Arne Kooistra^a,b & André van Beek ^a,b

^a Academic Rehabilitation Centre Beatrixoord, Haren, The Netherlands ^b Department of Endocrinology, University Hospital Groningen, Groningen, The Netherlands

Background: Effective management of diabetes is essential to prevent complications and improve quality of life. However, many individuals struggle to achieve optimal glycemic control despite standard care, necessitating alternative interventions. This study aimed to evaluate the effectiveness of a multidisciplinary diabetes rehabilitation program in addressing glycemic control and psychosocial well-being among individuals with persistent glycemic issues despite advanced therapies such as continuous or flash glucose monitoring, hybrid closed loop systems or psychological consultation.

Methods: A quantitative, prospective cohort study design was employed to assess the outcomes of the multidisciplinary program, performed at the Academic Rehabilitation Centre Beatrixoord. A total of 50 participants completed the 14-week program in 2023, receiving integrated care from various healthcare professionals, including physiotherapists, dieticians, endocrinologists, physician assistants, social workers, psychomotor therapists, (diabetes specialized) nurses, and psychologists. Pre- and post-intervention measurements were conducted to evaluate changes in glycemic control and psychosocial parameters. Statistical analyses, including paired t-tests and non-parametric correlations where appropriate.

Results: The multidisciplinary program led to significant improvements in glycemic control measures, including a mean reduction in HbA1c levels of 1.6%(16mmol/mol) (p=<0.001, d=1.07) and a mean increase in time in range by 23% (p=<0.001, d=1.05). Participants also reported significant improvements in psychosocial factors, such as reduced diabetes-related distress (p=<0.001, d=1.63) and increased confidence in self-care (p=<0.001, d=0.86). No significant associations were found between patient characteristics, including educational level, age, or total hours of care received, and changes in HbA1c levels.

Conclusions: The findings highlight the effectiveness of the multidisciplinary diabetes rehabilitation program in improving glycemic control and psychosocial well-being among individuals with persistent glycemic issues despite advanced therapies. These results underscore the importance of integrated care approaches in addressing the complex needs of individuals with diabetes and suggest the potential for broader implementation of such programs to optimize diabetes management outcomes.