Factors that influence improvement for patients with poorly controlled type 2 diabetes

Hartz, Arthur J.; Kent, Sarah; James, Paul A.; Xu, Yinghui; Kelly, Michael; Daly, Jeanette M.

doi:10.1016/j.diabres.2006.03.023

Cited by 69 publications

(67 citation statements)

References 6 publications

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“…There is strong evidence that good self-management in the chronic care of diabetes leads to better outcomes of the condition [4,21,22]. To further support patients in their effort toward better diabetes control, recent studies have tried to investigate the usage and effectiveness of incorporating technologies like the Internet and mobile phones to facilitate and support self-efficacy of diabetes patients [9,11,23].…”

Section: Discussionmentioning

confidence: 99%

“…Diabetes is a chronic condition that requires patient self-management as well as continual medical care by health care providers. Patients with better self-care behaviors such as adherence to meal recommendations and glucose monitoring have been shown to develop better control of their condition than patients who were given more medications [4]. …”

Section: Introductionmentioning

confidence: 99%

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Short-Term Trajectories of Use of a Caloric-Monitoring Mobile Phone App Among Patients With Type 2 Diabetes Mellitus in a Primary Care Setting

Goh

Tan²,

Malhotra³

et al. 2015

J Med Internet Res

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BackgroundSelf-management plays an important role in maintaining good control of diabetes mellitus, and mobile phone interventions have been shown to improve such self-management. The Health Promotion Board of Singapore has created a caloric-monitoring mobile health app, the “interactive Diet and Activity Tracker” (iDAT).ObjectiveThe objective was to identify and describe short-term (8-week) trajectories of use of the iDAT app among patients with type 2 diabetes mellitus in a primary care setting in Singapore, and identify patient characteristics associated with each trajectory.MethodsA total of 84 patients with type 2 diabetes mellitus from a public primary care clinic in Singapore who had not previously used the iDAT app were enrolled. The app was demonstrated and patients’ weekly use of the app was monitored over 8 weeks. Weekly use was defined as any record in terms of food entry or exercise workout entry in that week. Information on demographics, diet and exercise motivation, diabetes self-efficacy (Diabetes Empowerment Scale-Short Form), and clinical variables (body mass index, blood pressure, and glycosylated hemoglobin/HbA1c) were collected at baseline. iDAT app use trajectories were delineated using latent-class growth modeling (LCGM). Association of patient characteristics with the trajectories was ascertained using logistic regression analysis.ResultsThree iDAT app use trajectories were observed: Minimal Users (66 out of 84 patients, 78.6%, with either no iDAT use at all or use only in the first 2 weeks), Intermittent-Waning Users (10 out of 84 patients, 11.9%, with occasional weekly use mainly in the first 4 weeks), and Consistent Users (8 out of 84 patients, 9.5%, with weekly use throughout all or most of the 8 weeks). The adjusted odds ratio of being a Consistent User, relative to a Minimal User, was significantly higher for females (OR 19.55, 95% CI 1.78-215.42) and for those with higher exercise motivation scores at baseline (OR 4.89, 95% CI 1.80-13.28). The adjusted odds ratio of being an Intermittent-Waning User relative to a Minimal User was also significantly higher for those with higher exercise motivation scores at baseline (OR 1.82, 95% CI 1.00-3.32).ConclusionsThis study provides insight into the nature and extent of usage of a caloric-monitoring app among patients with type 2 diabetes and managed in primary care. The application of LCGM provides a useful framework for evaluating future app use in other patient populations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Short-Term Trajectories of Use of a Caloric-Monitoring Mobile Phone App Among Patients With Type 2 Diabetes Mellitus in a Primary Care Setting

Goh

Tan²,

Malhotra³

et al. 2015

J Med Internet Res

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show abstract

“…6 Among patients with diabetes, lower HbA1c levels have been associated with decreased mortality [7][8][9] and fewer complications. [10][11][12][13][14] Research suggests that performance of self-care behaviors, [15][16][17][18][19][20][21] increased diabetes knowledge, [22][23][24] and greater medication adherence [25][26][27][28] are associated with improved glycemic control.…”

mentioning

confidence: 99%

Associations Between Health Literacy, Diabetes Knowledge, Self-Care Behaviors, and Glycemic Control in a Low Income Population with Type 2 Diabetes

