Following a study looking into how adults living with Type 2 diabetes use technology to self-monitor lifestyle and health behaviors, researchers from the University of Texas Health Science Center at San Antonio found that technology-assisted self-monitoring was safe and effective in generating positive health outcomes.

The researchers noted several limitations to the study, but say the findings should be considered in future studies and in clinical practice. One limitation was that the participants were provided all necessary supplies, so the barrier of cost and access could not be assessed. Another is that the findings might not be generalizable because of the small sample size (n=10) that was already enrolled in a lifestyle intervention program with diabetes management health education.

TOP-LINE DATA

At both the six-week and six-month intervention, researchers found that technology-assisted self-monitoring allowed the participants to understand how their blood glucose reacted to their lifestyle, which led to the participants making healthy lifestyle choices to manage their diabetes.

“Our findings suggest that technology-assisted self-monitoring of lifestyle behaviors and diabetes-related health indicators helped the study participants understand the importance and rationale of selecting healthy choices and behaviors, and helped to make sense of why certain lifestyles must be adopted to control blood glucose,” the researchers said in the study. “Health providers, such as diabetes educators, can incorporate this into clinical practice and encourage patients to adopt self-monitoring of their lifestyles and health indicators for better diabetes management.”

These outcomes occurred even after the barriers that participants encountered at the beginning of the intervention, such as difficulties with technology and lack of time to self-report.

The study identified a learning-curve that developed between the two different intervention points, leading to more positive outcomes at the six-month mark.

“While working through the learning curve seen at 6 weeks, participants focused more on factors that would help them adapt to technology-assisted self-monitoring, such as getting help from family and friends,” the researchers said. “At the 6-month discussion, they appeared to be individually sufficient with regard to knowledge and technology in a more experienced way than before.”

Also of note, participants said that they would be willing to share their recorded lifestyle data with healthcare providers, friends and family members. This could lead to improved health outcomes, because sharing data could lead to patients getting help from others to manage their conditions, the researchers said.

METHODS

Participants were recruited from an American Diabetes Association-certified diabetes education program in a community health center primarily serving uninsured or underinsured individuals living in Harris County, Texas.

The 26 recruited participants were randomly placed into a control group (n=6), a paper-diary group (n=9) and the intervention group (n=10). Among the intervention group, participants were primarily African American, female and had a mean age of 59.4 years.

The intervention group was provided to use the LoseIt! app, which has since become FitNow, to record their diet, exercise and weight. They were also given a glucometer to monitor their blood glucose levels.

Interviews were conducted after six weeks and six months, and topics including the experience of using the health device and self-monitoring, as well as factors affecting self-monitoring, were discussed. 

THE LARGER TREND

Diabetes is a public health concern, with more than 34 million Americans living with the condition in 2018, according to the American Diabetes Association.

It was the seventh leading cause of death in the U.S. in 2017, with more than 270,000 death certificates citing it as a cause of death. But the ADA says diabetes could be an underreported cause of death, because only about 40% of people with diabetes who died had diabetes listed anywhere on the death certificate.

Managing diabetes is possible through self-management education programs, according to the Centers for Disease Control and Prevention. These programs can lower A1C levels, prevent or reduce diabetes complications, improve quality of life, and lower medical experiences.

One system that has been found to decrease medical spending is Abbott’s continuous glucose monitoring system, the FreeStyle Libre. Researchers found that the cost of care for individuals with Type 1 and Type 2 diabetes who used the FreeStyle Libre 14-day system was 61% and 63% less than for those who use the fingerstick method.

A retrospective analysis of more than 2,000 Livongo Diabetes Prevention Program (DPP) participants found that higher engagement with the program resulted in greater weight loss. Results showed an average weight loss of 5.1% from baseline after 12 months and 6.6% among those who were designated as high engagers.

ON THE RECORD

“Although there were some barriers, participants were able to identify various individual and external facilitators to adjust to and engage in technology-assisted self-monitoring, and it was concluded that the technology-assisted self-monitoring approach was beneficial, safe, and feasible to use for positive lifestyle change,” the researchers said in the study.