Diabetes & Metabolism Journal

Review

Technology/Device
Present and Future of Digital Health in Diabetes and Metabolic Disease: Sang Youl Rhee, Chiweon Kim, Dong Wook Shin, Steven R. Steinhubl; Diabetes Metab J. 2020;44(6):819-827. Published online December 23, 2020; DOI: https://doi.org/10.4093/dmj.2020.0088

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The use of information and communication technology (ICT) in medical and healthcare services goes beyond everyday life. Expectations of a new medical environment, not previously experienced by ICT, exist in the near future. In particular, chronic metabolic diseases such as diabetes and obesity, have a high prevalence and high social and economic burden. In addition, the continuous evaluation and monitoring of daily life is important for effective treatment and management. Therefore, the wide use of ICTbased digital health systems is required for the treatment and management of these diseases. In this article, we compiled a variety of digital health technologies introduced to date in the field of diabetes and metabolic diseases.

Citations

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Effectiveness of a Social Networking Site Based Automatic Mobile Message Providing System on Glycemic Control in Patients with Type 2 Diabetes Mellitus
Kyuho Kim, Jae-Seung Yun, Joonyub Lee, Yeoree Yang, Minhan Lee, Yu-Bae Ahn, Jae Hyoung Cho, Seung-Hyun Ko
Endocrinology and Metabolism.2024; 39(2): 344. CrossRef
Prediabetes in a French overseas territory: Clinical Characteristics, Risk Factors, and Implications for type 2 diabetes prevention
René Bun, Babacar Tounkara, Sébastien Leruste, Laurie Kichenapanaidou, Mathilde Simonson, Christine Kowalczyk, Jean-Marc Franco, Catherine Marimoutou, Estelle Nobécourt
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A data-driven approach to manage type 2 diabetes mellitus through digital health: The Klivo Intervention Program protocol (KIPDM)
Camila Maciel de Oliveira, Luiza Borcony Bolognese, Mercedes Balcells, Davi Casale Aragon, Roberto Luis Zagury, Clemente Nobrega, Chunyu Liu, Dured Dardari
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Lessons for Vietnam on the Use of Digital Technologies to Support Patient-Centered Care in Low- and Middle-Income Countries in the Asia-Pacific Region: Scoping Review
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Digital Behavior Change Interventions to Reduce Sedentary Behavior and Promote Physical Activity in Adults with Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
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Exploring the underlying mechanisms of obesity and diabetes and the potential of Traditional Chinese Medicine: an overview of the literature
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Original Article

Clinical Care/Education
Depressive Symptoms Are Negatively Associated with Glucose Testing and Eating Meals on Time among Individuals with Diabetes in Zambia: Given Hapunda, Amina Abubakar, Frans Pouwer, Fons van de Vijver; Diabetes Metab J. 2017;41(6):440-448. Published online November 17, 2017; DOI: https://doi.org/10.4093/dmj.2017.41.6.440

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Background

Depression is an established risk factor for cardiovascular diseases and mortality among individuals living with diabetes, and impaired self-care behaviors may play a mediating role. In Africa, this association is not very well known. In this study, we examined the associations between depressive symptoms and different aspects of diabetes self-care in Zambian individuals with diabetes mellitus.

Methods

A total of 157 individuals with diabetes mellitus participated. The sample was drawn from four city hospitals in Zambia. Diabetes self-care was assessed using the diabetes self-care inventory, and depression was assessed using the major depression inventory.

Results

Fifty-nine percent of the sample had type 1 diabetes mellitus. Variations in self-care activities and behaviors were reported as least adhered to by individuals with type 1 and type 2 diabetes mellitus, in adolescent and adult patients. Regression analysis indicated that there was no association between total diabetes self-care and the depression total score. However, depression was associated with poor glucose testing and not eating meals on time by patients with diabetes.

Conclusion

Some variance on poor self-care was explained by demographic characteristics, specifically age, body mass index, and to some extent, socioeconomic status. Recognition and successful treatment of depression in patients with diabetes might help to optimize self-care behaviors, especially glucose testing and eating meals on time. However, this hypothesis needs further testing.

Citations

Citations to this article as recorded by

Self-management practices for preventing complications of type II diabetes mellitus in low and middle-income countries: A scoping review
Pauline Muthoni Maina, Melanie Pienaar, Marianne Reid
International Journal of Nursing Studies Advances.2023; 5: 100136. CrossRef
Patient-reported outcomes for diabetes and hypertension care in low- and middle-income countries: A scoping review
Sarah Masyuko, Carrie J. Ngongo, Carole Smith, Rachel Nugent, Cesario Bianchi
PLOS ONE.2021; 16(1): e0245269. CrossRef
Peripheral and Central Metabolites Affecting Depression, Anxiety, Suicidal Ideation, and Anger in Complex Regional Pain Syndrome Patients Using a Magnetic Resonance Spectroscopy: A Pilot Study
Ye-Ha Jung, Hyeonjin Kim, So Yeon Jeon, Jeong Min Kwon, Won Joon Lee, Joon Hwan Jang, Dasom Lee, Yoonji Lee, Do-Hyung Kang
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Review

