What is meant by 'integrated personalized diabetes management': A view into the future and what success should look like

Evaluating the Impact of mySugr® Mobile Health Application on Glycemic Control in People with Diabetes Mellitus in India: A Real-World Data Analysis

INTRODUCTION

The rising prevalence of diabetes has driven extensive research into effective management strategies, emphasizing the importance of integrating self-management routines into daily life. This study presents real-world observations on the impact of the mySugr® app, used in conjunction with the Accu-Chek® Instant blood glucose monitoring device, on glycemic control and patient satisfaction in India.

METHODS

This retrospective, observational, non-interventional study was conducted at 29 sites in India, involving people with diabetes (PwD) who used the mySugr® app in conjunction with the Accu-Chek® Instant glucose meter for at least 3 months. Data from electronic health records and paper-based records were analyzed. The primary objective was to evaluate changes in glycated hemoglobin (HbA1c) levels over 3 months. Additionally, the study assessed the frequency of hypoglycemic and hyperglycemic events, changes in HbA1c based on monitoring frequency, and the use of insulin and non-insulin therapies. Patient satisfaction with the mySugr® app was also assessed.

RESULTS

A total of 111 PwD were included and had an average age of 53.2 years. The mean HbA1c level significantly decreased from 8.8% to 7.5% (p < 0.0001) in PwD using the mySugr® app in conjunction with the Accu-Chek® Instant glucose meter for at least 3 months. Frequent monitoring (≥ 6 times per week) resulted in a greater HbA1c reduction (1.5%-points) compared to less frequent monitoring (1.0%-point). Insulin-treated PwD showed a larger HbA1c reduction (1.6%-points) compared to those not on insulin (0.8%-points). PwD reported an average of 1.9 hypoglycemic and 20.0 hyperglycemic events.

CONCLUSION

The mySugr® app, used in conjunction with the Accu-Chek® Instant glucose meter, demonstrated improved glycemic control. Future research should focus on larger, diverse samples and long-term evaluations to confirm these findings and explore the cost-effectiveness of integrating such applications into routine diabetes care.

Personalized Chronic Care for Diabetes Management in Pakistan: A Report of Two Cases

This case report evaluates the efficacy of a personalized, multidisciplinary chronic care management (CCM) program aimed at improving health outcomes for individuals with polychronic conditions within Pakistan's under-resourced healthcare system. Implemented in November 2023, the intervention was designed to help two office employees newly diagnosed with type 2 diabetes and associated comorbidities, such as hypertension and obesity. Over six months, the participants engaged in a structured program that included teleconsultations, personalized care plans, and biweekly follow-ups through a social media application. The 'care team,' comprising doctors, nutritionists, wellness coaches, and care attendants, facilitated these interactions. Specific outcomes included a reduction in hemoglobin A1c (HbA1c) from 15% to 5.4% with a 26.3 kg weight loss for Participant 1 and a 3 kg weight loss with a decrease in HbA1c from 6.5% to 6.1% for Participant 2. This report highlights the potential of comprehensive, integrated, and patient-centered diabetes management to enhance glycemic control and weight management in settings burdened by high disease prevalence and limited healthcare resources.

Effectiveness of Message Framing Interventions on Improving Health Outcomes for Individuals in Diabetes Health Education Communication: A Systematic Review

OBJECTIVES

To identify the effects of message-framing interventions on improving health outcomes of individuals in diabetes health education communication.

METHODS

Four electronic databases including Web of Science, PubMed, EMBASE, and the Cochrane Library were the search engines used. The period of literature search was from their inception until December 2023. Randomized controlled trials (RCTs) and quasi-experimental trials reporting the effects of message-framing interventions for diabetes were included.

RESULTS

The review included 10 studies. Many studies have investigated multiple health outcomes. Of the seven studies that evaluated behavioral health-related outcomes, all studies (7/7, 100%) found a positive effect, and four studies (4/7, 57.1%) found that there was no significant difference between gain and loss framing. Of the seven studies that assessed nonbehavioral health-related outcomes, six studies (6/7, 85.7%) reported a positive postintervention effect, whereas four studies (4/7, 57.1%) found that loss-framed messages were more effective. One study (1/7, 14.3%) reported that there was no effect of the message framing on mental health-related outcomes.

CONCLUSIONS

In diabetes health education communication, message framing of gain and loss framing has a positive effect on health outcomes for individuals. The advantage of the loss framing is more significant in improving nonbehavioral health-related outcomes.

PRACTICE IMPLICATIONS

When constructing a message to promote health outcomes for patients with diabetes, the message framing is worth applying, and the advantages of loss framing can be considered more.

TRIAL REGISTRATION

PROSPERO registration ID: CRD42023445074. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=445074.