DEVELOPMENT OF BLOOD SUGAR CONTROL MODEL FOR UNCONTROLLED TYPE 2 DIABETES PATIENTS THROUGH CARBOHYDRATE COUNTING BY THE MECHANISMS OF VILLAGE HEALTH VOLUNTEERS AND NETWORK PARTNERS IN CHIANG MAI PROVINCE
Keywords:
Uncontrolled Type 2Diabetes Patients, Carbohydrate Counting, Village Health Volunteers, Network Partners, Chiang Mai ProvinceAbstract
Abstract
This study was participatory action research. Its objectives were 1) to study the diabetic patient care situation in Chiang Mai Province; 2) to develop a blood sugar control model for uncontrolled type 2 diabetes patients through carbohydrate counting by the mechanisms of village health volunteers (VHVs) and network partners in Chiang Mai Province; and 3) to evaluate the model. The implementation was divided into three phases. Phase 1 involved studying the diabetic patient care situation with a sample of 50 patients. Phase 2 focused on developing the blood sugar control model with a sample of 26 patients for model development and 72 patients who applied the model. Phase 3 evaluated the model with a sample of 79 patients. The tools used included questionnaires, in-depth interviews, and focus group discussion guides. Data were analyzed using Percentage, Mean, Standard Deviation, Paired t-test, and Repeated-measures ANOVA.
The study found that the current government healthcare system provides diabetic patient care that is fragmented and lacks comprehensiveness. Delays in service delivery are attributed to the large number of patients in the healthcare system. The existing family and community care model for diabetes patients remains insufficiently systematic. To address this gap, a blood sugar control model was developed for type 2 diabetic patients with poor glycemic control using carbohydrate counting. The “4C Model,” comprises the following components: The patient-centered approach, combined with carbohydrate counting, the role of village health volunteers (VHVs) as health coaches, close monitoring at the household level, and the establishment of a community-based care network, led to significant improvements in patients' knowledge and self-care behaviors. HbA1c was significantly reduced (p < 0.05) compared to baseline levels prior to the implementation of the model. Therefore, the model developed in this study has the potential to be scaled up to other areas to enhance the effectiveness of diabetes management.
Keywords: Uncontrolled Type 2Diabetes Patients, Carbohydrate Counting, Village Health Volunteers, Network Partners, Chiang Mai Province
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