Clinical Care/Education
A Clinical Practice Guideline to Guide a System Approach to Diabetes Care in Hong Kong: Ip Tim Lau; Diabetes Metab J. 2017;41(2):81-88. Published online April 14, 2017; DOI: https://doi.org/10.4093/dmj.2017.41.2.81

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The Hospital Authority of Hong Kong is a statutory body that manages all the public medical care institutions in Hong Kong. There are currently around 400,000 diabetic patients under its care at 17 hospitals (providing secondary care for 40%) and 73 General Outpatient Clinics (providing primary care for 60%). The patient population has been growing at 6% to 8% per year over the past 5 years, estimated to include over 95% of all diagnosed patients in Hong Kong. In order to provide equitable and a minimal level of care within resources and local system factors constraints, a Clinical Practice Guideline on the management of type 2 diabetes mellitus was drawn in 2013 to guide a system approach to providing diabetes care. There is an algorithm for the use of various hypoglycemic agents. An organizational drug formulary governs that less expansive options have to be used first. A number of clinical care and patient empowerment programs have been set up to support structured and systematic diabetes care. With such a system approach, there have been overall improvements in diabetes care with the percentage of patients with glycosylated hemoglobin <7% rising from 40% in 2010 to 52% in 2015.

Citations

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Calvin Ke, Emaad Mohammad, Juliana C. N. Chan, Alice P. S. Kong, Fok-Han Leung, Baiju R. Shah, Douglas Lee, Andrea O. Luk, Ronald C. W. Ma, Elaine Chow, Xiaolin Wei
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Qiao Jin, Cindy Lo Kuen Lam, Eric Yuk Fai Wan
Diabetes Research and Clinical Practice.2023; 205: 110924. CrossRef
Association Between SGLT2 Inhibitors vs DPP-4 Inhibitors and Risk of Pneumonia Among Patients With Type 2 Diabetes
Philip C M Au, Kathryn C B Tan, Bernard M Y Cheung, Ian C K Wong, Ying Wong, Ching-Lung Cheung
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mRNA (BNT162b2) and Inactivated (CoronaVac) COVID-19 Vaccination and Risk of Adverse Events and Acute Diabetic Complications in Patients with Type 2 Diabetes Mellitus: A Population-Based Study
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Ten-Year Effectiveness of the Multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM) on Macrovascular and Microvascular Complications and All-Cause Mortality: A Population-Based Cohort Study
Eric Ho Man Tang, Ivy Lynn Mak, Emily Tsui Yee Tse, Eric Yuk Fai Wan, Esther Yee Tak Yu, Julie Yun Chen, Weng Yee Chin, David Vai Kiong Chao, Wendy Wing Sze Tsui, Tony King Hang Ha, Carlos King Ho Wong, Cindy Lo Kuen Lam
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Greater variability in lipid measurements associated with kidney diseases in patients with type 2 diabetes mellitus in a 10-year diabetes cohort study
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Original Articles

Clinical Care/Education
Clinical Evaluation of OneTouch Diabetes Management Software System in Patients with Type 2 Diabetes Mellitus: Jung Min Kim, Hey Jean Lee, Keum Ok Kim, Jong Chul Won, Kyung Soo Ko, Byung Doo Rhee; Diabetes Metab J. 2016;40(2):129-139. Published online April 5, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.2.129

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Background

OneTouch Diabetes Management Software (OTDMS) is an efficient way to track and monitor the blood glucose level. It is possible to download data from the OneTouch Ultra via the meter's data port, and to transform the numbers of the blood glucose level into a graph, a chart, or statistics. The objectives of this study were to evaluate whether the use of OTDMS in consultation hours would improve patients' knowledge of diabetes mellitus (DM), compliance, satisfaction with doctor and medical treatment, doctor-patient reliability, and glucose control.

Methods

All patients were randomized into either the OTDMS group using OneTouch Ultra or the control groups not using it. Both groups had conventional DM education and only the OTDMS group used data from OTDMS as explanation materials during consultation hours. At enrollment and after 6 months, we performed a questionnaire survey consisting of the diabetes knowledge test, items for compliance of treatment, patient's satisfaction, doctor-patient reliability, and glycosylated hemoglobin (HbA1c).

Results

We analyzed 6-month follow-up data from 92 patients (OTDMS 42 vs. control 50). Both groups showed significant improvements in HbA1c, diabetes knowledge, compliance, reliability, and satisfaction after 6 months. However, there were no significant differences between OTDMS and control groups overall. Only "weekly frequency of checking blood glucose level" of compliance and "trying to follow doctor's order" of reliability showed better results in the OTDMS group.

