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

Background

Providing diabetes mellitus care to regional Australia remains a significant challenge due to limited access, workforce and travel. While primary care is essential, some patients require specialised care that necessitates adapted models of care.

Aims

The study assessed the effect on diabetes mellitus metrics in patients attending a multidisciplinary centre in regional Victoria. We assessed changes in HbA1c over 6 months. Secondary outcomes included biometrics, drug combinations, insulin initiation and the proportion achieving diabetes care targets.

Methods

We performed a longitudinal cohort study for all adult patients receiving multidisciplinary 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 low comorbidity 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 multidisciplinary services, including optometry, cDNE, dietetics and podiatry, but no change in drug regimens or insulin initiation.

Conclusion

This study highlights the impact of an adapted model of care for diabetes mellitus at South West Healthcare, focusing on a regional population. Among 90 patients over 6 months, there was a significant reduction in HbA1c levels and improved multidisciplinary engagement. This approach has successfully increased access to specialist and multidisciplinary diabetes care in rural areas.