The 5 P’s of Pre-Diabetes Bee Williamson Community Education Coordinator (Heart & Diabetes)

Problem Statistically 1:5 people over the age of 15 have Pre-diabetes 2008/2009 Adult Nutrition Survey, Otago University More Pre-diabetes being identified through Heart & Diabetes Checks Increasing numbers of Young adults 30 – 70% risk of developing Type 2 Diabetes Ackerman Et Al 2011, Tabák Et Al 2012 Also a risk factor for Heart Events Increase to Health $

Partnerships Collaborated with Green Prescription and Health Promotion team – unique opportunity to create seamless pathways Developed a programme “tool kit” aims & objectives, processes, and evaluation Involved links to existing health & community services Built on relationships in Secondary Care – Diabetes & Cardiac Nurse Specialists Sessions delivered monthly in the community (PHO or Library) Rolled out to Primary Care: 4 x large GP Practices

Programme A “one-off” 2.5 hour community group session Health literacy to build understanding Beliefs, behaviours and HOW to change Reflection / goal setting Take home resources Programme evaluation Follow –up for one year

Programme Reversing Pre-diabetes 3-Year Overview 2013-2016 64 122 220 2013-2014 2014-2015 2015-2016 Programme Reversing Pre-diabetes 3-Year Overview 2013-2016 patients patients patients 8 in Community 13 sessions 23 sessions 8 sessions 43% Under 65 years of age attended An additional 20 % family /whānau attended 6% Maori 2% Pacifika A minimum of 91% improved knowledge, self efficacy, and rated sessions > 8/10

Self-reported outcomes over 3,6 and 12 months Prevention Reversing Pre-diabetes 2013-2016 75% 59% Reduced stress levels Reduced HbA1c levels 88% Improved eating habits Self-reported outcomes over 3,6 and 12 months 61% 65% More active Reduced weight

Simple Inexpensive Existing Partnerships Evidence Prevention Simple Inexpensive Existing Partnerships Evidence

Personal Success One year later………. HbA1c 43 mmol/mol (pre-diabetes) Lindi 46 year old Māori amputee Single Mum High LDL and triglyceride levels / Low HDL HbA1c 43 mmol/mol (pre-diabetes) Overweight Trying to quit smoking No structured physical activity Stressed One year later……….

Acknowledgements Lindi Rule – Patient story Glenis Bell Health Promotion Manager Presenters; Bee Williamson and Marc Davidsen Nelson Bays Health Promotion Team Diabetes and Cardiac teams Nelson Hospital