Thinking Outside the Box: Exploring Diabetes Management Strategies

The need for patients to be well-informed, and even a bit tech-savvy in today's healthcare market is critical. Those living diabetes with or without comorbidities must be well-versed in disease management strategies like how to recognize the symptoms of high or low blood sugar and when to give insulin. According to the Centers for Disease Control and Prevention, there were more than 100 million adults in the U.S. living with pre-diabetes or diabetes in 2017. The American Diabetes Association reports that the total cost for those living with diabetes in 2017 was more than $300 billion. This makes diabetes 2.3 times more expensive to those living with it compared to people who have no diabetes diagnosis.

All of this data illustrates the importance of patient engagement and self-care for those with diabetes. A recent study conducted by researchers in China reports that the motivation some patients are missing to participate in self-care may be simpler to provide than ever before. The study found that sending a series of motivational text messages can improve the control of blood sugar in patients with diabetes and comorbidity of coronary heart disease.

Overview of the Study

Study participants included patients with a dual diagnosis of cardiovascular disease and diabetes. Patients were told that the study would help them better care for their bodies, given the serious nature of both conditions. Knowing that lifestyle changes are pivotal to the success of managing the symptoms of both diseases, made these researchers curious about the use of text messaging.

The study followed 502 patients in 34 different hospitals throughout China. Each patient received standard care for both conditions. Study participants were divided into two groups. The first group received six autogenerated or pre-programmed texts every week for the duration of the study. The messages focused on controlling blood pressure and glucose readings, providing advice on healthy lifestyles, and educating on the importance of following their medication regimen. An example of a message study participants received includes, "Afraid of testing blood glucose because it hurts? Try to test on the sides of your fingertips or rotate your fingers, which can help to minimize pain.” The second group of study participants received two messages each month. These messages did not offer education or encouragement but instead thanked each patient for their participation.

Patients in the motivational text messaging group experienced lower blood sugar levels after about six months. They also had a 0.2% decrease in their overall HbA1c levels compared to an increase of 0.1% of those patients in the control group. More than 69% of the motivational text messaging study participants reached the target value of HbA1c levels below 7%. Even though messaging targeted both diabetes and cardiovascular disease, there was no difference in blood pressure, cholesterol, or body mass index results of the two groups.

Could this Strategy Work for Other Conditions?

The results of this study are encouraging. If a few text messages can decrease overall sugar levels and increase disease control, just imagine what other conditions could be managed.

This isn't the first study to look at the use of mobile technology to help with chronic conditions. A 2018 study published in the British Medical Journal looked at the use of two-way digital text and voice messaging on the overall control of chronic diseases. The researchers reviewed four studies that provided patient observation, motivation, supportive communication, reminders, praise, and encouragement to those living with long-term illness. These studies also looked at the efficacy of using mHealth technologies with low literacy patients and those who may live in areas with minimal resources. Overall, this study found that increasing communication between patients with chronic conditions and their healthcare providers can improve health outcomes.

Moving Forward in a High-Tech Industry

Patients turn to technology for everything from logging workouts to tracking symptoms to attending visits with a provider. The more the healthcare community embraces the use of tech in healthcare treatments, monitoring, and overall management, the sooner we may see long term lifestyle changes that can impact overall health outcomes.

Do you have any experience, either in practice or first-hand, using communication tools like text or voice messaging for disease management? If you have a story or even a thought about this practice, drop a message in the comments below to get the conversation started.