[AVBC 2025] Improving outcomes of patients with recent diagnosis of diabetes through GEM programme
Care Continuum
Care Process & Redesign
Appropriate & Value-based Care Conference
National Healthcare Group
10 November 2025
To improve clinical outcomes, diabetes literacy, lifestyle behaviors, and diabetes distress through early intervention in. Participants showed improvements in clinical outcomes, diabetes literacy, lifestyle behaviors, and diabetes distress, proving that.
Year Submitted: 2025
Published Date: 10 November 2025
Tags: Care Continuum, Care Process ＆ Redesign, Chronic Care, Self Care, Preventive Care, Patient Education, Productivity, Cost Saving, Quality Improvement, Functional Outcome
About this Content
Aims
To improve clinical outcomes, diabetes literacy, lifestyle behaviors, and diabetes distress through early intervention in type 2 diabetes using the Group Education and Empowerment (GEM) program.
Background
Early intervention in type 2 diabetes is critical to reduce the risk of long-term complications. The GEM program focuses on education, individualized SMART goal planning, patient activation, and empowerment to sustain lifestyle changes for better clinical outcomes.
Methods
A pre-post evaluation was conducted with participants who underwent GEM between April 2022 and September 2024. Participants completed a 3-month intervention comprising a group education session, goal setting, and group follow-up. Outcomes assessed included glycaemic levels (HbA1c), diabetes-related distress, self-care behaviors, and diabetes knowledge.
Results
520 participants completed GEM, with a mean age of 55.3 years. There was significant improvement in HbA1c (-0.55%) and BMI levels. Greater HbA1c improvements were observed for patients with baseline 7%. Diabetes distress and lifestyle behaviors such as diet improved. Significant improvement in diabetes knowledge relating to symptoms of hypoglycemia and treatment was also observed. 97% of patients would recommend GEM to others.
Conclusion
Participants showed improvements in clinical outcomes, diabetes literacy, lifestyle behaviors, and diabetes distress, proving that GEM's early interventions achieved its empowerment goals. The reduction in HbA1c is associated with reductions in risk for complications, with healthcare savings.
Lessons Learnt
The GEM program demonstrates promising potential as an early intervention strategy for newly diagnosed Type 2 diabetes patients. It shows comprehensive impact on patient care, improving not just clinical markers but also psychological, behavioral changes, and knowledge enhancement.
Keywords
Diabetes, Empowerment, Education, Intervention, Clinical Outcomes
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | National Healthcare Group Polyclinics |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Nursing, Allied Health |
Applicable Specialty or Discipline | Endocrinology |
Project Lead(s) | Moses Tan Mong Heng |
Project Member(s) | Sabrina Wong Kay Wye |
Connect with this contributor!
Moses Tan Mong Heng - moses_mh_tan@nhgp.com.sg