First learning session | Implement diabetes guidelines and care delivery tools. Standardise chronic illness scope of service. Educate healthcare providers with diabetes guidelines.
| Hospitals had difficulty in establishing multidisciplinary teams, especially diabetic educators and case managers. Some hospitals faced supply issues related to albumin/creatinine and GFR laboratory reagents. Some hospitals had prescribing restrictions on newer antidiabetic medications, for example, GLP-1 receptor agonists. Difficulty in developing diabetes registry.
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Second learning session | Leadership engagement. Training programme for diabetic educators and case managers. Provision of essential supplies related to diabetes laboratory tests. Update prescribing privileges for diabetes medication. Development of central diabetes registry.
| Hospitals demonstrated modest improvements on process measures and outcome measure. Hospitals that implemented case management and integrated care had better outcomes. Leadership support facilitated improvements.
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Third learning session | Implementing diabetes registry for the enrolled hospitals. Patient stratification in relation to risk factors and HbA1c level. Including physician compliance to diabetes management guidelines in the physician yearly evaluation.
| Diabetes registry helped overview the sociodemographic and clinical measures of patients with diabetes. To track patients with uncontrolled type 2 diabetes who are prone to complication, develop more frequent follow-ups for them and manage the risk factors. Implementing sustainable interventions, for example, physician’s yearly evaluation with diabetes compliance to management guidelines.
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