ผลของโปรแกรมการสนับสนุนจัดการตนเองเรื่องการนับคาร์โบไฮเดรตต่อระดับน้ำตาลสะสมในเลือดของผู้ป่วยเบาหวานชนิดที่ 2 ที่ควบคุมระดับน้ำตาลในเลือดไม่ได้

Noppamas Chursa-ard; Nattaya Phadaennok; Kannaree Srichan

Authors

Noppamas Chursa-ard Department of Social Medicine, Chiang Kham Hospital
Nattaya Phadaennok School of Nursing, Mae Fah Luang University
Kannaree Srichan Mae Lao Sub-District Health Promoting Hospital, Chiang Kham District

Keywords:

self-management support program, carbohydrate counting, HbA1C, type 2 diabetes mellitus

Abstract

Background: Glycemic control among patients with type 2 diabetes mellitus (T2DM), particularly those with uncontrolled blood glucose levels, require effective self-management. Dietary carbohydrate control is a key component of diabetes management. Carbohydrate counting is an approach that helps patients appropriately plan their food intake and may improve glycemic control.

Objectives: To examine the effects of a carbohydrate-counting self-management support program on Hemoglobin A1c (HbA1c) levels among patients with uncontrolled type 2 diabetes mellitus.

Methods: This quasi-experimental study employed a one-group pretest–posttest design. The participants were 25 patients with T2DM who had HbA1C levels greater than 7% and received care at Mae Lao Sub-district Health Promoting Hospital, Chiang Kham District, Phayao Province, Thailand. Participants received a self-management support program focusing on dietary management using carbohydrate counting for six months. Data was collected before and after the intervention using questionnaires assessing carbohydrate-counting knowledge and self-management behaviors. The reliability coefficients of the questionnaires were 0.82 and 0.86, respectively. Data were analyzed using descriptive statistics and paired samples t-test.

Results: Most participants were female, with a mean age of 56.6 ± 9.1 years and a mean duration of diabetes of 10.1 ± 8.7 years. After the intervention, participants demonstrated a significant increase in carbohydrate-counting knowledge scores, from 11.4 ± 2.1 to 13.2 ± 1.3, and significantly improved dietary self-management behaviors related to carbohydrate counting (p < 0.05). Mean HbA1C levels also significantly decreased from 8.3 ± 0.8% to 7.7 ± 0.9% (p < 0.05).

Conclusion: The carbohydrate-counting self-management support program may help improve self-management behaviors and glycemic control among patients with uncontrolled T2DM. However, further studies with a control group and longer follow-up periods are recommended to confirm the effectiveness of the program.

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