Type 2 Phone
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Background: Recent evidence of the effectiveness of mobile phone-based diabetes management systems is generally based on studies conducted in tertiary hospitals or professional diabetes clinics.
Objective: This study aimed to evaluate the clinical efficacy and applicability of a mobile phone-based glucose-monitoring and feedback system for the management of type 2 diabetes mellitus (T2DM) in multiple primary care clinic settings.
Methods: In this multicenter, cluster-randomized controlled, open trial, 13 primary care clinics in Seoul and other large cities in South Korea were voluntarily recruited. Overall, 150 (9 clinics) and 97 (4 clinics) participants with T2DM were assigned to the intervention and control groups, respectively (2:1 allocation). Every month, participants in both groups attended face-to-face physicians' consultation for the management of diabetes in the clinic. For the intervention group, participants were required to upload their daily self-monitoring of blood glucose (SMBG) results using the mobile phone app in addition to outpatient care for 3 months. The results were automatically transmitted to the main server. Physicians had to check their patients' SMBG results through an administrator's website and send a short feedback message at least once a week. At baseline and 3 months, both groups had anthropometry and blood tests, including hemoglobin A1c (HbA1c), and responded to questionnaires about treatment satisfaction and compliance.
Conclusions: The mobile phone-based glucose-monitoring and feedback system was effective in glycemic control when applied in primary care clinic settings. This system could be utilized effectively with diverse institutions and patients.
Image-based dietary records have limited evidence evaluating their performance and use among adults with a chronic disease. This study evaluated the performance of a 3-day mobile phone image-based dietary record, the Nutricam Dietary Assessment Method (NuDAM), in adults with type 2 diabetes mellitus (T2DM). Criterion validity was determined by comparing energy intake (EI) with total energy expenditure (TEE) measured by the doubly-labelled water technique. Relative validity was established by comparison to a weighed food record (WFR). Inter-rater reliability was assessed by comparing estimates of intake from three dietitians. Ten adults (6 males, age: 61.2 ± 6.9 years old, BMI: 31.0 ± 4.5 kg/m(2)) participated. Compared to TEE, mean EI (MJ/day) was significantly under-reported using both methods, with a mean ratio of EI:TEE 0.76 ± 0.20 for the NuDAM and 0.76 ± 0.17 for the WFR. Correlations between the NuDAM and WFR were mostly moderate for energy (r = 0.57), carbohydrate (g/day) (r = 0.63, p < 0.05), protein (g/day) (r = 0.78, p < 0.01) and alcohol (g/day) (rs = 0.85, p < 0.01), with a weaker relationship for fat (g/day) (r = 0.24). Agreement between dietitians for nutrient intake for the 3-day NuDAM (Intra-class Correlation Coefficient (ICC) = 0.77-0.99) was lower when compared with the 3-day WFR (ICC = 0.82-0.99). These findings demonstrate the performance and feasibility of the NuDAM to assess energy and macronutrient intake in a small sample. Some modifications to the NuDAM could improve efficiency and an evaluation in a larger group of adults with T2DM is required.
Objective: Depression is common in diabetes and linked to adverse health outcomes. This study evaluated the efficacy of a guided web-based intervention in reducing depression in adults with type 1 and type 2 diabetes.
Conclusions: A guided, web-based intervention to reduce depression in adults with type 1 and type 2 diabetes is effective in reducing both depressive symptoms and diabetes-specific emotional distress.
Methods: Twenty-five patients were randomly assigned to an intervention group and 26 to a control group. The intervention was applied for six months. The goal of the intervention was to keep blood glucose concentrations close to the normal range. Participants were requested to input their blood glucose level, diet and exercise diary everyday in the website by cellular phone or wire Internet. The researcher sends optimal recommendations to each patient using SMS by cellular phone and wire Internet weekly.
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Background: Filipino Americans have a high prevalence of obesity, type 2 diabetes (T2D), and cardiovascular disease compared with other Asian American subgroups and non-Hispanic whites. Mobile health (mHealth) weight loss interventions can reduce chronic disease risks, but these are untested in Filipino Americans with T2D.
The Community Preventive Services Task Force recommends diabetes self-management mobile phone apps, implemented in health care systems, to improve blood sugar among patients with type 2 diabetes. These interventions aim to facilitate communication between patients and health care providers and to improve diabetes care. Patients enter data into the apps or use medical equipment that transmits data directly. The apps then provide patients with feedback from health care professionals or automated systems.
Guide to Community Preventive Services. (2017). Diabetes management: mobile phone applications used within healthcare systems for type 2 diabetes self-management. Retrieved from -management-mobile-phone-applications-used-within-healthcare-systems-type-2
Dr. Marina Basina is an ABMS board certified endocrinologist specializing in diabetes mellitus type 1 and 2, diabetes technology, thyroid nodules, and thyroid cancer. She is currently a clinical associate professor at Stanford University School of Medicine and is a medical director of inpatient diabetes at Stanford Hospital.
This app almost does it all for type I, type II, and gestational diabetes management. It offers carb counting, glucose tracking, and bolus dose calculation estimates. It can give you reports on your blood glucose levels over weeks, months, and even years. As a bonus, it can estimate your hemoglobin A1C based on your tracking. A clean, intuitive, customizable dashboard interface and the ability to sync with your glucose monitor can set this app apart. MySugr has features that can help you make the most out of the app, such as reminders that ping you to follow up with more data, like blood sugar levels after a workout. All the data and charts are usually easy to send to your doctor, so you can work together to adjust your treatment and better manage your diabetes based on accurate information.
Question For adults with poorly controlled type 2 diabetes treated with basal insulin without prandial insulin in primary care practices, does continuous glucose monitoring improve hemoglobin A1c (HbA1c) levels compared with blood glucose meter monitoring?
Meaning Continuous glucose monitoring resulted in better glycemic control compared with blood glucose meter monitoring in adults with poorly controlled type 2 diabetes treated with basal insulin without prandial insulin.
Importance Continuous glucose monitoring (CGM) has been shown to be beneficial for adults with type 2 diabetes using intensive insulin therapy, but its use in type 2 diabetes treated with basal insulin without prandial insulin has not been well studied.
Design, Setting, and Participants This randomized clinical trial was conducted at 15 centers in the US (enrollment from July 30, 2018, to October 30, 2019; follow-up completed July 7, 2020) and included adults with type 2 diabetes receiving their diabetes care from a primary care clinician and treated with 1 or 2 daily injections of long- or intermediate-acting basal insulin without prandial insulin, with or without noninsulin glucose-lowering medications.
Conclusions and Relevance Among adults with poorly controlled type 2 diabetes treated with basal insulin without prandial insulin, continuous glucose monitoring, as compared with blood glucose meter monitoring, resulted in significantly lower HbA1c levels at 8 months.
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(Notice all those words with "app" in them? Just our helpful reminder FreeStyle Libre 2 measures your glucose data every minute for up to 14 days, so you always have the most recent information available via your app on your compatible smartphone.)
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