care model with a sample group of 50 T2DM patients, with monitoring and revisions before full implementation; and 4) evaluating the model's outcomes at 12 and 24 weeks. The research tools included a health status record form and a care model for T2DM patients to achieve remission. The analysis involved comparing the mean values for weight, waist circumference, body mass index (BMI), and Hemoglobin A1C (HbA1c) levels at weeks 0, 12, and 24 using One-Way Repeated Measures ANOVA, along with assessing the reduction in diabetes incidence using frequencies and percentages.

The study found that the self-care behavior of T2DM patients was at a moderate level, with the most common issue being inappropriate dietary behavior, followed by moderate levels of inadequate exercise. At 12 and 24 weeks after implementing the developed care model for T2DM patients to achieve remission significant improvements were observed in average weight, waist circumference, body mass index (BMI), and HbA1c levels (p < 0.05). At the end of the 24-week study, 90% of T2DM patients were able to reduce their diabetes medication, while 50% of them stopped using diabetes medication entirely, and 26% maintained medication-free status for more than three months (remission phase).