Longitudinal Effects of an Intergenerational mHealth Program for Older Type 2 Diabetes Patients in Rural Taiwan

2020 ◽  
Vol 46 (2) ◽  
pp. 206-216 ◽  
Author(s):  
Kexin Yu ◽  
Shinyi Wu ◽  
Pey-Jiuan Lee ◽  
Du-An Wu ◽  
Hsin-Yi Hsiao ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Self Care ◽  
Medical Expenditure ◽  
Self Management ◽  
Glucose Testing ◽  
Longitudinal Effects ◽  
Endocrinology Clinic ◽  
Clinic Visits

Purpose The purpose of the study is to test the longitudinal efficacy of a mHealth intervention (Intergenerational Mobile Technology Opportunities Program, IMTOP) for older type 2 diabetes mellitus (T2DM) patients in rural Taiwan. Few mHealth programs targeted rural older adults and the longitudinal effects are unknown. Methods Ninety-seven T2DM patients aged 55+ were recruited from an outpatient in Hualien, Taiwan. The intervention comprised 8-week technology and diabetes self-management training and 4-week technical support. College student tutors facilitated T2DM patients to learn technology. Participants used a diabetes self-management app to track health behaviors. Outcomes measured at baseline and at 4 and 8 months including patient-reported self-care behaviors, T2DM symptoms, clinical outcomes, health resource utilization, and medical expenditure. Linear mixed-effect regressions of repeated measures were conducted for each outcome. Results At 4 months, improvements in self-care behaviors were reported in diet, exercise, smoking, and blood glucose testing. Patients paid less endocrinology clinic visits, spent less on endocrinology medications, and improvements in fasting blood glucose and total cholesterol were observed. At 8 months, the statistical significance of improvements in diet and smoking were maintained, and the averaged endocrinology clinic visits remained less than baseline. However, more frequent occurrence of diabetes symptoms were reported at both follow-ups. Conclusions: IMTOP had lasting effects on diet and decreased smoking behavior, clinic visits, and medication costs over 8 months. Self-monitoring through an app increased awareness and may explain the increased reporting of diabetes symptoms. IMTOP is a promising model for promoting T2DM self-management in rural areas.

scholarly journals Effects of an Outpatient Diabetes Self-Management Education on Patients with Type 2 Diabetes in China: A Randomized Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Fan Zheng ◽  
Suixin Liu ◽  
Yuan Liu ◽  
Lihua Deng
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Diabetes Education ◽  
Fasting Blood Glucose ◽  
Intervention Group ◽  
Self Care ◽  
Education Programme ◽  
Self Management ◽  
Control Group

Objective. This study is aimed at assessing the effectiveness of a simple outpatient diabetes self-management education programme. Methods. In the study, 60 patients with type 2 diabetes mellitus were randomly allocated into the control group (n=30) and intervention group (n=30). Regular and 2-session health education programmes were provided. The summary of diabetes self-care activity measure, problem areas in the diabetes scale, fasting blood glucose, postprandial 2 h blood glucose, and HbA1c were measured before and after the intervention to assess the effects of this 2-session diabetes education programme. Results. The total mean score of the summary of diabetes self-care activities measure was 17.60±6.63 points. The problem areas in the diabetes scale revealed that the total mean score was 29.82±15.22 points; 27% of the patients had diabetes-related distress, while 9% suffered from severe emotional distress. Compared with the control group, scores of the summary of diabetes self-care activities measure and problem areas in the diabetes scale, fasting blood glucose, postprandial 2 h blood glucose, and HbA1c were significantly improved in the intervention group after the intervention (P<0.01). Conclusion. This study showed that the 2-session diabetes education programme could effectively improve the level of self-reported self-management, psychological distress, and glycemic control in patients with type 2 diabetes mellitus.

The impact of structured blood glucose testing on attitudes toward self-management among poorly controlled, insulin-naïve patients with type 2 diabetes

2012 ◽  
Vol 96 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Lawrence Fisher ◽  
William H. Polonsky ◽  
Christopher G. Parkin ◽  
Zhihong Jelsovsky ◽  
Bettina Petersen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Self Management ◽  
Glucose Testing ◽  
Blood Glucose Testing ◽  
The Impact

scholarly journals Self-care adherence and affective disorders in Barbadian adults with type 2 diabetes

2021 ◽  
Vol 9 (1) ◽  
pp. 62-72
Author(s):  
Allison DaSantos ◽  
◽  
Carlisle Goddard ◽  
Dalip Ragoobirsingh ◽  
◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Management ◽  
Behavioral Problem ◽  
Self Care ◽  
Self Report ◽  
Diabetes Distress ◽  
Glucose Testing ◽  
Blood Glucose Testing ◽  
Distress Scale