Bains

Egede

2011

Diabetes Technology & Therapeutics

245

225

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Objective: This study assessed associations among health literacy, diabetes knowledge, self-care, and glycemic control in a low income, predominately minority population with type 2 diabetes. Methods: One hundred twenty-five adults with diabetes were recruited from a primary care clinic. Subjects completed validated surveys to measure health literacy, diabetes knowledge, and self-care (medication adherence, diet, exercise, blood sugar testing, and foot care). Hemoglobin A1c values were extracted from the medical record. Spearman's correlation and multiple linear regression were used to assess the relationship among health literacy, diabetes knowledge, self-care, and glycemic control controlling for covariates. Results: Cronbach's a was 0.95 for the Revised Rapid Estimate of Adult Literacy in Medicine. The majority of the sample was <65 years old (50.7%), female (72.5%), and African American (71.4%), had less than a high school education (68.2%) and a household income <$15,000 (64.2%), and reported their health status as worse than last year (73.9%). In adjusted models that examined the associations among health literacy, diabetes knowledge, medication adherence, and self-care, health literacy was only significantly associated with diabetes knowledge (b ¼ 0.55; 95% confidence interval [CI] 0.29, 0.82). In the final adjusted model for independent factors associated with glycemic control, both diabetes knowledge (b ¼ 0.12; 95% CI 0.01, 0.23) and perceived health status (b ¼ 1.14; 95% CI 0.13, 2.16) were significantly associated with glycemic control, whereas health literacy was not associated with glycemic control (b ¼ À0.03; 95% CI À0.19, 0.13). Conclusions: Diabetes knowledge and perceived health status are the most important factors associated with glycemic control in this population. Health literacy appears to exert its influence through diabetes knowledge and is not directly related to self-care or medication adherence.

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“…Studies of British Pakistani women and illiterate patients have indicated a gradient of improved diabetes knowledge with better self-care and glycaemic control [48,49]. Other researchers reported knowledge explained 16% -17% of the variance in HbA1c [50][51][52]. In contrast, some researchers have reported increased diabetes knowledge correlated with poorer self-care and glycaemic control [53,54].…”

Section: Significance Of Self Care In Diabetes Managementmentioning

confidence: 76%

Clinical critics in the management of diabetes mellitus

Gillani¹,

Sulaiman²,

Sundram³

et al. 2012

Health

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There is a global epidemic of diabetes with its prevalence expected to increase from 5.1% in 2003 to 6.3% in 2025. This increase in diabetes is occurring in all nations, however, developing nations are particularly at risk. It spares no group and affects men, women, the elderly, young and people from very racial and socioeconomic background. Nevertheless, certain ethnic groups including Asians are affected more than Caucasians. Large randomized clinical trials have shown that improvement in glycaemic control, together with management of diabetes-related risk factors like blood pressure and lipid control significantly reduce the micro and macro complications in individuals with type 1 and type 2 diabetes. Patient education plays a crucial role in the prevention of diabetic fool problems. In Geneva, the rate of lower limb amputations was reduced by almost 75% after an educational intervention. People with diabetes must acquire the knowledge and skills through education to provide daily self-care in diabetes management which involves maintenance of healthy living, recognition and management of diabetes problems when they arise and taking preventive measures. Some factors include patients' biomedical variables, the psychosocial environment, the knowledge, attitudes and beliefs of patients themselves, home careers and health care providers, healthcare systems' accessibility and availability and even the national political context may influence these self-care behaviors.

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Factors that influence improvement for patients with poorly controlled type 2 diabetes

Cited by 69 publications

References 6 publications

Short-Term Trajectories of Use of a Caloric-Monitoring Mobile Phone App Among Patients With Type 2 Diabetes Mellitus in a Primary Care Setting

Short-Term Trajectories of Use of a Caloric-Monitoring Mobile Phone App Among Patients With Type 2 Diabetes Mellitus in a Primary Care Setting

Associations Between Health Literacy, Diabetes Knowledge, Self-Care Behaviors, and Glycemic Control in a Low Income Population with Type 2 Diabetes

Clinical critics in the management of diabetes mellitus

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