Over the past year or two there have been many new health technology apps and services available to help patients understand their role in diabetes self management. To successfully manage diabetes the individual must possess knowledge of what diabetes is and what aspects of their lifestyle affects their blood sugar control. Most (over 90%) patients with diabetes cannot explain the multiple factors occurring that can affect their blood sugar, therefore most fail to achieve the control they hope for and eventually become frustrated with their efforts.
Mr. NP is a 57 year old retired individual who is 50 pounds overweight, loves to snack on chocolates, is not active and has an average blood sugar of over 180. He has been struggling with blood sugar control for 5+ years. He currently takes several oral medications but has still not obtained the 150 blood sugar average his provider is trying to achieve.
The patient was referred to me in the attempt to get him more engaged with his condition and to point out HIS role in managing his blood sugars. After meeting with the patient it was clear to me he really did not understand the reason for the recommendations his doctor had made to help him improve his blood sugar control. The doctor did not have the time to explain the complexities of diabetes self management to the patient, so he just kept on adding medications and/or increasing their dose.
In our initial meeting I inquired if the patient has any technical skills (using the Internet, using a Smart phone, etc.) and if he would like to try one of these tools to assist him in improving his diabetes control verses just adding more medications. He said he was willing to try anything to help him gain back his control. At that point I introduced the One Touch Reveal app to him which allows him to track his blood sugars and make notes about why the results were good, high or low. The patient was also able to share these results with me via a provider portal I use (The One Touch Verio Flex meter allows him to do this via Bluetooth technology). After using this simple app for about 2 weeks he started to notice that certain foods he was eating impacted his blood sugar very much. At this point he started modifying his food intake and had some nice success in lowering his blood sugars. To complement his efforts I then introduced the app Blue Star Diabetes to him Blue Star Diabetes is an app that allows the patient add notes on a log book as to what happened that day that affected his blood sugar readings ( food, activity, stress, sleep, etc.) BSD also is a resource for food choices, education videos, menus, tracking personal information such as weight, cholesterol, etc). Using BSD, he can also share this information with me and with his provider to help us plan action steps to keep him improving.
So far, after about 2 months of using these simple tools, he has lost 17 pounds and has improved his average blood sugar from 180 down to 121. Most of all, the apps have engaged him in his own care. He now understands what he should be doing to control his diabetes and make the life style changes needed to minimize the effects of poor blood sugar control. Best of all these self-management apps are provided at no charge to the patient. Blue Star Diabetes does require an activation code (something I make available to him ) and the Reveal app requires registration with my portal to share data with me) but there is no charge for either.
As an educator it’s very helpful for me to be able to check my portal several times a week to see how patients are doing and to coach them for improvement as needed. It’s a win-win situation that was not available 18 months ago. For more information on these and other apps to improve patient engagement and ultimately outcomes, please give me a call.
John Motsko, RPh, CDE
Core Clinical Care, LLC
Apple Diabetes Center
404 N. Fruitland Blvd.
Salisbury, MD 21801