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A Sugar Substitute That’s Good For You? The Science Behind Allulose - with Dr. Bikman - EP 169Improving glycemic control -
These data indicate that the CDSS-based u-healthcare service was effective in decreasing postprandial glucose surge by immediately alerting patients with lifestyle change recommendations. According to previous study results, postprandial glucose concentration is regarded as a risk factor for developing long-term complications 20 — Therefore, less fluctuation of glucose levels would lead to better prevention of long-term diabetes complications.
In this study, glycemic control also improved in the SMBG group, but this effect was attenuated over time. This implies that self-management of diabetes is difficult without close and consistent supervision. Thus, prompt follow-up involving appropriate recommendations and consistent reminder messages that motivate patients may be more important than the frequency of glucose self-measurement per se.
Although, the frequency of SMBG was directly related to the mean A1C levels, it is noteworthy to recognize its attenuating relationship at the end of the study. In addition, u-healthcare service group showed a decrease in BMI and LDL-cholesterol level. These results can be interpreted as unintended benefits resulting from adhering to lifestyle change recommendations that were generated by the CDSS rule engine.
Thus, u-healthcare service has many other beneficial effects pertaining to healthy lifestyle changes encouraged by automated messages. Several studies have used a different telehealth system in different settings. A previous study from our group confirmed the use of the glucometer with a mobile system and Zigbee communication protocol and showed improved self-care in diabetes management in elderly diabetic patients 8.
An Internet-based glucose control system used in the middle-aged type 2 diabetic patients recently showed a significant reduction of the A1C level More recently, another group from South Korea reported that the combined application of a mobile device and a Web-based monitoring system for 12 weeks improved various metabolic parameters in obese patients with diabetes and hypertension Thus, various applications of advanced information technology in different settings and populations would be helpful in diabetes management, and as a result, a great number of studies are ongoing in this field 13 , 23 — Patients in this study were allowed to change their therapeutic regimen according to the text messages generated by the CDSS rule engine.
Generally, every change in the drug regimen in Korea must be certified by a doctor. This study, however, was conducted under controlled and special circumstances where the participants were educated intensively and the dose of self-adjustment was limited to a very narrow range.
In addition, the investigators frequently monitored the text messages, and an active alert system also sent timely notification of adverse events. Nevertheless, the issue of self-changing therapy by patients is an area of uncertainty and concern, and more clinical studies are required to support its validity.
This study has some limitations. First, the study population size was relatively small. Second, the overall follow-up period was only 6 months. In addition, study participants were limited to elderly individuals, and only blood glucose levels were involved. Thus, a large-scale, long-term clinical trial using the advanced CDSS rule engine for type 2 diabetic patients is required in the near future.
Despite more frequent testing, This could be attributed to education, reminder messages generated by the glucometer, and patient satisfaction with the glucose results associated with frequent testing.
The high proportion of elderly patients who completed the study is important for several reasons. The successful completion serves as an indication that even technologically challenged elderly individuals can adopt a new and advanced system.
It is critical, however, to provide sufficient education and training before such system implementation, as was done in this study.
Another significance of this adapted population is its implication on the use of a new system in the general public. Successful adoption of new technology by the general public when the u-healthcare system is widely implemented is anticipated from the results of our study.
In conclusion, we have demonstrated that the 6-month application of the u-healthcare system, which is characterized by a proactive automated communication system using the CDSS rule engine, helped diabetic patients achieve target glycemic control with less hypoglycemia.
In the near future, we hope that the individualized u-healthcare system will contribute to diabetes management by reducing complications and improving quality of life and self-care in patients with diabetes.
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Volume 34, Issue 2. Previous Article Next Article. RESEARCH DESIGN AND METHODS. Article Navigation. Improved Glycemic Control Without Hypoglycemia in Elderly Diabetic Patients Using the Ubiquitous Healthcare Service, a New Medical Information System Soo Lim, MD ; Soo Lim, MD.
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Int J Environ Res Public Health. Download references. The authors gratefully acknowledge the financial support of the Gesellschaft für Forschungsförderung Niederösterreich m. H GFF and the provincial government of Lower Austria through the Life Science Calls Project ID LS We would like to thank the NÖ Landesgesundheitsagentur, the Austrian diabetes self-help groups, and involved students for their support of this study.
Furthermore, we acknowledge the permission to use the following questionnaires:. Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany for the SDSCA-G:. Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University, Germany for the AScale:.
Pharm World Sci ; Michigan Diabetes Research Center, Michigan, USA for the Diabetes Knowledge Scale. The project was supported by Grant Number P30DK MDRC from the National Institute of Diabetes and Digestive and Kidney Diseases. Downloadable questionnaires [Internet].
Danner D, Rammstedt B, Bluemke M, Treiber L, Berres S, Soto C, et al. Die deutsche Version des Big Five Inventory 2 BFI Zusammenstellung Sozialwissenschaftlicher Items Skalen ZIS [Internet]. EH is the study coordinator. EH, JG, MW, DWK, and JP conceived the study and led the proposal and protocol development.
