Abstract #70: Supervised Autonomy with Diabetes Self-Management by Using Telemedicine Allows Better Glycemic Control in Patients with Diabetes

This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.

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Diabetes Distress Among Dyads of Patients and Their Health Supporters: Links With Functional Support, Metabolic Outcomes, and Cardiac Risk

Annals of Behavioral Medicine ◽

10.1093/abm/kaaa081 ◽

2020 ◽

Author(s):

Aaron A Lee ◽

Michele Heisler ◽

Ranak Trivedi ◽

D Scott Obrosky ◽

Maria K Mor ◽

...

Keyword(s):

Glycemic Control ◽

Hdl Cholesterol ◽

Cardiac Risk ◽

Self Management ◽

Diabetes Distress ◽

Glucose Testing ◽

Diabetes Outcomes ◽

The United Kingdom ◽

Metabolic Outcomes ◽

Patients With Diabetes

Abstract Background Patients with diabetes (PWD) often experience diabetes distress which is associated with worse self-management and glycemic control. In contrast, PWD who receive support from family and friends (supporters) have better diabetes outcomes. Purpose To examine the associations of PWD diabetes distress and supporters’ distress about PWDs’ diabetes with supporters’ roles and PWD cardiometabolic outcomes. Methods We used baseline data from 239 adults with Type 2 diabetes and their supporters participating in a longitudinal trial. PWD and supporter diabetes distress (high vs. low) were determined using the Problem Areas in Diabetes Scale-5. Outcomes included PWD-reported help from supporters with self-care activities, supporter-reported strain, PWD metabolic outcomes (glycemic control [HbA1c], systolic blood pressure [SBP], and non-HDL cholesterol) and 5 and 10 year risk of cardiac event (calculated using the United Kingdom Prospective Diabetes Study algorithm). Results PWDs with high diabetes distress were more likely to report that their supporters helped with taking medications, coordinating medical care, and home glucose testing (p’s < .05), but not more likely to report help with diet or exercise. High supporter distress was associated with greater supporter strain (p < .001). High supporter diabetes distress was associated with higher PWD HbA1c (p = .045), non-HDL cholesterol (p = .011), and 5 (p = .002) and 10 year (p = .001) cardiac risk. Conclusions Adults with high diabetes distress report more supporter help with medically focused self-management but not with diet and exercise. Supporter distress about PWD diabetes was consistently associated with worse outcomes. PWD diabetes distress had mixed associations with their diabetes outcomes.

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Effect of diabetes self-management education program on glycemic control in diabetic patients attending the family medicine outpatient clinic, Suez Canal University Hospital, Ismailia, Egypt

The Egyptian Journal of Internal Medicine ◽

10.1186/s43162-021-00058-9 ◽

2021 ◽

Vol 33 (1) ◽

Author(s):

Reham Abo Emara ◽

Madeha Hamed ◽

Mohamed Awad ◽

Wael Zeid

Keyword(s):

Glycemic Control ◽

Family Medicine ◽

Education Program ◽

Management Education ◽

Self Care ◽

Suez Canal ◽

University Hospital ◽

Self Management ◽

The Family ◽

Patients With Diabetes

Abstract Background Diabetes mellitus (DM) is a chronic disease with debilitating complications. Patients with diabetes are recommended to take various self-management decisions and carry out complex care activities. Diabetes self-management education (DSME) and support help people with diabetes to take these decisions and activities to improve health outcomes. DSME may serve as the basis to minimize and avoid catastrophic diabetes-related complications and the resulting financial and personal costs associated with this disorder. We aimed to assess the effect of diabetes self-management education program on glycemic control on patients with diabetes. A quasi-experimental pre-post study was conducted at the family medicine clinic in Suez Canal University hospital, Ismailia, Egypt. A total of 116 patients with uncontrolled DM were recruited by a simple random technique after applying the inclusion and exclusion criteria. Participants were subjected to a 12-week health education program (1 session/week). The sessions focused on areas of diabetes self-management based on the American Diabetes Association (ADA) guidelines. The glycosylated hemoglobin (HbA1c) was assessed at baseline and again at the end of the program. Also, self-care activities were evaluated pre-post intervention using the Arabic version of the Summary of Diabetes Self-Care Activities (SDSCA) instrument which measured the activities related to diet, exercise, blood sugar testing, foot care, and medications. Results The mean age of participants was 47 years (± 11.54), male patients represented 54%. About two-thirds (67%) were from urban areas and came from a middle socioeconomic level. About half of the participants (51.7%) were diagnosed as diabetics for 5–10 years duration. More than half (52.7%) were on combination therapy of insulin and oral antidiabetic drugs. After the intervention program, there was a statistically significant decrease in HbA1c level (p value < 0.001), and 21% of the participants reached the ADA treatment goal for HbA1c below 7. Conclusion Appropriate DSME programs are practical and have a benefit to patients with diabetes.

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Glycemic Control Using Mobile-based Intervention in Patients With Diabetes Undergoing Coronary Artery Bypass to Promote Self-management

Case Medical Research ◽

10.31525/ct1-nct04192409 ◽

2019 ◽

Author(s):

Keyword(s):

Coronary Artery ◽

Glycemic Control ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Self Management ◽

Patients With Diabetes

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Differences in Secure Messaging, Self-management, and Glycemic Control Between Rural and Urban Patients: Secondary Data Analysis

JMIR Diabetes ◽

10.2196/32320 ◽

2021 ◽

Vol 6 (4) ◽

pp. e32320

Author(s):

Stephanie A Robinson ◽

Dane Netherton ◽

Mark Zocchi ◽

Carolyn Purington ◽

Arlene S Ash ◽

...

