Development and Usability of a Text Messaging Program for Women with Gestational Diabetes: Mixed Methods Study (Preprint)

2021 ◽  
Author(s):  
Rachel A. Blair ◽  
Christine E. Horn ◽  
Jennifer M. Dias ◽  
Marie E. McDonnell ◽  
Ellen W. Seely
Keyword(s):  
Blood Glucose ◽  
Gestational Diabetes ◽  
User Experience ◽  
Text Messaging ◽  
Diabetes Management ◽  
Secondary Outcome ◽  
Program Text ◽  
Usability Study ◽  
Maternal Complications ◽  
Self Monitoring

BACKGROUND Gestational diabetes mellitus (GDM) affects 5-10% of pregnancies and can lead to serious fetal and maternal complications. SMS text messaging is an effective way to improve diabetes management outside of pregnancy, but has not been well studied in GDM. OBJECTIVE This study aimed to perform user experience testing and assess usability and acceptability of a text messaging program (Text 4 Success) for women with GDM. METHODS An automated two-way texting program was developed. It included: 1) reminders to check blood glucoses, 2) positive feedback to user-reported glucoses, 3) weekly educational messages and 4) weekly motivational messages. For the user experience testing, women received simulated messages. For the usability study, women were enrolled in the program and received messages for 2 weeks. All women participated in semi-structured interviews. For women in the usability study, glucose measuring devices were downloaded to assess adherence to self-monitoring of blood glucose (SMBG), measured as the percent of recommended SMBG checks performed (a secondary outcome). RESULTS Ten women participated in user experience testing. Suggestions for optimization included further customization of message timing and minimization of jargon which were incorporated. Ten women participated in the usability study. All 10 would recommend the program to other women with GDM. Participants liked the immediate feedback to glucose values. Suggestions included further flexibility of messages related to mealtimes and the ability to aggregate blood glucose data into a table or graph. Overall, adherence to SMBG testing was high at baseline (>90%). In comparing the week prior to the trial to the two weeks during the trial, there was a small but statistically insignificant difference in the percentage of recommended SMBG performed (median 93% [5 to 95 percentile 82-100%] vs median 97% [83-100%]). CONCLUSIONS Overall, women with GDM would recommend the Text 4 Success in GDM program and think it is helpful for GDM self-management. The program was usable and acceptable. The program may be better suited to those who have a low adherence to self-monitoring of blood glucose at baseline. Adaptations to the program will be made based on user suggestions. Further study of text messaging to improve SMBG in GDM is needed.

Evaluation of a Continuous Blood Glucose Monitor: A Novel and Non-Invasive Wearable Using Bioimpedance Technology

2021 ◽  
pp. 193229682110541
Author(s):  
Farid Sanai ◽  
Arshman S. Sahid ◽  
Jacqueline Huvanandana ◽  
Sandra Spoa ◽  
Lachlan H. Boyle ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Blood Glucose ◽  
Real World ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Relative Difference ◽  
Self Monitoring ◽  
Non Invasive ◽  
Adult Participants ◽  
Blood Glucose Monitor

Background: Frequent blood glucose level (BGL) monitoring is essential for effective diabetes management. Poor compliance is common due to the painful finger pricking or subcutaneous lancet implantation required from existing technologies. There are currently no commercially available non-invasive devices that can effectively measure BGL. In this real-world study, a prototype non-invasive continuous glucose monitoring system (NI-CGM) developed as a wearable ring was used to collect bioimpedance data. The aim was to develop a mathematical model that could use these bioimpedance data to estimate BGL in real time. Methods: The prototype NI-CGM was worn by 14 adult participants with type 2 diabetes for 14 days in an observational clinical study. Bioimpedance data were collected alongside paired BGL measurements taken with a Food and Drug Administration (FDA)-approved self-monitoring blood glucose (SMBG) meter and an FDA-approved CGM. The SMBG meter data were used to improve CGM accuracy, and CGM data to develop the mathematical model. Results: A gradient boosted model was developed using a randomized 80-20 training-test split of data. The estimated BGL from the model had a Mean Absolute Relative Difference (MARD) of 17.9%, with the Parkes error grid (PEG) analysis showing 99% of values in clinically acceptable zones A and B. Conclusions: This study demonstrated the reliability of the prototype NI-CGM at collecting bioimpedance data in a real-world scenario. These data were used to train a model that could successfully estimate BGL with a promising MARD and clinically relevant PEG result. These results will enable continued development of the prototype NI-CGM as a wearable ring.