<abstract><sec> <title>Purpose</title> <p>Diabetes management requires adherence to complicated self-care behaviors. Therefore, the emotional state of the individual living with diabetes, is likely to affect their ability to comply with recommendations. This study explored the relationship of self-care adherence to diabetes distress and depression in Barbadian adults with type 2 diabetes.</p> </sec><sec> <title>Methods</title> <p>Adults aged 20 to 80 years, with type 2 diabetes, completed self-report questionnaires comprised of a profile section consisting of demographic and clinical characteristics; and standardized questionnaires comprising, The Diabetes Distress Scale (DDS), The Patient Health Questionnaire (PQH-9), and the Summary of Diabetes Self-care Activities Scale (SDSCA). Additionally biological measures (BP and HbA1c) were collected.</p> </sec><sec> <title>Results</title> <p>For the 509 participants there were no differences in adherence for males (30.8%) and females (69.2%), high diabetes distress and depression were associated with low adherence. General diet was negatively associated with BP and HbA1c; while HbA1c was positively correlated with blood glucose testing.</p> </sec><sec> <title>Conclusion</title> <p>Self-care non-adherence is more than a behavioral problem; it is a multidimensional phenomenon inclusive of demographic factors, condition or disease factors, psychological and social factors.</p> </sec></abstract>

Putting Self-Management in the Context of Community-Dwelling American Indians Living With Type 2 Diabetes

2019 ◽  
Vol 46 (1) ◽  
pp. 108-117 ◽  
Author(s):  
Jacqueline Jones ◽  
R. Turner Goins ◽  
Mark Schure ◽  
Blythe Winchester ◽  
Vickie Bradley
Keyword(s):  
Type 2 Diabetes ◽  
American Indians ◽  
Management Education ◽  
Self Care ◽  
Community Support ◽  
Community Dwelling ◽  
National Standards ◽  
Self Management ◽  
Community Food Security

Purpose The purpose of this qualitative descriptive study was to examine the National Standards for Diabetes Self-Management Education and Support (DSMES) defined diabetes self-care behaviors (healthy eating, being active, taking medication, monitoring, problem solving, reducing risk, and healthy coping) in the context of older community-dwelling American Indians (AIs). Methods Secondary theme analysis of transcribed semistructured qualitative interview data from 28 participants in the Native Elder Care Study aged >60 years identified factors that influence the DSMES self-care behaviors in the context of community-dwelling AIs. Results Four themes that characterized barriers, facilitators, and opportunities for DSMES to support self-care behaviors included community food security, care partners in self-care, community opportunities for diabetes support, and blending of both health worlds. Conclusion Tribal communities have contemporary strengths and cultural traditions that can be activated to enhance diabetes self-management education and support. Diabetes educators can work in tandem with community health representatives to strengthen the social and community support within which individual AIs with type 2 diabetes mellitus live. Community-based participatory research with AI caregivers, dyads, families, youth, and Indian Health Service clinicians may help to improve tribal food policy and school health initiatives, as well as develop intergenerational interventions for modeling effective diabetes self-management.

scholarly journals Participation of Patients With Type 2 Diabetes in Online Support Groups is Correlated to Lower Levels of Diabetes Self-Management

2020 ◽  
Vol 15 (1) ◽  
pp. 121-126
Author(s):  
Noelia Herrero ◽  
Frederic Guerrero-Solé ◽  
Lluís Mas-Manchón
Keyword(s):  
Type 2 Diabetes ◽  
Support Groups ◽  
Care Management ◽  
Online Survey ◽  
Self Care ◽  
Self Management ◽  
Online Support ◽  
Online Support Groups

Background: Support groups play an important role in diabetes understanding and education. This study aims to find connections between participating in diabetes-related online communities (groups and forums) and the self-reported degree of self-care management and health problems associated with type 1 and 2 diabetes. Methods: A cross-sectional study using an online survey was conducted and 307 participants were recruited. Participants were asked about diabetes self-care management (glucose management, healthcare, dietary restrictions, and physical activity) and complications related to the disease, as well as their participation in online social groups and forums (duration, time, and intensity). Results: Belonging to diabetes-related online support groups (OSGs) was associated with lower scores in healthcare and self-management of diabetes ( M = 2.98, SD = 1.07, n = 207, for belonging to OSGs; and M = 4.22, SD = 0.59, n = 97, for not belonging to OSGs). These differences were not statistically significant for type 1 diabetes individuals ( M = 4.33, SD = 0.47, n = 28, for belonging to OSGs, and M = 4.29, SD = 0.48, n = 52, for not belonging to OSGs), but were highly significant for type 2 diabetes (T2D) individuals ( M = 2.41, SD = 0.68, n = 144, for belonging to OSGs; and M = 4.14, SD = 0.64, n = 61, for not belonging to OSGs). People with both type 1 and 2 diabetes reported to have suffered more complications derived from diabetes when they belonged to an OSG, but greater statistically significant differences were found in type 2 individuals. Conclusion: Patients with T2D who participate in OSGs show a higher correlation with having lower levels of diabetes self-care management as well as health complications related to the disease.

scholarly journals Effectiveness of Patient-centered Care for Diabetes Self-management to Improve Glycemic Control and Self-care Behaviors in Adults With Type 2 Diabetes: a Systematic Review

