Development of a Nurse-led Multidisciplinary Based Program to Improve Glycemic Control for People with Uncontrolled Diabetes Mellitus in a Community Hospital, Thailand

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Nongnut Oba
Charlotte D. Barry
Shirley C. Gordon
Navarat Chutipanyaporn


               A multidisciplinary approach is strategy for glycemic control management for diabetes care, yet the type of health workforce at each level of the healthcare system is unequal. This participatory action research was designed in three phases and undertaken in a community hospital in Thailand. Phase 1 aimed at discovering the causes of uncontrolled blood glucose by two focus group discussions with healthcare providers and people with diabetes. In Phase 2, focus group discussion with stakeholders were undertaken to learn from the Phase 1 data to build a program for improving glycemic control among uncontrolled diabetes. Phase 3 aimed at implementing and evaluating the effectiveness of the developed program using a quasi-experimental design. Data from focus group discussions were analyzed by content analysis while the data before and after intervention were analyzed by percentages, mean, standard deviation, and paired t-test.

              Four categories related to causes of uncontrolled glycemia: poor hypoglycemic drug adherence, high energy dietary consumption, limitation on physical activity, and vigorous stress in life event. The improving glycemic control program developed in Phase 2 was the Nurse-led Multidisciplinary Based Program for People with Uncontrolled Diabetes. The Program goal was a decreased fasting blood glucose and an A1C of >8% and no hospital admission with either a hypoglycemic or hyperglycemic crisis. Program outcomes included significantly lower A1C compared with baseline levels (p<.01), and no hospital admissions. This Program provides an avenue for nurses to manage glycemic control in diabetes within a cooperative program in the community hospital.

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Oba N, Barry CD, Gordon SC, Chutipanyaporn N. Development of a Nurse-led Multidisciplinary Based Program to Improve Glycemic Control for People with Uncontrolled Diabetes Mellitus in a Community Hospital, Thailand . PRIJNR [Internet]. 2020 Jul. 9 [cited 2022 Dec. 9];24(3):349-62. Available from:
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