“Effectiveness of Nurse Led Diabetes Management Programme on Selected Clinical & Biochemical Parameters among Patients with Type II Diabetes Mellitus”
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Abstract
A Study to Assess the Effectiveness of a Nurse-Led Diabetes Management Program on clinical & Biochemical Parameters among Patients with Type II Diabetes Mellitus in Selected Villages of Mehsana District, Gujarat.
Background: Clinical and biochemical parameters are essential indicators for evaluating the severity, progression, and management outcomes of Type II Diabetes Mellitus (T2DM). Poor control of parameters such as fasting blood glucose, post-meal glucose, HbA1c, urine sugar, blood pressure, BMI, and waist circumference contributes to increased risk of microvascular and macrovascular complications. Nurse-Led Diabetes Management Programmes (NLDMP) have demonstrated significant promise in improving metabolic control through structured education, lifestyle modification, stress reduction practices, and continuous follow-up. This study aimed to determine the effectiveness of an NLDMP on clinical and biochemical parameters among 208 patients with T2DM.
Methods: A true experimental pre-test–post-test control group design was used. A total of 208 participants (104 experimental, 104 control) were selected using proportionate stratified random sampling from selected villages in Mehsana District. Clinical parameters assessed included BMI, waist circumference, blood pressure, and anthropometric measurements. Biochemical parameters included fasting blood glucose, post-meal blood glucose, 2-hour post-prandial glucose, urine sugar levels, and HbA1c.
The experimental group underwent a structured Nurse-Led Diabetes Management Programme, which included comprehensive diabetes education, personalized lifestyle modification counselling, diet planning, physical activity guidance, Rajyoga and mindfulness meditation sessions, self-care logbooks, and continuous telephonic follow-ups over a six-month period. The control group received routine standard care. Assessments were conducted at baseline, 3 months, and 6 months. Data were analyzed using descriptive and inferential statistics including paired and independent t-tests.
Results: The experimental group demonstrated highly significant improvements (p < 0.001) across multiple clinical and biochemical parameters, while the control group showed no significant changes. Detailed findings include: Clinical Parameters BMI: Notable reduction due to improved dietary adherence and regular physical activity. Waist Circumference: Significant decrease indicating reduced abdominal obesity and improved metabolic health. Blood Pressure: Reduction in systolic and diastolic BP attributed to stress reduction and lifestyle modification. General Clinical Condition: Improvement in symptom burden, reduction in fatigue, and enhanced physical functioning.
Biochemical Parameters Fasting Blood Glucose (FBG): Marked reduction at 3 and 6 months with statistically significant differences compared to control. Post-Meal Glucose (PPBS): Significant decline reflecting better carbohydrate regulation and medication adherence. 2-Hour Post-Prandial Glucose: Significant improvement indicating enhanced glycaemic stability throughout the day. Urine Sugar Levels: Substantial decrease demonstrating improved renal glucose threshold and controlled hyperglycaemia. HbA1c: Clinically meaningful reduction over six months reflecting sustained glycaemic control.
The control group showed minimal or no change across all parameters, demonstrating that routine care alone was insufficient to produce measurable improvements.
Conclusion: The Nurse-Led Diabetes Management Programme was highly effective in improving clinical and biochemical outcomes among patients with Type II Diabetes Mellitus. The structured, comprehensive, and patient-centered approach—combining education, lifestyle modification, meditation, and continuous follow-up—resulted in significant metabolic improvements. Incorporating NLDMP into routine clinical practice can reduce long-term complications, enhance glycaemic stability, and strengthen overall disease management.