None listed
Conditions
Brief summary
Background: Diabetes is on the rise, increasing the burden on our health system. Many people are admitted into hospital with poorly managed diabetes and require insulin initiation to improve their health outcomes. This project aims to improve the transition of care from hospital to the home, using an innovative new Transition Diabetes Team. If successful, it would improve the current care provision to this vulnerable population group, reducing costs and improving health outcomes. This model could be replicated at other Australian hospitals, improving health outcomes and reducing costs nation-wide. Aims: To trial the functionality and effectiveness of Transition Diabetes Team, comprising: a credentialed diabetes educator (CDE) and diabetes specialist in commencing insulin in the home versus in the hospital. To compare hospital Length of Stay (LOS), blood-glucose control and patient satisfaction for patients with poorly managed Type 2 Diabetes between patients receiving Transition Diabetes Team care to people who receive Standard Care. Methods: Eligible participants: * Adults greater than 18 years of age * Admitted into Austin Health *Type 2 diabetes * Need to start or change insulin or other injectable therapy post discharge to improve their glycaemic management – necessitating a diabetes educator to provide education prior to discharge to undertake self-management. All who consent will then be randomly allocated to either the standard care group or the Transition Diabetes Team group: Standard care Group: inpatient diabetes educators providing insulin initiation education while the patient is admitted in hospital. Transition Diabetes Team Group: An RDNS credentialled diabetes educator working with an Austin Health Endocrinologist to provide insulin initiation education after the person is discharged from hospital – in their own homes. Data will be collected on demographics, medical history, medications, diabetes management, HbA1c, hospital length of stay and diabetes treatment satisfaction.
Interventions
Transition Diabetes Team consisting of a community based credentialed diabetes educator working with a hospital based endocrinologist, to support the person with type 2 diabetes initiating insulin to self manage insulin therapy in their home.
Duration of visit likely 1.5 hours for the first visit, with subsequent contact being either home visits or phone contact, with the duration of contact dictated by the needs of the participant. Part of this project is to collect information regarding the
Transition Diabetes Team consisting of a community based credentialed diabetes educator working with a hospital based endocrinologist, to support the person with type 2 diabetes initiating insulin to self manage insulin therapy in their home. Duration of visit likely 1.5 hours for the first visit, with subsequent contact being either home visits or phone contact, with the duration of contact dictated by the needs of the participant. Part of this project is to collect information regarding the number and duration of contact required to have people with type 2 diabetes initiate insulin. The home visits will include discussion of: 1. Diabetes - physiology, signs and symptoms, reason/methods for management 2. Insulin - doses, administration, action, injection technique etc.. 3. Self Blood Glucose Management - Meter/supplies, technique, testing times/frequency/records, factors affecting tests. 4. Hypoglycemia - causes, signs and symptoms, treatment and prevention, glucagon administration. 5. Exercise - rationale/effect on blood glucose levels, pracautions, exercise plan. 6. Nutrition - general guidelines and referral to dietitian. 7. National Diabetes Services Scheme. 8. Driving Written information will also be provided on the above. Once credentialed diabetes educator confident that the participant is able to self-manage insulin, they will refer the participant to local community diabetes services and cease follow up - this can be up to 4 months post discharge. Part of the project aims is to evaluate how long it takes for people starting insulin to be able to self manage. Each participant will be given a follow up appointment with the Austin Health Endocrinologist at 4 months post discharge.
Sponsors
RDNS, Royal District Nursing Service
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
a. Adults greater than 18 years of age b. Type 2 diabetes patients needing insulin post discharge c. Admitted into Austin Health d. Diabetes management can be improved by adding or changing insulin or other injectable therapy to management.
Exclusion criteria
Those who do not fit the inclusion criteria, and patients who are unable to give informed consent
Outcome results
None listed