Online diabetes management program shows gains

Early momentum hard to sustain, however
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A nurse-led, multidisciplinary health team working through an online disease management program helped Type 2 diabetes patients achieve better A1C results at six months, though the gains were not sustained at 12 months. Still, the researchers found the program a viable way to help patients manage their disease.

In the study, published at the Journal of American Medical Information Association clinicians at the Palo Alto Medical Foundation in California sought to engage and motivate patients through an online monitoring system that included features including wirelessly uploaded home glucometer readings, online messaging with the health team, advice from a nurse care manager and dietician and personalized text and video clips sent to patients.

The online care management program was built upon a leading, commercially available EHR product, according to a summary at ClinicalTrials.gov.

At six months, the 193 patients who had used the online system had significantly reduced A1C levels, compared with the 189 patients who underwent usual care. But there was no significant difference in their level of control at 12 months, though more of the intervention group showed improvement than the controls.

A recent report by the eHealth Initiative found that interventions such as telemedicine, mobile health and patient web portals show "tremendous promise" to help socially disadvantaged populations manage diabetes. In an analysis of more than 100 peer-reviewed articles, it found sustained improvements in glucose levels attributed to the use of telemedicine and mobile health initiatives. While web portals are growing more popular, it remains unclear how patients are using them, it said.

Diabetes care has been among the most prolific areas of smartphone app development as providers seek new ways to motivate patients to take self-care more seriously. Big improvements in glucose levels through the use of apps were shown in a University of Maryland School of Medicine study. And Norwegian researchers reported a sense of empowerment among teenagers who manage their disease with apps.

Meanwhile, Swedish researchers, in a paper published at BMC Medical Informatics and Decision Making, describe how they used a collaborative approach to write content for a website for pregnant women and new mothers with Type 1 diabetes.

To learn more:
- read the abstract
- here's the ClinicalTrials.gov summary
- check out the BMC Medical Informatics and Decision Making paper

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