Imagine you’re in the shoes of Bill, a type 2 diabetes patient. You’ve just left the doctor’s office, where you’ve told your PCP that things seem to be going pretty well. You are eating better, you are starting to take some short walks, and overall you feel pretty good. Your doctor seems happy about all of this, but your A1c is higher than he’d like, he tells you. He says you should pay more attention to things like carbs, and creating a balanced plate at meals. And you should exercise more, because the walks aren’t doing the trick.
What? You just told him that you’re eating well and you’re exercising. You feel let down as you leave the appointment. On your way out, the receptionist hands you a few pamphlets that your doctor wants you to take home and read.
You scan the titles: Eating Healthy with Diabetes, The Diabetes Diet, and Type 2 Diabetes and Exercise. You toss the pamphlets in the trash on your way to your car.
What just happened here? The short version is this: Bill goes to his quarterly appointment feeling energized and proud of the work he’s done caring for his diabetes, only to be told that what he’s doing isn’t enough, and he needs to do more to get tighter control of his numbers. His doctor hasn’t truly heard him, and is treating him like a number. On top of that, his provider gives him information-heavy, generic materials covering topics Bill already thought he was managing well. Bill leaves feeling defeated and annoyed with his doctor.
These well-intentioned informational materials typically get tossed aside for these reasons and others. In the research we’ve conducted with patients with chronic diseases, they’ve told us the number one quality they value in their doctors is their ability to listen. They want a doctor to hear their view point and take their position into consideration when coming up with an action plan. Patients want a management plan that reflects both their expertise (as the patient) and the doctor’s expertise. The complete opposite happened to Bill.
There are so many ways Bill’s scenario could be improved. Key tactics that could have a big impact on Bill’s situation include:
- Point of care tools delivered to his PCP to help him work with Bill to uncover his key behavioral drivers to change
- Trainings to help his PCP communicate more effectively and utilize appointment time more efficiently
- Behaviorally-based content provided to Bill to help him set personal goals that are of interest to him and that will help him work through his unique problems and obstacles
These kinds of personalized solutions allow us to reach an audience more effectively and promote positive change. They help facilitate better in-office communication between doctors and patients, which impacts how a patient views his or her condition and ultimately how it gets managed. And these solutions serve as extensions of the appointment, helping patients manage their conditions over the 3 or 4 months they are on their own between appointments.
It’s time to rethink how we’re educating our patients and truly begin energizing them to take an active role in their care.(Read full post)
According to a report just released by the Center for Health Law and Policy Innovation of Harvard Law School, people with type 2 diabetes could lose up to 15 years of life because of the disease, and by 2025, diabetes could cost the state over $17 billion a year in medical expenses and lost productivity if the epidemic continues on its current path. Changing this is not simple, but there are many initiatives underway focused on making sure this does not become a reality.
This was the topic of the PATHS (Providing Access to Healthy Solutions) conference I attended on May 30. The good news is that there are many people who care about this issue and want to do something about it. The hard part, at times, is knowing where to start and how to actually make a difference.
While at the conference, I had the pleasure of sharing our work on women and diabetes along with Brandy Barnes of DiabetesSisters, as you see in the image below. I’ve been collaborating with Brandy for the last 5 years, and she has been able to take insights from our study to help inform the programs she offers through her organization.
I also had the opportunity to share some information about MicroMass’s Time2Focus diabetes app with some other conference attendees. As I wrote on April 22, 2014 in a previous blog post, this app is designed to help build patient confidence and problem solving skills so patients can make educated and empowered decisions on a day-to-day basis related to their diabetes. Recruitment for our clinical trial is underway, and we are eager to begin helping patients, one-by-one, make changes in their lives so they can live healthier, more productive lives.(Read full post)
When I was in school, I always thought “class participation” was a wonky thing to grade. You get credit for showing up and speaking every now and then? Psh! But, maybe there’s something to that.
As I’ve ventured out into the real world I’ve started to notice how important participation can be—especially when it comes to patient engagement. From being too shy to ask questions to not tracking dosage, patients who only show up to appointments but then don’t do their part when they’re on their own are only making it harder on themselves.
Case in point? Diabetes patients. In their case, participation is all important. 95% of their care depends on self-management. That’s huge.
What’s so hard about self-management? Well. It’s hard. And it takes a lot of time. And it can be tedious. Ever tried to count calories for more than a week? It’s no fun. And that’s where we come in. Beyond recognizing the importance of self-management, our task is to find new ways to get patients involved so they can stay engaged in their own treatment for the long haul.
Since the importance of self-management for patients isn’t likely to change, we have to help patients change the way they see self-management. They need to see that it can be done and that it should be done and that if they stick with it, they may actually feel better which means they can participate in the more glamorous things in life.(Read full post)
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 understand 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)