Conclusion

Using the OTDMS system for explanation during consultation hours seems to be more helpful to improve patient's compliance and reliability, especially for checking blood glucose level and trying to follow the doctor's order.

Citations

Citations to this article as recorded by

Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes
Kristin J Konnyu, Sharlini Yogasingam, Johanie Lépine, Katrina Sullivan, Mostafa Alabousi, Alun Edwards, Michael Hillmer, Sathya Karunananthan, John N Lavis, Stefanie Linklater, Braden J Manns, David Moher, Sameh Mortazhejri, Samir Nazarali, P. Alison Pap
Cochrane Database of Systematic Reviews.2023;[Epub] CrossRef
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Nirali A. Shah, Carol J. Levy
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Ji-Hee Sung, Da Young Lee, Kyoung Pil Min, Cheol-Young Park
Clinical Therapeutics.2019; 41(11): 2426. CrossRef
Impact of initial active engagement in self-monitoring with a telemonitoring device on glycemic control among patients with type 2 diabetes
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Potential of OneTouch Diabetes Management Software System in Real Field for Korean Type 2 Diabetes Patients
Borami Kang, Jae Hyoung Cho
Diabetes & Metabolism Journal.2016; 40(2): 115. CrossRef

A Smartphone Application Significantly Improved Diabetes Self-Care Activities with High User Satisfaction: Yu Jin Kim, Sang Youl Rhee, Jong Kyu Byun, So Young Park, Soo Min Hong, Sang Ouk Chin, Suk Chon, Seungjoon Oh, Jeong-taek Woo, Sung Woon Kim, Young Seol Kim; Diabetes Metab J. 2015;39(3):207-217. Published online April 22, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.3.207

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Background

We developed for the first time a smartphone application designed for diabetes self-management in Korea and registered a patent for the relevant algorithm. We also investigated the user satisfaction with the application and the change in diabetes related self-care activities after using the application.

Methods

We conducted a questionnaire survey on volunteers with diabetes who were using the application. Ninety subjects responded to the questionnaire between June 2012 and March 2013. A modified version of the Summary of Diabetes Self-Care Activities (SDSCA) was used in this study.

Results

The survey results exhibited a mean subject age of 44.0 years old, and males accounted for 78.9% of the subjects. Fifty percent of the subjects had diabetes for less than 3 years. The majority of respondents experienced positive changes in their clinical course after using the application (83.1%) and were satisfied with the structure and completeness of the application (86.7%). Additionally, the respondents' answers indicated that the application was easy to use (96.7%) and recommendable to others (97.7%) and that they would continue using the application to manage their diabetes (96.7%). After using the Diabetes Notepad application, diabetes related self-care activities assessed by SDSCA displayed statistically significant improvements (P<0.05), except for the number of days of drinking.

Conclusion

This smartphone-based application can be a useful tool leading to positive changes in diabetes related self-care activities and increase user satisfaction.

Citations

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Education as Prescription for Patients with Type 2 Diabetes Mellitus: Compliance and Efficacy in Clinical Practice: Mi Yeon Kim, Sunghwan Suh, Sang-Man Jin, Se Won Kim, Ji Cheol Bae, Kyu Yeon Hur, Sung Hye Kim, Mi Yong Rha, Young Yun Cho, Myung-Shik Lee, Moon Kyu Lee, Kwang-Won Kim, Jae Hyeon Kim; Diabetes Metab J. 2012;36(6):452-459. Published online December 12, 2012; DOI: https://doi.org/10.4093/dmj.2012.36.6.452

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Abstract PDF PubReader

Background

Diabetes self-management education has an important role in diabetes management. The efficacy of education has been proven in several randomized trials. However, the status of diabetes education programs in real Korean clinical practice has not yet been evaluated in terms of patient compliance with the education prescription.

Methods

We retrospectively analyzed clinical and laboratory data from all patients who were ordered to undergo diabetes education during 2009 at Samsung Medical Center, Seoul, Korea (n=2,291). After excluding ineligible subjects, 588 patients were included in the analysis.

Results

Among the 588 patients, 433 received education. The overall compliance rate was 73.6%, which was significantly higher in the subjects with a short duration or living in a rural area compared to those with a long duration (85.0% vs. 65.1%, respectively; P<0.001) or living in an urban area (78.2% vs. 70.4%, respectively; P=0.037). The hemoglobin A1c decreased greater in the compliant group (from 7.84±1.54 at baseline to 6.79±1.06 at 3 months and 6.97±1.20 at 12 months after prescription in the compliant group vs. from 7.74±1.25 to 7.14±1.02 and 7.24±1.24 in the non-compliant group; P=0.001). The decrease in hemoglobin A1c was greater in the subjects with a short duration (P=0.032).

