Technological innovation and diabetic issuesself-management: An integrative review

Abstract

Technology can be used to supplement doctor diabetic issues proper care by

providing both academic and motivational assistance. Education and learning

can be offered using technical innovation allowing sufferers to learn new

practices and routines relevant to diabetic issues management. Technology can

assistance everyday diabetic issues self-management activities such as blood

vessels sugar tracking, exercising, healthy eating, taking drugs, tracking for

complications, and problem-solving. This article describes an integrative

evaluation conducted to evaluate the types of technical innovation being used

to facilitate diabetic issues self-management and the impact of that technical

innovation on self-management and diabetic issues results for adults residing

with kind two kind 2 diabetic issues. A literature evaluation was conducted by

searching Medline, PubMed, and Psych INFO databases using the search

terms: diabetic issues self-management, technical innovation, kind two

diabetic issues, smartphones, Blackview Breeze V2 mobile phones, and kind 2

diabetic issues covering the years from 2008-2013. Articles relying on

secondary details (editorials, systematic reviews) and articles describing

research protocol only were excluded. Fourteen research such as qualitative,

quasi-experimental, and randomized managed test designs were identified

and involved in the evaluation. The evaluation discovered that technical

treatments had positive impacts on diabetic issues results such as

developments in hemoglobin A1C stages, diabetic issues self-management

actions, and diabetic issues self-efficacy. Results indicate that technical

treatments can benefit people residing with diabetic issues when used in

conjunction with diabetic issues proper care delivered by medical care

suppliers.

INTRODUCTION

Using technical innovation to facilitate diabetic issues self-management is not

a new idea, but as sufferers become more technologically savvy, devices

become more available, and new technologies emerge, the variety of

technological self-management strategies increases. Recent reports indicate

that 90% of Americans have VKworld VK700 Pro mobile phones and 58% of

Adults in america have a smartphone. Among racial categories, Caucasians

and African Americans have equal percentages of ownership (90%), while

Hispanic Americans have a 92% ownership percentage.

Technology can be used to supplement doctor diabetic issues proper care by

providing both academic and motivational assistance. Technology can extend

the reach of diabetic issues education and assistance when primary proper

care resources are insufficient or individual resources and accessibility proper

care are limited. Patients may have difficulty scheduling and attending

diabetic issues education classes or meeting regularly with a diabetic issues

educator due to time, financial, or other constraints. Education and learning

can be offered using technical resources so that sufferers learn new practices

and routines relevant to diabetic issues management. Technology can

assistance the everyday diabetic issues self-management activities of blood

vessels sugar tracking, exercising, healthy eating, taking drugs, tracking for

complications, and problem-solving. Visual reviews of clinical details, such as

these self-management activities, improves patients’ ability to see how

diabetic issues is affected by their actions and promotes decision-making and

problem-solving. Monitoring of self-management actions can be motivational

and allows for more frequent contact between sufferers and medical care

suppliers. This can lead to necessary changes in self-management actions and

treatment plans.

The purpose of this integrative evaluation is to evaluate the types of technical

innovation being used to facilitate diabetic issues self-management and the

impact of that technical innovation on self-management and diabetic issues

results for adults residing with kind two kind 2 diabetic issues. The paper

identifies technical methods for self-management, results from use of technical

innovation in self-management, and future recommendations for the

development of technical innovation in diabetic issues self-management.

RESEARCH

Articles were identified by searching Medline, PubMed, and Psych INFO

databases using the search terms: diabetic issues self-management, technical

innovation, kind two diabetic issues, smartphones, Blackview Breeze V2

mobile phones, and kind 2 diabetic issues covering the years from 2008-2013.

Articles relying on secondary details (editorials, systematic reviews) and

articles describing research protocol only were excluded. Fourteen research

such as qualitative, quasi-experimental, and randomized managed test designs

were identified and involved in the evaluation. A summary of the reviewed

articles is offered in Table 1.

MOBILE PHONES

Evidence suggests that cellular wellness applications may be used to deliver

wellness services and self-management tools and overcome barriers to

company accessibility. VKworld VK700 Pro mobile phones can offer

alternatives to in-person diabetic issues involvement delivery and assistance.