Keyword(s):

Glycemic Control ◽

Diabetes Management ◽

The United States ◽

Diabetes Control ◽

Self Management ◽

Patient Portal ◽

Cross Sectional ◽

Secure Messaging ◽

Patients With Diabetes ◽

Rural Patients

Background Rural patients with diabetes have difficulty accessing care and are at higher risk for poor diabetes management. Sustained use of patient portal features such as secure messaging (SM) can provide accessible support for diabetes self-management. Objective This study explored whether rural patients’ self-management and glycemic control was associated with the use of SM. Methods This secondary, cross-sectional, mixed methods analysis of 448 veterans with diabetes used stratified random sampling to recruit a diverse sample from the United States (rural vs urban and good vs poor glycemic control). Administrative, clinical, survey, and interview data were used to determine patients’ rurality, use of SM, diabetes self-management behaviors, and glycemic control. Moderated mediation analyses assessed these relationships. Results The sample was 51% (n=229) rural and 49% (n=219) urban. Mean participant age was 66.4 years (SD 7.7 years). More frequent SM use was associated with better diabetes self-management (P=.007), which was associated with better glycemic control (P<.001). Among rural patients, SM use was indirectly associated with better glycemic control through improved diabetes self-management (95% CI 0.004-0.927). These effects were not observed among urban veterans with diabetes (95% CI –1.039 to 0.056). Rural patients were significantly more likely than urban patients to have diabetes-related content in their secure messages (P=.01). Conclusions More frequent SM use is associated with engaging in diabetes self-management, which, in turn, is associated with better diabetes control. Among rural patients with diabetes, SM use is indirectly associated with better diabetes control. Frequent patient-team communication through SM about diabetes-related content may help rural patients with diabetes self-management, resulting in better glycemic control.

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Analysis of “Use of Blood Glucose Meters Featuring Color Range Indicators Improves Glycemic Control and Patients With Diabetes in Comparison to Blood Glucose Meters Without Color (ACCENTS Study)”

Journal of Diabetes Science and Technology ◽

10.1177/1932296818793115 ◽

2018 ◽

Vol 12 (6) ◽

pp. 1220-1222 ◽

Cited By ~ 3

Author(s):

Andjela T. Drincic

Keyword(s):

Blood Glucose ◽

Glycemic Control ◽

Current Issue ◽

Self Management ◽

Self Monitoring ◽

Glucose Levels ◽

Fundamental Part ◽

Color Range ◽

Oral Agents ◽

Patients With Diabetes

Self-monitoring of blood glucose is a part of integral care of patients with diabetes mellitus. Understanding and appropriately responding to glucose levels is a fundamental part of self-management. Grady et al’s work, published in the current issue of Journal of Diabetes Science and Technology, investigated whether switching people with diabetes from their usual meter to a meter featuring color range indicator (CRI) could improve glycemic control, by facilitating improved understanding of blood glucose targets. In this small but well-designed study, the authors have shown that meters with CRI features offer a potential advantage and may improve glucose control in patients with diabetes, both with T1D and T2D, across the therapy spectrum from oral agents to insulin therapy.

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The Effect of Diabetes Self-Management Education on Glycemic Control in Minority Patients With Diabetes Mellitus

Cureus ◽

10.7759/cureus.16888 ◽

2021 ◽

Author(s):

Xiu Ying Au ◽

Sneha Kola ◽

Vinuta Mohan

Keyword(s):

Diabetes Mellitus ◽

Glycemic Control ◽

Management Education ◽

Self Management ◽

Patients With Diabetes

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Differences in Secure Messaging, Self-management, and Glycemic Control Between Rural and Urban Patients: Secondary Data Analysis (Preprint)

10.2196/preprints.32320 ◽

2021 ◽

Author(s):

Stephanie A Robinson ◽

Dane Netherton ◽

Mark Zocchi ◽

Carolyn Purington ◽

Arlene S Ash ◽

...

Keyword(s):

Glycemic Control ◽

Diabetes Management ◽

The United States ◽

Diabetes Control ◽

Self Management ◽

Patient Portal ◽

Cross Sectional ◽

Secure Messaging ◽

Patients With Diabetes ◽

Rural Patients

BACKGROUND Rural patients with diabetes have difficulty accessing care and are at higher risk for poor diabetes management. Sustained use of patient portal features such as secure messaging (SM) can provide accessible support for diabetes self-management. OBJECTIVE This study explored whether rural patients’ self-management and glycemic control was associated with the use of SM. METHODS This secondary, cross-sectional, mixed methods analysis of 448 veterans with diabetes used stratified random sampling to recruit a diverse sample from the United States (rural vs urban and good vs poor glycemic control). Administrative, clinical, survey, and interview data were used to determine patients’ rurality, use of SM, diabetes self-management behaviors, and glycemic control. Moderated mediation analyses assessed these relationships. RESULTS The sample was 51% (n=229) rural and 49% (n=219) urban. Mean participant age was 66.4 years (SD 7.7 years). More frequent SM use was associated with better diabetes self-management (P=.007), which was associated with better glycemic control (P<.001). Among rural patients, SM use was indirectly associated with better glycemic control through improved diabetes self-management (95% CI 0.004-0.927). These effects were not observed among urban veterans with diabetes (95% CI –1.039 to 0.056). Rural patients were significantly more likely than urban patients to have diabetes-related content in their secure messages (P=.01). CONCLUSIONS More frequent SM use is associated with engaging in diabetes self-management, which, in turn, is associated with better diabetes control. Among rural patients with diabetes, SM use is indirectly associated with better diabetes control. Frequent patient-team communication through SM about diabetes-related content may help rural patients with diabetes self-management, resulting in better glycemic control.

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