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Overcoming difficulties and pursuing excellence
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Speech Abstracts / Diabetes Research and Clinical Practice 120S1 (2016) S1–S39
Planning: Help survey diabetic populations particularly vulnerable in disaster events, develop a special care program. Addressing needs: Evaluate the quality and quantity of medical resources for diabetic care, establish guidelines for coordinating the donation of equipment and medicine from other countries. Communications: Regularly preview with relief organisations (such as the Red Cross) and various government agencies, Conduct periodic rehearsals. Response during disaster: Provide information to people with diabetes, caregivers, and the media and direct patient medical care, Contact relief organisations to obtain information and statistics and ascertain the type of assistance required, Contribute to identifying resources of medication supplies, Assist to organise multidisciplinary medical teams. Resolution and recovery: Review and discuss diabetes management strategies for diabetic people during and after a disaster, and revise the guideline program as necessary. In 2014 WPR council meeting in Singapore, members met to hear the synthesis of the program and a decision was made to review the guideline after 3–5 years, and individuals who prepared the original sections were invited to review and update their section taking into consideration new evidence and new treatments. This initiative need further steps to be taken. As a follow up, we need to look for resource persons, creating teams to prepare workshop topics and organising training centres regionally, and financial supports. The suggestion is that it could be organised after the next IDF WPR meeting in Taipei 2016. People with diabetes, health providers, and official emergency departments should always be prepared, and by way of such preparedness the impact an emergency may have on their condition will be lessened. SP04-3 Disasters and patients with diabetes – an endocrinologist’s experience in missions in Africa and the Philippines Vivien LIM1. 1International Diabetes Federation Western-Pacific Region Disaster Program Diabetes is termed the modern epidemic of our times and plaques not only developed countries but also developing ones. It is predicted to increase exponentially in the next couple of decades, especially in Asia. Healthcare systems to combat diabetes are suboptimal in many places, not only with regards to prevention but also its detection and management of the disease itself and its complications. What is worse, many of such places might themselves be affected by disasters – man-made or natura – and this would impact on the already weak health infrastructure to further detriment diabetic patients and their treatment. This talk touches on the reality of such situations, drawing on experience in missions in both Africa as well as in Asia, namely the Philippines. It showcases a field worker’s take of the situation, who happens to also be an endocrinologist.
Integration of Diabetes Management in Taiwan S39-1 Overcoming difficulties and pursuing excellence Shi-Yu CHEN1. 1Tri-Service General Hospital, Taipei, Taiwan The aim of the present study is to provide practical guidance on improving diabetes care through highlighting the need for: (1) increasing patients’ understanding of type 2 diabetes and reaching glycemic goals (2) sharing responsibility/common philosophy for achieving glycemic goals, and (3) building a multidisciplinary team approach to treating type 2 diabetes. In order to overcome the barriers of achieving good glycemic control and share better understanding and mutual agreement regarding good glycemic control among members in the
multidisciplinary team, establishing a good rapport with the patients and motivating them to achieve and maintain glycemic control are extremely essential. The methods of motivating and supporting patients to change their lifestyle are carried out by: (1) providing practical and realistic advices on implementing and sustaining lifestyle changes; (2) discussing steps that can be implemented punctually; (3) involving, where possible, other members of the diabetes care team, particularly family and friends; and (4) emphasizing the role of the multidisciplinary team. There are two key functions of the multidisciplinary team. The first is to provide continuous, accessible and consistent care focusing on the needs of individuals with type 2 diabetes, including collections of information concerning diagnosis of conditions and continually thereafter, agreements of care standards, discussions on rational therapeutic suggestions, monitoring guideline adherence in accompany with short-term outcomes, and avoiding early complications or providing timely intervention to decrease diabetes-related complications. The second is to enable patients’ long-term self-management. A multidisciplinary team can reduce 62% annual cost of treatment. Other than this, the benefits of a multidisciplinary team approach to type 2 diabetes care include: (1) improving glycemic control, (2) increasing patient follow-up, (3) lowering risk of complications, (4) improving quality of life, (5) increasing patients’ sense of satisfaction1 and (6) decreasing healthcare costs. S39-2 Diabetes case management: Improvement measures at Changhua Christian Hospital Shang-Ren HSU1. 