Managing diabetes is complicated. You need a base understanding of what the disease is doing inside your body – how it behaves, what keeps it in check, and what it can do to you. Without this, you wouldn’t even know where to begin (or why you should want to manage it). You also have to be motivated. You have to believe management is within your control. Otherwise, what’s the point in even trying? You have to realize there are things you can do – however small – that can impact how it behaves. Lastly, you have to know what to do. You need to learn the skills to be able to manage it. You need to believe you can actually do it.
You might be asking yourself how people with diabetes get along with the disease. How do they manage the day-to-day demands placed on them? How do they make decisions that will help them be as healthy as possible? And the answer is that some people do manage the disease every day, taking it into consideration as they make choices for themselves. But others may deliberately ignore it, or may not even realize it’s something that requires their attention.
We know that close to 95% of diabetes management falls on the shoulders of patients, and we wanted to figure out a way to reach them where they are. Daily challenges come up that are difficult to manage. By building patients’ skills, we can help them take the actions necessary to most optimally manage their disease.
Patients are constantly on the go, so providing them with something that would not only accomplish the above disease management goals but also fit into a busy lifestyle was critical. Creating an app was the logical choice. When we looked at apps currently available, what we found were a lot of trackers and programs focused purely on information dissemination. What was missing was the behavioral component to help patients actually make and sustain the desired changes. Trackers are great for keeping logs of eating habits, exercise, and even blood glucose. But not much more.
And so the Time2Focus diabetes mobile app was born. We’re in the midst of putting the final touches on what will be a groundbreaking phone app to help patients with type 2 diabetes more successfully navigate the ins and outs of the disease, make educated and empowered decisions on a daily basis, and be able to work around real-world obstacles that stand in their way.
The 12-week program is grounded in the behavioral concept of problem solving. In simple terms, this is all about helping patients learn how to apply their own understanding of their diabetes to handle new situations that arise. It requires that patients not only understanding their disease and learn key skills, but also are able to apply what they’ve learned to new diabetes-related situations that come up (which happen every day) so they can work around these new obstacles and stay on track.
We’re also using gamification principles to help keep patients motivated and engaged. We’ve designed challenges that not only test knowledge, but ask patients to rely on their new disease understanding and experiences to navigate obstacles. Patients are challenged to apply new concepts and make choices within the app that mimic real-world situations.
As the Time2Focus program development nears completion, we’re gearing up for a clinical trial to test its efficacy among over 100 people living with type 2 diabetes. Patients will spend 12 weeks participating in the program building their problem solving skills and ultimately making improvements in their diabetes health. In addition to behavioral outcome measures, we’ll also be measuring change in HbA1c.
Stay tuned for more details as the app continues to progress.(Read full post)
Since the 2nd century AD, humans have been fascinated by one thing: ourselves.
Roman Emperor Marcus Aurelius’s To Myself (Τὰ εἰς ἑαυτόν), written around 180 AD, is one of the first existing diaries ever written. Today, most of us have smartphones for life-logging and many even have technology that keeps track of our lives for us. (I have been wearing a FitBit for the past few weeks. This device records the number of steps I take, calories I burn throughout the day, and other data.)
The digital age has made the process of recording everything we do even easier, and the Quantified Self movement, as it has come to be known, is gaining in popularity. We may bemoan our friends instagramming their every bite and tweeting their every trip to the gas station. However, there are some useful applications of these activities for the management of chronic diseases.
In conditions like diabetes it is known as self-monitoring: paying attention to changes in symptoms and other data like blood glucose levels or the effects of medications. Patients and their providers can use information gathered through self-monitoring to make treatment decisions and reinforce positive behaviors. For example, if a patient with diabetes feels more energetic and sees their blood glucose levels drop when they stick to a healthy diet, they may be more likely to make that lifestyle change a habit.
So whatever your opinion on life logging, it isn’t going away anytime soon. Let’s just hope we use our obsession with ourselves for good.(Read full post)
Last week I had the privilege of spending two days with diabetes experts in Washington, DC at the American Diabetes Association’s 5th Disparities Partnership Forum.
The goal of the conference was to provide a forum for discussion around the onset of type 2 diabetes in high-risk populations. One of the many populations discussed was women. Brandy Barnes, the Founder and CEO of DiabetesSisters, and I submitted an abstract to the ADA highlighting the unique needs of women living with diabetes and it was selected as one of two Promising Practices to be presented at the conference.
I was so excited about being able to share the work of MicroMass and DiabetesSisters with an audience of experts who are all genuinely interested in understanding how to positively influence women with diabetes. Creating sustainable behavior change is critical, and I know together our organizations are already making great strides.(Read full post)
If you know me, you’ve heard me talk about DiabetesSisters. It’s a thriving organization serving women with diabetes. DiabetesSisters was founded in 2008 by Brandy Barnes, who wanted to create a place for women with diabetes to come together and talk, support each other, and live well with the disease.
