Zinn Caryn, Campbell Jessica L, Po Marina, Sa'ulilo Losi, Fraser Lily, Davies Glen, Hawkins Marcus, Currie Olivia, Unwin David, Crofts Catherine, Harris Nigel, Stewart Tom, Schofield Grant
Human Potential Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
Turuki Healthcare, Mangere, Auckland, New Zealand.
J Diabetes Res. 2024 Dec 24;2024:4843889. doi: 10.1155/jdr/4843889. eCollection 2024.
This study explores a novel healthcare model employed in the primary care setting integrating a carbohydrate-reduction dietary approach and health coaching for managing prediabetes (PD) and Type 2 diabetes (T2D) in New Zealand. Using qualitative methods, we conducted focus groups with 46 patients and individual interviews with health coaches and general practitioners across two regions. Five major themes emerged from inductive thematic analysis: reduced carbohydrate lifestyles, health coaching, implementation, empowerment, and sustainability. Patients reported significant health improvements, including weight loss, reduced medication burden, and increased energy. Challenges included resistance from some medical professionals and negative public perceptions. Health coaching played a crucial role in patient care, providing individualised support and enhancing health literacy. The study found that this model both improved patient outcomes and also alleviated the burden on healthcare professionals by managing time-intensive aspects of patient care. Barriers to the adoption of this model include scepticism about low-carbohydrate diets and the need for more education and awareness among healthcare professionals. The findings suggest that this healthcare model has the potential to transform the management of PD and T2D in primary care, shifting patients from lifelong medication dependence to significant health improvements and potential disease remission or reversal.
本研究探索了新西兰基层医疗环境中采用的一种新型医疗模式，该模式整合了减少碳水化合物的饮食方法和健康指导，用于管理前驱糖尿病（PD）和2型糖尿病（T2D）。我们采用定性方法，在两个地区对46名患者进行了焦点小组访谈，并对健康指导师和全科医生进行了个人访谈。归纳主题分析得出了五个主要主题：减少碳水化合物的生活方式、健康指导、实施、赋权和可持续性。患者报告健康状况有显著改善，包括体重减轻、药物负担减轻和精力增加。挑战包括一些医学专业人员的抵制和公众的负面看法。健康指导在患者护理中发挥了关键作用，提供个性化支持并提高健康素养。研究发现，该模式既改善了患者的治疗效果，又通过管理患者护理中耗时的方面减轻了医疗专业人员的负担。采用该模式的障碍包括对低碳水化合物饮食的怀疑以及医疗专业人员需要更多的教育和认识。研究结果表明，这种医疗模式有可能改变基层医疗中PD和T2D的管理方式，使患者从终身药物依赖转变为健康状况显著改善以及可能实现疾病缓解或逆转。