1Division of Endocrinology & Metabolism, Changhua Christian Hospital, Changhua, Taiwan With an ever-growing population of people with chronic diseases, it is estimated that Taiwan now has over 1.5 million diabetic patients. The crippling burden of diabetes on health expenditure is felt in healthcare institutions large and small as well as in governmental levels. At our hospital, a tertiary care medical center in central Taiwan, well over 10,000 patients are regularly treated for diabetes. With the majority of the patients enrolled in a diabetes share-care program, it has been a constant challenge to deliver comprehensive care to the patients while complying with the regulations and requirements of national health insurance reimbursement and meeting the quality standards imposed by the share-care program. Fortunately, with the full support of the hospital’s administrative office, much resource and planning have been invested in diabetes case management at our hospital. Under constant supervision, various improvement measures have also been implemented to facilitate case management over the years. Indispensable among them are a constantly evolving information system which not only keeps comprehensive patient information in a robust, easy to access database but also provide physicians and case managers helpful guidance and reminders to guard against errors and oversights, a patient-friendly environment and arrangements that make each visit as hassle-free as possible, and various communication and standardized procedures to ensure coordinated and integrated teamwork in the delivery of care. Such efforts have earned us much recognition for the present. However, the growing burden of diabetes and the increasing complexity of its treatment and management will undoubtedly demand continual evolvement of our case management system. S39-3 Experience of diabetes management in an integrated polyclinic of Taiwan Yau-Jiunn LEE1. 1Lee’s Endocrinology Clinic, Pingtung, Taiwan Diabetes a lifelong condition that is essentially need selfmanaged but requires regular monitoring. The standard of care in diabetes includes emphasis on self-management
Speech Abstracts / Diabetes Research and Clinical Practice 120S1 (2016) S1–S39
Planning: Help survey diabetic populations particularly vulnerable in disaster events, develop a special care program. Addressing needs: Evaluate the quality and quantity of medical resources for diabetic care, establish guidelines for coordinating the donation of equipment and medicine from other countries. Communications: Regularly preview with relief organisations (such as the Red Cross) and various government agencies, Conduct periodic rehearsals. Response during disaster: Provide information to people with diabetes, caregivers, and the media and direct patient medical care, Contact relief organisations to obtain information and statistics and ascertain the type of assistance required, Contribute to identifying resources of medication supplies, Assist to organise multidisciplinary medical teams. Resolution and recovery: Review and discuss diabetes management strategies for diabetic people during and after a disaster, and revise the guideline program as necessary. In 2014 WPR council meeting in Singapore, members met to hear the synthesis of the program and a decision was made to review the guideline after 3–5 years, and individuals who prepared the original sections were invited to review and update their section taking into consideration new evidence and new treatments. This initiative need further steps to be taken. As a follow up, we need to look for resource persons, creating teams to prepare workshop topics and organising training centres regionally, and financial supports. The suggestion is that it could be organised after the next IDF WPR meeting in Taipei 2016. People with diabetes, health providers, and official emergency departments should always be prepared, and by way of such preparedness the impact an emergency may have on their condition will be lessened. SP04-3 Disasters and patients with diabetes – an endocrinologist’s experience in missions in Africa and the Philippines Vivien LIM1. 1International Diabetes Federation Western-Pacific Region Disaster Program Diabetes is termed the modern epidemic of our times and plaques not only developed countries but also developing ones. It is predicted to increase exponentially in the next couple of decades, especially in Asia. Healthcare systems to combat diabetes are suboptimal in many places, not only with regards to prevention but also its detection and management of the disease itself and its complications. What is worse, many of such places might themselves be affected by disasters – man-made or natura – and this would impact on the already weak health infrastructure to further detriment diabetic patients and their treatment. This talk touches on the reality of such situations, drawing on experience in missions in both Africa as well as in Asia, namely the Philippines. It showcases a field worker’s take of the situation, who happens to also be an endocrinologist.
