Outcome measures after attending a specialist-led diabetesmellitus model of care in regional Victoria, Australia

Abstract

Background: Providing diabetes mellitus care to regional Australia remains a signifi-cant challenge due to limited access, workforce and travel. While primary care is essen-tial, some patients require specialised care that necessitates adapted models of care.Aims: The study assessed the effect on diabetes mellitus metrics in patients attending amultidisciplinary centre in regional Victoria. We assessed changes in HbA1c over6 months. Secondary outcomes included biometrics, drug combinations, insulin initia-tion and the proportion achieving diabetes care targets.Methods: We performed a longitudinal cohort study for all adult patients receiving multi-disciplinary diabetes care at South West Healthcare between 1 July 2020 and 30 June 2022.Participants who had followed up over 6 months at three-monthly intervals (V1, V2 and V3)were included, excluding haemodialysis or transplant care or failure to attend three visits.Results: We assessed 90 participants with a balanced demographic with a generally lowcomorbidity burden. There was a significant decrease in HbA1c at 3 months (OR = 1.2(95% CI: 1.6 to 1.1), P < 0.001) and 6 months (OR = 1.8 (95% CI: 2.2 to 1.5), P< 0.001) for all groups. Attendance within the cohort significantly increased for multi-disciplinary services, including optometry, cDNE, dietetics and podiatry, but no change indrug regimens or insulin initiation.Conclusion: This study highlights the impact of an adapted model of care for diabetesmellitus at South West Healthcare, focusing on a regional population. Among90 patients over 6 months, there was a significant reduction in HbA1c levels andimproved multidisciplinary engagement. This approach has successfully increasedaccess to specialist and multidisciplinary diabetes care in rural areas.