2021 ◽  
Author(s):  
Kainat Asmat ◽  
Khairunnisa Dhamani ◽  
Raisa Gul ◽  
Erika Sivarajan Froelicher
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Self Care ◽  
Self Management ◽  
Foot Care ◽  
Patient Centered ◽  
Management Interventions ◽  
Centered Care ◽  
Care Outcomes

Abstract Background: Patient-centered care in diabetes self-management might be a significant factor in improving self-care outcomes yet the supporting evidence is inadequate. This review is aimed to assess the effectiveness of patient-centered self-management care interventions on self-care outcomes such as glycemic control (HbA1c) and self-care behaviors in adults with type-2 diabetes compared with usual care. Methods: CINAHL, PubMed, Cochrane Library, Google Scholar and the HEC Pakistan digital library were searched for English language studies that assessed patient-centered self-management educational and/or behavioral interventions in adults aged 18 years or above with type 2 diabetes from 1991 to 2020. Interventional studies comprising randomized controlled trials (RCT) and quasi experimental studies (QES) with at least three months follow up and reporting on self-care outcomes with glycemic control (HbA1c) as primary outcome and self-care behaviors including diet control, physical activity, medication adherence and foot care as secondary outcomes were included. Results: Of the 168 identified records, 25 were found eligible comprising 21 RCTs and 4 QESs with total 4,443 participants. The meta-analysis involved 23 studies that provided enough information for a pooled estimate of HbA1c. Compared with the control group, patient-centered self-management interventions significantly lowered HbA1c −0.53 (95% CI −0.73, −0.32). Stratified analysis for HbA1c with respect to various aspects of intervention showed larger effects in interventions employing both educational and behavioral components −0.59 (95% CI −0.86, −0.32), spanned over shorter (<03 months) duration −0.56 (95% CI −0.86, −0.27), administered by nurses −0.80 (95% CI −1.44, −0.16) and delivered in community setting −0.65 (95% CI −1.00, −0.29). Moreover, patient-centered self-management interventions were found effective in improving diet control, physical activity and foot care. Conclusion: This systematic review provided the evidence supporting the effectiveness of patient-centered self-management care interventions in improving glycemic control and self-care behaviors in adults with type 2 diabetes and identified key features of intervention contributing towards success.

scholarly journals Blood Glucose Monitoring and Sharing Amongst People With Diabetes and Their Facilitators: Cross-sectional Study of Methods and Practices

JMIR Diabetes ◽  
10.2196/29178 ◽  
2021 ◽  
Vol 6 (4) ◽  
pp. e29178
Author(s):  
Amr Jamal ◽  
Shabana Tharkar ◽  
Weam Saleh Babaier ◽  
Shrooq Faisal Alsomali ◽  
Allulu Saad Alsulayhim ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Cross Sectional Study ◽  
Diabetes Control ◽  
Self Management ◽  
Sectional Study ◽  
Cross Sectional ◽  
Self Monitoring ◽  
Digital Devices

Background The last two decades have witnessed a burgeoning rise in the prevalence of diabetes globally. It has already reached epidemic proportions in Saudi Arabia, with reported high risk among women. As a result, diabetes monitoring and self-management programs are being highly prioritized for diabetes control and management. Objective To investigate measuring and sharing practices of the self-monitoring of blood glucose (SMBG) among patients with type 1 or 2 diabetes using insulin. Methods A cross-sectional study was conducted on a sample of 203 patients attending primary care clinics at a tertiary care center. The questionnaire assessed the measuring, recording, and sharing of SMBG practices of patients having diabetes with their physicians. The methods used for recording and sharing were categorized into paper-based and electronic-based. In addition, the determinants of the different methods used and frequency of sharing were analyzed. Results The overall monitoring prevalence was 95% (193/203), and 57% (117/203) of participants shared the SMBG results. Among the 193 individuals that performed self-monitoring, 138 (72%) performed daily monitoring, and 147 (76%) recorded their blood sugar levels. Almost 55% (81/147) used paper-based materials like notebooks and paper for recording, while the rest (66/147, 45%) used digital devices like laptops and smartphones. A shift towards the use of digital devices and smart applications was observed in patients below 50 years of age. The digitally recorded blood glucose measurements were being shared thrice more often than the recordings made on paper or in notebooks (OR [odds ratio] 2.8; P=.01). Patients >50 years of age (OR 2.3; P=.02), with lesser formal education, married (OR 4.2; P<.001), with smaller family size (OR 2.6; P=.01), having type 2 diabetes (OR 4.1; P<.001) and any comorbid conditions (OR 2.6; P=.01) were associated with higher odds of using paper-based sharing methods. Only the female gender and type 2 diabetes were associated with increased frequency of sharing, while uncontrolled diabetes, the presence of other comorbidities, and duration of diabetes did not show any influence. Conclusions Good monitoring and optimal sharing practices were found. Sharing using electronic devices can be emphasized. Diabetes self-management programs can incorporate the use of digital technology in training sessions. Digital literacy and its applications in health care may enhance SMBG practices resulting in better diabetes control.

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