Prevalence of Different Brands and SMBG Frequency of Glucometer in Dakshina Kannada

2021 ◽  
Vol 11 (9) ◽  
pp. 284-288
Author(s):  
Abhishek Pradhan ◽  
Arya P P ◽  
A.R. Shabaraya
Keyword(s):  
Blood Glucose ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Diabetes Management ◽  
Essential Element ◽  
Diabetic Patients ◽  
University Graduates ◽  
Self Monitoring ◽  
Elementary School Education ◽  
The Relationship

Glucometer is helpful to find out the glucose in blood. The purpose of the study was to assess the frequency of self-monitoring of glucose and the prevalence of different brands of glucometer used by the diabetic patients. The prospective observational study was conducted among 150 patients above 18 years of age. 45.33% of participants were males and 54.67% of patients were females. The big percentage of age group belongs to 51-70 years (76.6%) followed by 71-90 years (16%) and age of 31-50 years (7.3%). Of the total, 24% has elementary school education, were 33.3% high school pass outs, and 42.6% were college/university graduates. Out of 150 patients, 54.67% used glucometer and 45.33% were not using glucometer. Among these, 30.49% used Accu-chek, 21.95% One-touch, 14.63% Gluco-one and 32.93% used other brands. Out of 54.67%, 5.33% of people were using daily, 21.33% weekly once, 28.00% were using monthly and 45.33% were not using glucometer. The present study concluded that SMBG is to help people with diabetes to improve their glycemic control. The relationship between blood glucose and SMBG frequency supported the view that SMBG is an essential element in diabetes management. The patient compliance regarding SMBG is finite. Thus, almost 60% of patients did not perform daily SMBG and above 45% did not perform routine test. Accu-chek glucometer to have an acceptable accuracy with the sensitivity of 81%, specificity 65%, PPV (positive predictive value) 74% and NPV (negative predictive value) 74%. Accu-chek was found to be the most accurate and widely used glucometer. Key words: Frequency, Glucometer brand, SMBG (Self monitoring of blood glucose).

scholarly journals Evaluation of information retention and adherence to treatment in patients with gestational diabetes mellitus after multidisciplinary group

2016 ◽  
Vol 62 (3) ◽  
pp. 212-217 ◽  
Author(s):  
Ana Maria da Silva Sousa ◽  
Daine Fiuza ◽  
Fernanda Cristina Ferreira Mikami ◽  
Karen Cristine Abrão ◽  
Rossana Pulcineli Vieira Francisco ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Contact Method ◽  
Information Retention ◽  
Multidisciplinary Group

SUMMARY Objective: To evaluate the retention of information after participation in multidisciplinary group in patients with gestational diabetes mellitus (GDM) through a phone contact. Method: 122 pregnant women diagnosed with gestational diabetes were included. After diagnosis of gestational diabetes, the patients were referred to the multidisciplinary group where they received medical, nutrition and nursing guidelines related to the disease. After three days these patients received one telephone call from a nurse, who made the same questions regarding the information received. In the statistical analysis, results were presented as absolute and relative frequencies. Results: Most patients 119/122 patients (97.5%) were managing to do self glucose monitoring. Twenty-one patients (17.2%) reported having difficulty performing the blood glucose, especially finger pricking. When questioning whether the woman was following the proposed diet, 24/122 (19.7%) patients said they did not; the meal frequency was not reached by 23/122 (18.9%) of the women, and forty-seven (38.5%) of the women reported having ingested sugar in the days following the guidance in multidisciplinary group. Conclusion: Regarding the proposed treatment, there was good adherence of patients, especially in relation to blood glucose monitoring. As for nutritional control, we observed greater difficulty in following the guidelines demonstrating the need for long-term monitoring, as well as further clarification to the patients about the importance of nutrition in diabetes management.