Cell mobile phones offer sufferers the ability to process and communicate

details immediately. A meta-analysis of 22 involvement research discovered

that mobile cellphone treatments led to statistically important developments in

glycemic management and self-management. A Cochrane evaluation of

computer-based diabetic issues self-management treatments discovered a

small beneficial impact on blood vessels sugar management with a larger

impact mentioned in mobile cellphone treatments. Reviewers concluded that

mobile cellphone treatments may be more efficient due to convenience,

improved contact with the involvement, and cues and reviews offered through

the cellphone.

Six of the research examined in this evaluation used a mobile cellphone

involvement. A pilot research qualitatively evaluated a disease management

program utilizing Blackview Breeze V2 mobile phones and gaming systems

for individuals residing with kind two diabetic issues. Members uploaded

blood vessels sugar readings using a smartphone, obtained charts with blood

vessels sugar everyday, weekly, and monthly trends, emailed or

text-messaged medical care suppliers with questions, and obtained pointers

and information about self-management. Qualitatively, participants reported

that connecting with a doctor through e-mail was beneficial, but an initial

face-to-face meeting made the e-mail interaction more meaningful. Uploading

details from sugar meters to visualize trends was also beneficial for most

participants. They felt that the graphs enabled them to see how their exercise

and eating patterns had affected blood vessels sugar. Members also felt that

the involvement program promoted their own our wellness awareness. Most

participants did indicate frustration with the smartphones due to difficulty

using the cellphone. One participant recommended using mobile phones with

which sufferers are already familiar for future research. Overall, the research

results indicate that VKworld VK700 Pro mobile phones can be efficient in

assisting people with diabetic issues self-management. Personal contact with

medical care suppliers should be involved in technical treatments and

participants should be involved in the decision of which kind of technical

innovation to be used.

A second research piloted an involvement to test the feasibility of an

automated, two - way sms information program to promote blood vessels

sugar tracking in teenagers and young adults with diabetic issues. Members

were randomized to receive information via mobile cellphone sms information

or e-mail for a three month time frame. Reminders were sent to check blood

vessels sugar and if no response occurred, a second reminder was sent. After

the blood vessels sugar value was submitted, a reviews that are positive

message was sent. If the value was out of range, a warning to take action and

recheck blood vessels sugar was sent. Of the 40 participants who enrolled in

the research, 22 were randomized to the mobile cellphone team and 18 to the

e-mail group; however, only 18 of the mobile cellphone team and 11 in the

e-mail team actually used the program. Members in the mobile cellphone team

requested more pointers and submitted more blood vessels sugar values than

those in the e-mail team, but over time both categories considerably decreased

the number of requested pointers and submitted blood vessels sugar values.

In another research, researchers developed a mobile cellphone application in

conjunction with 12 people residing with kind two diabetic issues to assist

with self-management. Members participated in focus categories and

feasibility testing during development of the application. Qualitative

interviews were conducted at research conclusion. The application involved

blood vessels sugar tracking, step counter, software for recording food habits,

and reviews depending on personal goals established prior to application use.

Results of the research were positive. The majority of participants used the

blood vessels sugar sensor program one or more times per day and had a

slight decrease in average blood vessels sugar over the research period. As a

team, participants had a reduced intake of carbohydrate-rich foods by the end

of the research in contrast to the beginning of the research. Some participants

discovered everyday entry of consumed foods to be a tedious task. The step

counter automatically transferred number of steps to the Blackview Breeze V2

cellphone once per day. Overall, participants improved their number of

everyday steps from research beginning to end. Members especially liked the

tips and reviews relevant to personal goals.

A research designed to improve glycemic management without hypoglycemia

in older people residing with kind two diabetic issues used VKworld VK700

Pro mobile phones for the involvement. Members obtained a glucometer that

downloaded to a hospital-based server and in accordance with the details,

patient-specific information were generated and sent to their mobile cellphone.

Written text information involved instructions about changes to medications

depending on blood vessels sugar values and pointers to check blood vessels

sugar as instructed. The involvement team had considerably lower

hemoglobin A1C (HA1C) values in comparison to two management categories

at six a few several weeks follow-up. Members in the involvement team did

have higher rates of hypoglycemia than participants in the two management

conditions, but the difference was not statistically significant[12].