DiabetesSisters has grown from a small online group to an international community of more than 10,000 women from countries across the world. Every time I meet with Brandy, I am just in awe of all she has accomplished and am so glad I am a part of her organization.
While Brandy has events running year long, with the New Year comes the 3rd annual overnight Weekend for Women conference in Raleigh, NC. Part of her weekend includes the orange:will Diabetes Awareness Walk, taking place on May 20, 2012. It’s a free, one mile walk with the goals of creating greater awareness of diabetes and supporting all women living with the disease, regardless of type. And, you don’t have to be a woman to walk! All people are welcome. There are also great prizes (like an iPad, airline tickets, and designer sunglasses) for those who raise the most money.
MicroMass will be wearing orange on May 20th. We can’t wait to see you there.(Read full post)
DiabetesSisters, a nonprofit organization dedicated to improving the lives of women with diabetes, just launched its new and improved SisterMatch Program. The original SisterMatch Program (which was designed as a buddy program) was launched a couple of years ago to help fill the void that many women with diabetes often have in their lives – a friendship with another woman with diabetes who truly “gets” it. And the program really took off.
Over time, though, Brandy Barnes, the founder of the organization, realized she needed to match women on more than just demographics to make SisterMatch more of a success. She wanted women to have the opportunity to connect with others based on qualities that go deeper than diabetes type. As a result, Brandy partnered with Ayogo Games to create this new, innovative program that matches women based on attitudes, personalities and preferences, rather than just demographics alone. It allows women to build their own personal network of like-minded friends (or “SisterMatches”), allowing for the exchange of support, information, advice, and more.
SisterMatch is for those women who want to take a more active role in their diabetes management and build a circle they can tap into and one they really “click” with. It allows for the customization of a support network and provides a forum for women to share ideas, interact with each other, and just have fun.(Read full post)
This past weekend, I saw firsthand that orange certainly does empower women with diabetes.
Women living with diabetes face unique challenges, and Brandy Barnes founded DiabetesSisters with the purpose of supporting and advocating on behalf of all women living with the disease. Brandy’s vision for DiabetesSisters fed the development of orange:will, a nationwide campaign created by MicroMass and DiabetesSisters to establish orange as the official color of women with diabetes.
I believe Brandy is well on her way.
On May 1st, just two days ago, I participated in the first annual orange:will awareness walk in downtown Raleigh. I was joined by 25 of my friends from MicroMass and 75 courageous women with diabetes for a one mile awareness walk, culminating with an official proclamation by Mayor Charles Meeker that May 1st is “Orange Will Empower Women with Diabetes Day” in the city of Raleigh. He urged all citizens to show their support of women with diabetes and the fight against diabetes by wearing the color orange.
What an incredible day for DiabetesSisters all around the world! I’m so glad that I was able to share in the excitement.
Today is Diabetes Alert Day, and the American Diabetes Association is asking all Americans to take its Risk Test today to learn their risk for developing type 2 diabetes. The ADA’s hope is that those at high risk will talk with a doctor or other healthcare professional about next steps to manage their health.
Learning that you are at high risk for developing a chronic disease like diabetes can be difficult to accept and understand, especially when so much of managing diabetes is the responsibility of the patient. Going to a healthcare professional is the first step, but once patients go home, they need to take specific steps to stay as healthy as can be. But, this can be really tough for people.
Brandy Barnes recognized this and decided to do something about it. She is the founder and CEO of DiabetesSisters, an organization devoted to improving the health and quality of life of women with all types of diabetes, and to advocate on their behalf. Thanks to Brandy and her vision for this great organization, women at risk for or with diabetes can find the support they need.
Brandy’s vision for DiabetesSisters fed the development of orange:will, a nationwide campaign created by MicroMass and DiabetesSisters to establish orange as the official color of women with diabetes. MicroMass’ work was recognized on February 25, 2011 at the Triangle Area ADDY Awards, where together, MicroMass and DiabetesSisters were honored with an ADDY.
Below is a picture of Brandy and I next to the work produced in an effort to not only make orange the official color of women with diabetes, but also create awareness that women with diabetes are unique and deserving of this kind of recognition.
To learn more about women and diabetes, take a look at MicroMass’ most recent white paper, Understanding Differences to Make a Difference.
(Read full post)
I’ve been reading Yoni Freedhoff’s Weighty Matters blog for a little over a year now and have been converted to his way of thinking about weight loss. I believe that eating out and consuming processed foods are two key players in the current obesity epidemic. With so many of us trying to make healthier choices in 2011, I was pleased to find Red Robin’s Customizer.
