Effects of Case Management Model on Glycemic Control in Patients with Type 2 Diabetes of Ban Lan Laem Health Promoting Hospital in Nakhon Pathom Province

Abstract

Diabetes is a chronic non-communicable disease that is a major global problem and requires systematic management to reduce complications and premature death. This quasi-experimental one-group pretest-posttest design was to examine the effects of case management on glycemic control in type 2 diabetic patients who had blood sugar level greater than or equal to 126 milligrams per deciliter. Data were collected at Ban Lan Laem Health Promoting Hospital in Nakhon Pathom Province from December 2023 to January 2025. The sample consisted of 30 type 2 diabetic patients. The research instruments included a case management model developed based on Kanfer and Gaelick-Buys’ self-management theory and a diabetes health behavior modification approach. The program involved education on diet, exercise, medication adherence, and regular follow-up. It also incorporated self-management strategies, home visits and counseling on a case-by-case. The data collection were health behavior questionnaire, fingertip glucose level (DTX), average blood glucose level (HbA1C), and satisfaction questionnaires. Data were analyzed using descriptive statistics and paired t-tests.

The results found that the DTX and HbA1C levels at the 3-month follow-up were significantly lower compared to pre-intervention levels (p-value<.01). Health behavior scores-covering diet, exercise, medication adherence, and follow-up were significantly higher than pre-intervention scores (p-value <.05). These findings suggest that the case management model should be extended with a large number of diabetic patients to promote appropriate health behaviors and patient participation in self-care, which results in significantly lower fingertip blood sugar and HbA1C levels for reducing complications and long-term health care costs.