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Enhancing self-management of T2DM with an Automated Reminder and Feedback System

Project Final Report (PDF, 468.64 KB) Disclaimer

Project Details -
Completed

Type 2 diabetes mellitus (T2DM) occurs in 9 percent of adult Americans and is more prevalent among ethnic minorities. Tight control of blood sugars is critical in reducing complications of diabetes. Exercise and a healthy diet can lead to better control than medication and are important components in diabetes management. Yet many diabetics do not eat properly or exercise regularly, which leads to suboptimal control. Because optimum control requires significant self-management, this project sought to develop an automated self-management monitor (ASMM) and test its impact of on glycemic control and self-management behaviors. The ASMM was composed of a simple personal computer-glucometer interface, a docking unit, and specialized software. The device reminded patients to self-monitor their blood glucose, prompted them to take their medications, and provided education on the importance of lifestyle choices.

The specific aims of the study were to:

  • Demonstrate that use of the ASMM improves glycemic control in people with T2DM.
  • Demonstrate that this effect is sustained over longer-term followup.
  • Identify self-management practices that improve control in people using the ASMM.

Participants with poorly controlled T2DM were recruited from the Veterans Health Administration and community-based primary care clinics. Individuals were randomized to either the intervention or the usual care group. Study visits took place at baseline, 3, 9, and 15 months. The final analysis showed that 43 percent of the intervention group who completed the trial used the system regularly and had a significant reduction in hemoglobin A1c compared to infrequent users. Regular system users trended toward being older, had longer duration of disease, were more likely to be on insulin, and spent fewer hours in sedentary behavior.