Conclusion

In our study a large percent of patients refuse to get education despite having a prescription from their physician. This refusal rate was higher in the patients with long-standing diabetes or in urban residence. Furthermore, education was more effective in patients with a short duration of diabetes in clinical practice.

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Effect of Diabetes Education Program on Glycemic Control and Self Management for Patients with Type 2 Diabetes Mellitus.: Ji Hyun Kim, Sang Ah Chang; Korean Diabetes J. 2009;33(6):518-525. Published online December 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.6.518

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Abstract PDF

BACKGROUND
Diabetes mellitus is a chronic disease requiring continuous treatment and vigorous self-management. Reinforcement of effective self management and diabetes education are important factors in successful treatment. The aim of this study was to evaluate the effectiveness of the current diabetes education program on blood glucose control, self-management, and self-efficacy of patients with type 2 diabetes mellitus. METHODS: A total of 592 patients with newly diagnosed or uncontrolled type 2 diabetes mellitus were recruited to the diabetes education program from January to December 2007. We surveyed 338 patients from April to July 2008. A total of 117 patients had biochemical examinations and completed a questionnaire about knowledge, self-management and self-efficacy of diabetes treatment (no education group (n = 23), education group (n = 94)). RESULTS: The total scores from the questionnaires and the results of laboratory data showed no differences between the two groups. However, there were significant reductions in hemoglobin A1c level in the education group, as compared with the no education group (P = 0.039). Although the score for knowledge about diabetes mellitus was significantly higher in the education group (P = 0.005), greater knowledge was not reflected in the self-management or self-efficacy of the patients. CONCLUSION: The current diabetes education program had no effect on the self-management or self-efficacy of patients with diabetes, although did show some degree of association with blood glucose control and diabetes knowledge level. We conclude that a more effective diabetes education program needs to be developed and applied to daily practice for the improvement ofself-efficacy in patients with diabetes mellitus.

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Comparison of the Effects between Positive Message and Negative Message in Diabetes Mellitus Education.: Bong Jo Lee, Mee Ock Gu; Korean Diabetes J. 2009;33(4):344-352. Published online August 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.4.344

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Abstract PDF

BACKGROUND
Given the nature and chronicity of diabetes mellitus (DM), the role of self care and adequate patient education, in addition to the support of medical professional, is essential in its management. The aim of the present study was to compare the effects of positive messages and negative messages in DM education and to identify the superior method of motivation for self care behaviors. METHODS: A total of 99 DM patients (50 positive message group: 49 negative message group) at Gyeongsang National University Hospital participated in the study. The collected data were analyzed by Chi square and t-test. RESULTS: There were no significant differences in the attitude of messages and in the attitude of self care behaviors between the positive and negative message group, though the negative message group had a significantly higher intention of self care behaviors than did the positive message group. CONCLUSION: These results suggest that the negative messages are more effective than positive messages for increasing the intention of self care behaviors in patients with DM.

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Effects of 'Ubiquitous Healthcare' on the Ability of Self-Management in Elderly Diabetic Patients.: Sung Hoon Yu, Sun Hee Kim, So Yeon Kim, Sung Hee Choi, Soo Lim, Yoon Seok Chang, Hak Jong Lee, Young Joo Park, Hak Chul Jang; Korean Diabetes J. 2009;33(1):58-64. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.58

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BACKGROUND
The need for a new healthcare system is growing due to the paradigm shift from health supervision to health maintenance. Previously, we performed a pilot study that examined the effectiveness of a ubiquitous healthcare (U-healthcare) diabetes management program which consists of self-monitoring of blood glucose (SMBG) and mobile phone services for elderly patients with type 2 diabetes mellitus. In this study, we investigated the effect of a diabetes management program using U-healthcare based on the self-care skills of elderly patients with diabetes mellitus. METHODS: From July to October 2005, 17 patients were recruited and provided with a blood glucometer with the ZigBee module and a mobile phone. In addition, the patients' understanding of diabetes self-care skills was examined at the beginning and end of the study. At the end of the study, we determined the level of patient satisfaction regarding U-healthcare services. RESULTS: The patients' test scores on their understanding of diabetes mellitus improved from 57.2 +/- 20.7 to 72.7 +/- 13.4%. Specifically, patient knowledge of the basic principles for a proper diabetic diet (52.9% vs. 82.4%, P = 0.046), foods that influence blood sugar level (41.2% vs. 76.5%, P = 0.007) and the influence of beverage choice (41.2% vs. 64.7%, P = 0.007), all increased. In addition, a significant increase in knowledge of living standards regarding diabetes mellitus was observed (64.7% vs. 88.2%, P = 0.0032). CONCLUSION: We conclude that the U-healthcare incorporating SMBG could be promising, as it improves self-management skills of diabetes mellitus patients, as well as their understanding of the disease.

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