EH and JG wrote the first draft of the manuscript. JP edited and made substantial contributions to the manuscript. EH is responsible for study management, measurements, and data management. UH, AEZ, EH, JG, DWK, WK, and SS developed the IMS strategy and the trainings.
JG and AEZ will be responsible for interpreting communication data. UH is the dietitian in contact with moderators. MW and WK are the clinicians responsible for analyzing biochemical parameters. PK and EG will carry out the FoKo database query and contact potential participants as well as internists and physicians in Lower Austria.
SS will be responsible for statistical analysis. All authors read and approved the final manuscript. This study is publicly funded by the Gesellschaft für Forschungsförderung Niederösterreich m.
The funding organization has no influence on the design, collection, analysis, and interpretation of data, or the writing of the manuscript. The Data Management Coordinating Center EH, UH, AEZ, JG will oversee the intra-study data sharing process, with input from the Data Management Subcommittee.
Data sharing will be done in exclusively encrypted form. Also, only the encrypted data will be used for any publications. Medical samples will be destroyed after the analyses according to the quality criteria of ISO and will not be stored for further examinations.
The collected data and backup copies are protected by passwords and are also only accessible to those persons who are entrusted with their processing and evaluation.
An ID code is created for each participant encryption by means of sequential numbering, from which only the assignment to the corresponding group is possible, but no conclusion regarding the identity of the participant. Institute of Health Sciences, St.
Department of Internal Medicine I, University Hospital St. Bachelor Degree Program Dietetics, St. Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria.
Fachbereich Versorgungsmanagement 3, Austrian Health Insurance Fund, St. Christian Doppler Forschungsgesellschaft, Vienna, Austria. You can also search for this author in PubMed Google Scholar. Correspondence to Elisabeth Höld. Written, informed consent to participate will be obtained from all participants.
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Reprints and permissions. Höld, E. et al. Improving glycemic control in patients with type 2 diabetes mellitus through a peer support instant messaging service intervention DiabPeerS : study protocol for a randomized controlled trial. Trials 23 , Download citation. Received : 27 September Accepted : 26 March Published : 14 April Anyone you share the following link with will be able to read this content:.
Sorry, a shareable link is not currently available for this article. Regular physical activity helps manage diabetes and reduces the risk of serious health complications associated with the disease.
Exercise increases the amount of glucose used by the muscles and helps the body use insulin more efficiently. Doing different activities each week provides the most health benefits. Mixing cardiovascular activities with strength training and stretching provides a variety of health benefits and keeps patients from becoming bored with their routines.
Although most physical activity helps with glucose control, certain activities may be unsafe for some individuals. Pharmacists should always counsel patients to check with their physicians before starting exercise routines.
In addition, patients should drink plenty of water, not only to stay hydrated but to flush glucose from the kidneys; get enough sleep, as irregular sleep can result in glucose intolerance; and reduce stress, because stress causes the body to release hormones called cortisol and glucagon, which cause blood glucose levels to rise.
Kathleen Kenny, PharmD, RPh, is a clinical medical writer for Healthline Media in Colorado Springs, Colorado. Diabetes and prediabetes. Updated September 6, Accessed March 13, Blonde L, Aschner P, Bailey C, Ji L, Leiter LA, Matthaei S; Global Partnership for Effective Diabetes Management. Gaps and barriers in the control of blood glucose in people with type 2 diabetes.
Diab Vasc Dis Res. All about your A1C. Updated September 30, Monitoring your blood sugar. Updated December 30, Manage blood sugar. Glycemic index food guide. Diabetes Canada. National Institute of Diabetes and Digestive and Kidney Diseases. Updated December Updated November 30, The impact of poor sleep on type 2 diabetes.
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Glycemix Promoting healthy glucose utilization 2. Authors of goycemic article:. Gpycemic Traditional lifestyle Imprvoing have shown limited success in improving diabetes-related outcomes. Digital interventions with continuously Health benefits of fruits support and personalized educational content may offer unique advantages for self-management and glycemic control. Objective: In this study, we evaluated changes in glycemic control among participants with type 2 diabetes who enrolled in a digital diabetes management program. Methods: The study employed a single-arm, retrospective design. A total of participants with a hemoglobin A 1c HbA 1c baseline value of at least 7. Glycemmic Improving glycemic control. Keeping blood glucose levels glyemic a target range delays prevents serious health Metabolism Booster associated with type 2 diabetes. More Improvinng Promoting healthy glucose utilization million individuals conhrol the United States have diabetes, and 96 million Contrlo prediabetes, many of whom do not know it. It is important to keep blood glucose levels within a target range as much as possible to delay or prevent long-term, serious health problems such as heart or kidney disease, neuropathy, and vision loss. This leads to a higher risk of avoidable, serious complications. The hemoglobin A1C HbA1C test is the gold standard for measuring blood glucose levels, according to the American Diabetes Association. The test measures average blood glucose levels over a 2- to 3-month period.
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