Serum glucose patterns of hyperglycemic patients receiving dietary and medical intervention in a hospital based home care program

Abstract

Hospital Based Home Care (HBHC) is a multidisciplinary teaching program offered to veterans to improve their health status. The purpose of this study was to determine the effects of nutritional and medical management of hyperglycemic veterans in a home environment. Twenty-five male veterans, middle-aged (x̄ age = 55 years, 78% Black), low to middle income, diagnosed with non insulin dependent diabetes mellitus (NIDDM) and/or insulin dependent diabetes mellitus (IDDM) were selected from the HBHC caseload to study. The HBHC team comprised of nurses, a physician, Social Worker, and a Registered Dietitian conducted weekly and monthly follow up visits to the veteran's home to assess, teach and reinforce dietary and medical adherence. Dietitian taught veterans and/or caregivers dietary management using food models and conducted 24 hour recalls to assess dietary compliance. Weights and lab data were obtained by HBHC nurses. Monthly and quarterly chart reviews were held with the team physician for adjustment in diet and/or medication regimen. Results showed 34% decline in serum glucose levels for veterans studied the first month. After three months, 56% had serum glucose values within normal range (70–110 mg/dl). Within six months, 48% had serum glucose levels in normal range whereby 85% had normal serum glucose levels after nine months. This percentage remained the same after twelve months. The results showed a steady decline in serum glucose patterns of veterans participating in a HBHC program except during the six months follow up period. It was noted one veteran (4%) had a foot infection during this study period. The HBHC program may be a way of treating home bound veterans with hyperglycemia and requires further investigation.