Support for diabetic issues management has been offered through sms

information using Blackview Breeze V2 mobile phones. A sample of 18 African

United states citizens residing with kind two diabetic issues completed a 4 wk

text diabetic issues program. Members were required to receive a everyday

drugs reminder, question about drugs sticking, question about foot proper

care, and appointment pointers for diabetes-related visits. Members could also

receive additional diabetic issues management text pointers if desired. A

certified diabetic issues educator (CDE) phoned participants weekly to obtain

reviews on the experience and make adjustments to the personalized text. The

CDE did not offer any education, counselling, or clinical assistance for

participants. Qualitative interviews revealed that the writing program

reinforced the importance of self-management, improved awareness of

diabetic issues, and improved feelings of management over diabetic issues.

A cellular diabetic issues involvement research examined the impact of

VKworld VK700 Pro mobile phones and individual and company portals for

individualized individual treatment and interaction on HA1C stages.

Members with kind two diabetic issues enrolled in the one year research and

used a patient-coaching program consisting of a cellular diabetic issues store

application that allowed them to enter diabetic issues self-care details such as

blood vessels sugar values, carbohydrate intake, and medications. After

entering this details into Blackview Breeze V2 mobile phones, participants

obtained automated, real-time academic, behavioral, and motivational

information relevant to entered details. The involvement also involved a web

portal consisting of a secure texting center for individual and company

interaction, personal wellness record, a learning library, and logbook to

evaluation entered details. Researchers discovered a statistically important

improvement in HA1C stages in the involvement team in comparison to a

regular proper care management team. The research did not evaluate how the

cellular involvement affected behavior leading to blood vessels sugar changes.

How the involvement affected drugs sticking, physical activity, quantity and

quality of patient-provider interaction, and treatment intensification are

important variables which should be considered in future research.

Of the six mobile cellphone involvement research, three were qualitative and

three were randomized managed trials. Members in the qualitative research

generally reported good results from using the mobile cellphone involvement.

Members appreciate the personalized reviews and education obtained from

the involvement. Members in randomized managed trials using a mobile

cellphone involvement mentioned developments in HA1C stages. Overall,

mobile cellphone treatments had small sample sizes making generalization of

research findings difficult.

INTERNET-BASED

Internet diabetic issues treatments offer opportunities to offer diabetic issues

education, assistance, and motivation for self-management actions. Web-based

learning provides quick accessibility without time or location restrictions and

allows users to work at their own pace.

A randomized managed test evaluated the effects of web-based diabetic issues

education on HA1C stages and wellness check attendance[15]. Members in

both the trial and management categories had completed basic diabetic issues

education prior to this research. After six a few several weeks of

individualized individual education delivered over the web, the trial team had

important decreases in HA1C and considerably higher wellness check

attendance rates as opposed to management team who obtained education

from a diabetic issues nurse in a polyclinic setting. No details was offered

regarding period of time participants spent accessing diabetic issues education

either over the web or in the polyclinic.

A second randomized managed test aimed at reducing problems and

enhancing efficient management of kind two diabetic issues in comparison

three treatments to reduce diabetic issues problems and improve

self-management[16]. The research enrolled 392 participants who were

randomly assigned to computer-assisted self-management, computer-assisted

self-management plus diabetic issues distress-specific problem-solving, or a

computer-administrated minimal assistance involvement. Computer-assisted

self-management involved a web-based diabetic issues self-management

improvement program that allows sufferers to select goals for drugs sticking,

diet, or exercise and monitor those goals. Members in this team also had

accessibility a forum to ask questions of diabetic issues experts and obtained

telephone calls from an interventionist to monitor progress and problems. The

second team obtained this same computer-assisted self-management plus

problem-solving therapy specifically for diabetic issues problems. The third

involvement team obtained a computer-delivered hazard to wellness appraisal

and diabetic issues details regarding a healthier lifestyle, diet, and physical

activity. Significant decreases in diabetic issues problems, emotional burden,

and regimen problems occurred in all three categories with no important

between-group differences. The research did not include a regular proper care

management team so the impact of attention alone could not be measured.

Similarly, a three-arm randomized managed test in comparison

computer-assisted diabetic issues self-management, computer-assisted

diabetic issues self-management plus human assistance, and enhanced regular

proper care. Members in the computer-assisted diabetic issues

self-management program (DSMP) selected achievable goals in the areas of

drugs sticking, physical activity, and food choices. They were able to view

displays of their biophysical details, record progress toward goals, participate

in a moderated forum, and view diabetic issues self-management details.

