Analysis of the association of multidisciplinary team care and education intervention in patients with early-stage diabetic kidney disease in Taiwan

Abstract

The National Health Insurance Bureau in Taiwan introduced several initiatives to slow the progression of diabetic kidney disease (DKD) through early interventions and comprehensive patient education. This study evaluates the association of a multidisciplinary care and education model for patients with type 2 diabetes mellitus and early-stage DKD in Taiwan. A total of 355 participants enrolled in an integrated care program from May 2022 to September 2023 and followed up until April 2024 were analyzed. The intervention included personalized education, exercise management, dietary counseling, and multimedia tools aimed at improving disease self-management. The results demonstrated that compared to baseline, the patients with second follow-up data had lower systolic blood pressure (p < 0.001), lower diastolic blood pressure (p < 0.001), lower glycosylated hemoglobin A_1c (HbA_1c) (7.51% vs. 7.10%, p < 0.001), lower total cholesterol (p = 0.047), lower high-density lipoprotein cholesterol (p = 0.047), lower low-density lipoprotein (LDL) cholesterol (p = 0.009), lower estimated glomerular filtration rate (p < 0.001), lower log urine albumin to creatinine ratio (p < 0.001), used fewer types of antihypertensive agents (p < 0.001), more types of oral hypoglycemic agents (p = 0.045), more insulin (p < 0.001), and more statins (p = 0.029). These findings showed that the multidisciplinary care model significantly improved glycemic control, blood pressure, lipid profiles, and albuminuria in patients with type 2 diabetes and early-stage DKD. Specifically, reductions in HbA_1c, systolic and diastolic blood pressure, total cholesterol, LDL-cholesterol, and albuminuria were achieved, underscoring the importance of a comprehensive team-based approach.