ประสิทธิผลของโปรแกรมการปรับเปลี่ยนพฤติกรรมการใช้ชีวิตต่อการป้องกันโรคเบาหวานชนิดที่ 2 ในประชากรไทยกลุ่มเสี่ยง

Duangdao Sriyakun; Santi Lapbenjakul; Samrit Srithamrongsawat; Vorasith Sornsrivichai; Jiruth Sriratanaban; Phanuwich Kaewkamjornchai

Authors

Duangdao Sriyakun Phetchabun Hospital
Santi Lapbenjakul Thawung Hospital
Samrit Srithamrongsawat Faculty of Medicine Ramathibodi Hospital, Mahidol University
Vorasith Sornsrivichai Faculty of Medicine, Prince of Songkla University
Jiruth Sriratanaban Faculty of Medicine, Chulalongkorn University
Phanuwich Kaewkamjornchai Faculty of Medicine Ramathibodi Hospital, Mahidol University

Keywords:

prediabetes,, lifestyle modification,, effectiveness

Abstract

This study aimed to assess effectiveness of lifestyle modification program on reduction of diabetic risks among adults with prediabetes by adapting an effective lifestyle modification program from abroad to fit the Thai context. The program started with an awareness raising activity followed by 5 consecutive group learning sessions. Session 1 stage of change, started from the indifference stage to the modification and maintenance of new behaviors after setting a realistic weight loss goal at 3–5% of the initial weight. Session 2 employed a patient-centered approach, doctors as a friend so called “peer professional”, assisting participants to design own individual self-care plan focusing on caloric restrictions and increasing physical activity. Session 3 raised motivation through dialogue and game playing by using a “toolbox set” consisting of game cards, video and various media to create learning of how to adjust the self-care plan by gradually increasing frequency and intensity of activities (e.g. exercise). Session 4 organized group learning to create social reinforcement by exchanging experiences and making commitments with flexibility as to their convenience. Session 5 employed a nudge theory for follow-up and maintaining healthy behavior by sending stickers on personal Line accounts, chatting on Facebook, etc., to monitor participants’ continuous compliance to their plans.

The program was piloted in 4 districts of 4 regions divided into experimental sub-districts and control sub-districts. Adults with prediabetes in each sub-district were recruited, there were 423 samples in experimental group and 443 samples in control group. Assessment of lifestyle behaviors was done prior and after completion of the program and analyzed the changes by using relative change statistics.

Result illustrates that experimental group had significant reduction in body mass index of 1.9 kg/m2, waist circumference of 4.5 cm, fasting blood sugar average of 3.8 mg/dL and diabetic risk score of 14.9, all with statistical significance reductions compared to control group. In conclusion, the lifestyle modification program was able to reduce prediabetic risk at least one level by 77.5% of the experimental group and reduced the chance to be diabetes within next 10 years by 12.7%.

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