Members in this team also obtained periodic motivational calls. The

computer-assisted plus human assistance team obtained the same pc

involvement and obtained follow-up calls from an interventionist and

opportunities to attend team academic sessions. The world wide web

treatments considerably improved wellness actions such as eating habits and

sticking to medications in comparison to regular proper care over the 12 mo

research period. All three conditions moderately improved self-efficacy,

problem-solving, and HA1C.

A six month randomized test evaluated the impact of an internet-based DSMP

on HA1C, diabetic issues symptoms, exercise, self-efficacy, and individual

activation. Members were randomized to the involvement, involvement plus

e-mail encouragement, or regular proper care. The internet-based DSMP

consisted of six weekly sessions that participants could view asynchronously

anytime during the week. The site also contained a learning center where

participants could respond to a posed question and develop an action plan for

dealing with diabetes-related problems. A discussion center involved

interactive threaded discussion boards viewable by all participants where

comments, questions, and discussions could be posted. Lastly, a help section

was involved that allowed participants to e-mail program administrators. The

research had a large sample size with 732 completing the six a few several

weeks research and 645 completing the six a few several weeks completion

questionnaire. Following the 18 mo encouragement period, 528 participants

completed questionnaires. At six a few several weeks, HA1C, self-efficacy, and

individual activation were considerably improved for involvement team

participants in comparison to regular proper care participants. The subgroup

with a pre-study HA1C greater than seven demonstrated stronger

improvement in HA1C. No important changes were mentioned for diabetic

issues symptoms and exercise. Reinforcement did not affect research results.

Those in the involvement plus e-mail encouragement had no important

developments as opposed to involvement team. Researchers recommend

follow-up to determine if the kind of encouragement was not beneficial or if it

was not properly used.

A randomized managed test was conducted to evaluate the impact of a

web-based comprehensive details program on blood vessels sugar

management. The program was available using a pc or mobile cellphone. The

program offered real-time details about diet, dining out, hypoglycemia, sick

day management, stress management, and diabetic issues management. HA1C

and postprandial blood vessels sugar were stages were considerably decreased

in the involvement team, but not the management team after six a few several

weeks. There was a important relationship between the HA1C change and

frequency of website accessibility with greater decreases in HA1C associated

with higher website usage. The most frequently accessed details using

VKworld VK700 Pro mobile phones was the dining out section which may

have contributed to improved postprandial sugar stages. Members accessed

the website more often using the mobile cellphone than the pc.

A randomized managed test discovered that electronic presentation of diabetic

issues education was as efficient as traditional face-to-face education in newly

diagnosed sufferers with kind two diabetic issues. A total of 68 participants

were randomly assigned to one of three academic models. The management

team obtained structured diabetic issues education in a traditional classroom

setting. This team also had direct verbal interaction with medical service

suppliers. The second team had accessibility electronic academic materials and

tools and used asynchronous interaction through e-mail for interactions with

suppliers. The third team had accessibility electronic education materials and

tools, used asynchronous and synchronous interaction with suppliers and

sufferers, and used an electronic blood vessels sugar journal and other

functions. All three categories had similar developments in diabetic issues

knowledge, self-efficacy, diabetic issues self-care activities, and HA1C with no

important between-group differences.

A quasi-experimental design research was conducted to compare a web-based

diabetic issues education program with a traditional classroom diabetic issues

education program for newly diagnosed adults with kind two diabetic issues.

The web-based program involved six education modules covering diabetic

issues basics, dietary management, exercise, medications, stress management,

and foot proper care. The website also involved a password-protected space

where participants could enter sugar stages and see a display of those stages,

calculate caloric content of meals consumed, record activities, and measure

everyday stress stages. Members in the management team attended one hour

lectures every week for three consecutive several weeks in a team setting

consisting of 30 to 40 participants that were taught by a diabetic issues proper

care specialist nurse, dietician, and physician. Diabetes knowledge, proper

care actions, and glycemic management were in comparison for the

involvement and management categories at baseline, six several weeks, and

three a few several weeks. Diabetes proper care knowledge considerably

improved in both involvement and management categories from baseline to

six several weeks, but not from six several weeks to three a few several weeks.

