Controlling Glucose: Mobile Apps to the Rescue

In the United States, diabetes affects 25.8 million people, for whom the costs of care exceed $100 billion annually. Clinical trials suggest that improved self-care and lifestyle changes can lead to better diabetes-related outcomes. Unfor­tunately, other studies indicate that just 55% of patients with type 2 diabetes receive diabetes education, and only 16% report adhering to recommended self-care practices. Part of the problem behind the poor dissemination of and adherence to behavioral interventions is that patients with diabetes are generally limited to 15-minute office visits with their primary care providers. In that short period, it’s often challenging for physicians and healthcare providers to thoroughly educate patients on their disease. Further complicating the issue is that many patients do not have access to one-on-one or group interventions that can enhance adherence to important self-care practices. Testing a Mobile Apps on Glucose Control In a study published in the September 2011 issue of Diabetes Care, my colleagues and I tested a diabetes coaching system for patients with type 2 diabetes. The system uses mobile phone applications and patient/provider portals to provide feedback on self-management and blood glucose results. It also collects data on lifestyle behaviors and clinical manage­ment. The hope was that this program could reduce A1C levels over 1 year. In our analysis, three intervention groups consisting of patients and physicians received different amounts of infor­mation. Maximal treatment consisted of automated, real-time education and behavioral messaging in response to individu­ally analyzed blood glucose values, diabetes medications, and lifestyle behaviors communicated by cell phone. Quarterly reports were given to providers that summarized patients’ gly­cemic control, medication management, lifestyle behaviors, and evidence-based...