Integration of Diabetes Management in Taiwan S39-1 Overcoming difficulties and pursuing excellence Shi-Yu CHEN1. 1Tri-Service General Hospital, Taipei, Taiwan The aim of the present study is to provide practical guidance on improving diabetes care through highlighting the need for: (1) increasing patients’ understanding of type 2 diabetes and reaching glycemic goals (2) sharing responsibility/common philosophy for achieving glycemic goals, and (3) building a multidisciplinary team approach to treating type 2 diabetes. In order to overcome the barriers of achieving good glycemic control and share better understanding and mutual agreement regarding good glycemic control among members in the
multidisciplinary team, establishing a good rapport with the patients and motivating them to achieve and maintain glycemic control are extremely essential. The methods of motivating and supporting patients to change their lifestyle are carried out by: (1) providing practical and realistic advices on implementing and sustaining lifestyle changes; (2) discussing steps that can be implemented punctually; (3) involving, where possible, other members of the diabetes care team, particularly family and friends; and (4) emphasizing the role of the multidisciplinary team. There are two key functions of the multidisciplinary team. The first is to provide continuous, accessible and consistent care focusing on the needs of individuals with type 2 diabetes, including collections of information concerning diagnosis of conditions and continually thereafter, agreements of care standards, discussions on rational therapeutic suggestions, monitoring guideline adherence in accompany with short-term outcomes, and avoiding early complications or providing timely intervention to decrease diabetes-related complications. The second is to enable patients’ long-term self-management. A multidisciplinary team can reduce 62% annual cost of treatment. Other than this, the benefits of a multidisciplinary team approach to type 2 diabetes care include: (1) improving glycemic control, (2) increasing patient follow-up, (3) lowering risk of complications, (4) improving quality of life, (5) increasing patients’ sense of satisfaction1 and (6) decreasing healthcare costs. S39-2 Diabetes case management: Improvement measures at Changhua Christian Hospital Shang-Ren HSU1. 1Division of Endocrinology & Metabolism, Changhua Christian Hospital, Changhua, Taiwan With an ever-growing population of people with chronic diseases, it is estimated that Taiwan now has over 1.5 million diabetic patients. The crippling burden of diabetes on health expenditure is felt in healthcare institutions large and small as well as in governmental levels. At our hospital, a tertiary care medical center in central Taiwan, well over 10,000 patients are regularly treated for diabetes. With the majority of the patients enrolled in a diabetes share-care program, it has been a constant challenge to deliver comprehensive care to the patients while complying with the regulations and requirements of national health insurance reimbursement and meeting the quality standards imposed by the share-care program. Fortunately, with the full support of the hospital’s administrative office, much resource and planning have been invested in diabetes case management at our hospital. Under constant supervision, various improvement measures have also been implemented to facilitate case management over the years. Indispensable among them are a constantly evolving information system which not only keeps comprehensive patient information in a robust, easy to access database but also provide physicians and case managers helpful guidance and reminders to guard against errors and oversights, a patient-friendly environment and arrangements that make each visit as hassle-free as possible, and various communication and standardized procedures to ensure coordinated and integrated teamwork in the delivery of care. Such efforts have earned us much recognition for the present. However, the growing burden of diabetes and the increasing complexity of its treatment and management will undoubtedly demand continual evolvement of our case management system. S39-3 Experience of diabetes management in an integrated polyclinic of Taiwan Yau-Jiunn LEE1. 1Lee’s Endocrinology Clinic, Pingtung, Taiwan Diabetes a lifelong condition that is essentially need selfmanaged but requires regular monitoring. The standard of care in diabetes includes emphasis on self-management