Now, I wouldn’t say Red Robin is my idea of a great restaurant. Far from it. But as the parent of a toddler, it’s in our dining out rotation fairly regularly, for reasons that have less to do with the food and more to do with the volume of background noise. And the balloons.
The Customizer tool allows you to see full nutritional information on menu items as you add or subtract ingredients. While this bit of transparency has probably crossed the Caesar’s Chicken Wrap (852 calories) and the Mountain High Mud Pie (1373 calories) off my list forever, it has allowed me to identify healthier options and given me a more realistic view of the items as I would order them.
For example, it’s pretty amazing to see how dramatically the calories drop on a sandwich by simply removing the mayo and cheese. Little changes can make a big difference.
I would love to see more user-friendly transparency tools from other restaurants.
While it’s still not my favorite restaurant, I’m more likely to choose Red Robin over similar restaurants now that I have a clearer picture of what my family will actually be consuming there.
Hopefully a more mobile-friendly version is in the works.(Read full post)
Most Americans are somewhat familiar with diabetes and high blood pressure. In fact, if you yourself don’t have high blood pressure or diabetes, chances are someone in your immediately family has at least one of these metabolic diseases. Nearly 8% of the US population (23.6 million children and adults) have diabetes and one in three adults has high blood pressure.
Fortunately, there are a number of medical treatment options that help people manage these metabolic diseases and keep potential complications at bay. And then there’s that other important aspect to treatment — lifestyle changes such as diet and exercise.
But did you know that there are psychological interventions that may also improve disease management and outcomes associated with diabetes and hypertension?
An article in the July issue of Cleveland Clinic Journal of Medicine provides a nice review of evidence-based psychophysiologic interventions that have been used in patients with diabetes and hypertension. Studies using techniques such as biofeedback and relaxation have demonstrated improved glucose and blood pressure levels.
There are several pieces of biologic evidence that may explain why these approaches work:
- Chronic stress affects the body systems, including the nervous and endocrine systems .
- Research has demonstrated that psychological states such as anger, hostility and anxiety may be associated with the development of high blood pressure.
- Anxiety, which activates the body’s stress response, impacts blood pressure and glucose levels even in healthy individuals. And the effects of anxiety in persons with metabolic syndrome are even greater.
- The quality and length of sleep affects metabolism.
- Specifically related to blood pressure, an important period of blood pressure reduction takes place at night during sleep.
So, aside from being interesting, what does this mean?
I think this type of evidence underscores the importance of a broad approach to disease management – an approach that takes into account those important mind-body connections. Not everyone is a candidate (nor is everyone interested) in biofeedback or relaxation therapy. But programs and interventions that offer patients and healthcare professionals access to information and tools that support positive lifestyle changes such as stress reduction and others, will only drive better health outcomes long term.
Being a nurse, I am a big proponent of medical treatment and I have seen firsthand the power of medicine. But I think true power and impact on health can be realized when our health system embraces, values, and incorporates complementary, evidence-based approaches.(Read full post)
Wireless technology used to track packaged items has made a big turn towards healthcare monitoring. New technologies that you wear will help doctor monitor your vital signs and your compliance to prescription medications.
One such device consists of a Band-Aid looking patch and microchips attached to your pills. When the microchips are activated by your stomach fluids, they will send a signal to the patch. When you get near your smart phone, the data collected by the patch will be uploaded over the Internet. If you give permission, this data can be shared with your doctor. The device is being pioneered by Proteus Biomedical, a company that started with their smart-pill system.
These kinds of devices will have a profound effect on health care. The near real-time data can help your doctor help you almost immediately if events in your life keep you from taking your medication as prescribed. This should benefit you in a couple of ways. First, if you have a chronic disease, like hypertension, it will enable you to take greater control of your condition and your health. Second, it will provide your doctor with more accurate information. All of this should help you avoid costly hospital stays – and that is money saved.
Many believe these kinds of extensions to current health care practices is the key to cutting costs. This is just the beginning of remote monitoring, especially for the most acute cases. If these devices can keep enough people from going to the hospital unnecessarily, hospitals can utilize their limited resources more effectively.
Proteus is one of many companies with wireless monitoring technologies. Coventis is developing CardioMems to address congestive heart failure conditions (watch the video below); Cambridge Consultants is developing PHT to tackle asthma; DexCom is developing SEVEN PLUS for diabetes; and Airstrips Technologies is developing Airstrip for obstetricians (watch the video below).
These medical devices are putting a whole new twist on wearable, wireless technology.(Read full post)