scholarly journals SUN-692 Comprehensive and Structured Care Program for Patients with Type 2 Diabetes Mellitus: A Preliminary Report from Raipur, Chhattisgarh State of India

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Kalpana Dash ◽  
Surekha Tippisetty ◽  
Samba Siva Rao ◽  
Vamsi Krishna Kolukula
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Care Program ◽  
Mobile App ◽  
Phone Call ◽  
Hypoglycemic Agents ◽  
Oral Hypoglycemic Agents ◽  
Self Monitoring ◽  
Structured Care ◽  
Glycemic Outcomes

Abstract Aim: To assess the glycemic outcomes of T2DM patients enrolled in comprehensive structured care program at the outpatient clinic of Apollo Sugar at Raipur, India. Methods: This is a preliminary, prospective, single-center, observational study on T2DM patients from Jan 2018 to December 2018. Uncontrolled diabetes or patients with comorbid conditions with the duration of disease for more than one year and age ≥18 years and who gave consent to enroll in the program were included in the study. The structured care program is a 6 months program where patients were continuously engaged by counseling them on diabetes management- diet and exercise, self-monitoring of blood glucose, health interactions with the remote health coach through a mobile app. Baseline demographics and clinical data were collected at the time of enrollment and were followed up for 6 months. HbA1c reduction is the target measurement of this program. Descriptive statistics were used to analyze and report the data. A paired t-test is used to check the significant reduction in HbA1c from baseline to follow up Results: Total 102 patients were included in this study. Mean (SD) age was 50.7 (10.5) years, males were 78 (76%) and females were 24 (24%). The mean (SD) duration of diabetes and BMI were 7.9 (7.0) years and 27.5 (4.5) kg/m2 respectively. At the time of enrollment, patients were at mean HbA1c of 9.0(2.1)%, fasting (F) and post-prandial (PP) blood (BG) glucose was 194(68) mg/dL and 247(94) mg/dL respectively. Among these patients 38% had neuropathy and 15% had retinopathy as their complications. These patients were regularly followed up over the phone call to counsel on diabetes management with a healthy diet, exercise, self-monitoring of blood glucose, and medication compliance. After 6 months followup the HbA1c, FBG, and PPBG were 7.6 (1.5) %, 139 (50) mg/dL, and 196 (75) mg/dL, respectively with a significant mean reduction of 1.4%, 56 mg/dL, and 51 mg/dL (p <0.001). Further analysis of glycemic outcomes between these patients on oral hypoglycemic agents (OHAs) and OHAs+insulin, the reduction in HbA1c (1.5%) was not significant. Conclusion: Our study demonstrates that a structured care program might bring a clinically significant glycemic control through tight adherence to SMBG, diet, exercise, and medication. To establish these results a study in large sample is in progress.

scholarly journals Self-monitoring of blood glucose as a basis for diabetes management

2013 ◽  
Vol 4 (1) ◽  
pp. 47-54
Author(s):  
A. Yu Mayorov ◽  
O. G Melnikova ◽  
Yu. I Filippov
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
International Organization ◽  
Diabetes Treatment ◽  
Self Monitoring ◽  
Antidiabetic Therapy ◽  
New Methods ◽  
Before And After ◽  
External Conditions

The article represents the review of issues of self-monitoring of blood glucose (SMBG) in diabetes treatment. The therapeutic purposes are considered when carrying out SMBG before and after the meals, accepted in Russia, providing an individualization depending on age, existence of severe complications and the risk of hypoglycemia. SMBG frequency is presented at various options of the antidiabetic therapy. The value of carrying out SMBG for the patient and the doctor is discussed. The principles of the work photometric and electrochemical glucometers are given. Issues of accuracy of blood glucose measuring accepted by the International organization for standardization for the systems of SMBG are presented. The reasons of errors to the system evaluation of blood glucose are connected with incorrect hand washing, improper coding of test strips, external conditions (altitude, temperature, humidity), hematocrit, acidosis, hyperlipidemia, concentration of oxygen in blood, exogenous interfering substances (some medicines). The structure and rules of maintaining the diary as the main way of the storage of results of SMBG are presented. Data of the international and Russian studies on an assessment of efficiency of SMBG are shown. The SMBG new methods are discussed in the section on continuous glucose monitoring.

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