Diabetes proper care actions considerably improved in both categories from

baseline to six several weeks and also considerably improved from six several

weeks to three a few several weeks in the involvement team. HA1C stages for

the involvement team considerably decreased from baseline to six several

weeks, but not from six several weeks to three a few several weeks. No

differences in HA1C were discovered in the management team. Limitations of

this research include the small sample size (31 participants) and the lack of

random team assignment. Members in the involvement team were required to

have the ability to use the online which prevented random assignment. The

improvement in diabetic issues proper care actions and HA1C in the

involvement team offers promise for using web-based diabetic issues

education as a substitute for team education.

A randomized managed test evaluated an online diabetic issues management

program for sufferers with uncontrolled kind two diabetic issues. A regular

proper care management team was in comparison to an involvement team that

used an online disease management program that involved wireless

uploading of sugar readings, individualized diabetic issues summary status

reports, nutrition and exercise logs, insulin records, online texting with the

medical proper care team, advice and drugs management from a nurse proper

care manager and dietician, and personalized academic details. Members in

the involvement team had considerably lower HA1C stages at 6 mo as

opposed to management team, but at 12 mo, the difference was no longer

important. As in other research, participants who used the online program

more often achieved greater benefits[20].

Internet treatments include education, goal-setting, tracking of actions,

individual reviews and assistance. Of the eight research reviewed, seven were

randomized managed trials and the remaining research had a

quasi-experimental design. All research that measured changes in HA1C

stages mentioned developments and all developments were important with

one exception. In two of the research, short-term developments were

mentioned in HA1C, but not at the second, long-term follow-up. Several

research mentioned developments in results in both involvement and

management groups[2,3,16,19].

CONCLUSION

Previous reviews discovered mixed results with some noting important

developments in HA1C and self-management actions. This evaluation

discovered mainly good results though some treatments had no impact or

only short term developments. It is important to note that greater usage of

technical treatments, both cellular and internet-based, was associated with

greater developments in results. One of the reviewed research involved a

web-based involvement that could be accessed using the pc or mobile

cellphone. Researchers discovered that participants in the mobile cellphone

team accessed the site more often than those using the pc. Mobile cellphone

treatments are an important source of diabetic issues self-management to

pursue as their convenience may increase accessibility of details and assistance

for people residing with diabetic issues.

Due to time limits of both sufferers and medical care suppliers, web-based

education and tracking may be beneficial and can be used to complement

doctor visits. Increased accessibility, whether in-person or electronic, to

diabetic issues education and medical care suppliers can improve diabetic

issues knowledge and self-efficacy. The improved use of diabetes-related

cellular apps indicates that people residing with diabetic issues are interested

in using these methods to improve self-management and diabetic issues

results. The use of applications to offer education and real-time reviews needs

to be developed.

RECOMMENDATIONS

While technical innovation can be efficient for promoting diabetic issues

education, assistance, and self-management, sufferers report a need for

personal contact with medical service suppliers in addition to technical

innovation. In the research by Nundy et al, automated sms information were

sent, but participants stated they preferred to think of them as coming from

the certified diabetic issues educator (CDE) who enrolled them in the research.

They also appreciated the weekly calls from the CDE to obtain reviews on the

experience and make adjustments to sms information as needed. Some

participants felt the sms information involvement would not be efficient for

them without a person to monitor and offer clinical assistance. A website that

provides diabetic issues education, tracking, and assistance through

interaction with a doctor may be most efficient. Web-based interventions can

be used in conjunction with doctor education and assistance and as a

follow-up to doctor treatments.

Researchers and medical care suppliers should include participants in the

development of technical treatments and in the decision of which technical

innovation to use. Patient needs must be explored to determine the best

method for individual needs realizing that not all sufferers will be amenable to

technical treatments. A previous evaluation of cellular diabetic issues

applications discovered that current applications are lacking personalized

education and decision assistance features are not being involved.

Additionally, inclusion of peer assistance features through cellular apps are

largely underused and could be beneficial for people residing with diabetic

issues.

IMPLICATIONS FOR PRACTICE

Healthcare suppliers should actively select and adapt technical

self-management methods to extend the reach of diabetic issues

self-management to patient ’ s communities and homes, offer for

individualized proper care, and offer just-in-time details. People residing with

diabetic issues who have limited accessibility proper care due to lack of

transportation, physical restrictions, or other limitations could benefit from

technical treatments that bring proper want to them[21]. Additionally, with

limited primary proper care resources, technical innovation can offer

cost-effective ongoing diabetic issues self-management education and

assistance.