A total of 793 individuals were referred to the study and assessed for eligibility between June 2015 and November 2016. Of these, 366 were randomised to the intervention and control groups (n=183 each; fig 1). The final nine month follow-up assessments were completed in August 2017, with loss to follow-up (that is, no follow-up data on any outcome) low in both groups (overall 7/366=2%). A total of 12 participants (six per group) were excluded from the primary outcome analysis because of no follow-up HbA1c results after randomisation. Baseline characteristics of participants are presented in table 1, and no adverse events were recorded from the study or protocol deviations.


The use of apps to record blood glucose was the most favored function in apps used by people with diabetes, with interest in insulin dose calculating function. HPs do not feel confident in recommending insulin dose calculators. There is an urgent need for an app assessment process to give confidence in the quality and safety of diabetes management apps to people with diabetes (potential app users) and HPs (potential app prescribers).

Additional data on all patients were collected from the hospital management system, including age, and the most recent values within the previous 12 months from date of survey for blood pressure (BP), glycated hemoglobin (HbA1c), urinary microalbumin to Creatinine ratio (ACR), low density lipoprotein cholesterol (LDL), and total cholesterol to HDL ratio (C:HDL). Prescription of lipid lowering drugs, anti-hypertensive drugs, insulin, or other hypoglycemic medication were also extracted from the medication list from the last visit within the sample period. Type of diabetes was self-reported in the survey (type 1 [T1DM], type 2 [T2DM], other or unknown) and in four participants who had selected ‘other’ or ‘unknown’ diabetes type was determined by examination of the clinical records. For categorization of participants by app use, 4 responders who did not indicate if they had a mobile phone or not were included in the non-app group.

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The growing prevalence of diabetes is considered to be one of the biggest global health issues.1 People of ethnic minorities, including Pacific and Māori (New Zealand indigenous population) groups, are particularly vulnerable to the development of diabetes, experience poorer control, and increased rates of complications.23456 In New Zealand, 29% of patients with diabetes were found to have HbA1c levels indicative of poor control (≥65 mmol/mol or 8%), putting them at risk for the development of debilitating and costly complications.7 Diabetes complications can be prevented or delayed with good blood glucose control, which is not only advantageous for a person’s quality of life but also will substantially reduce healthcare costs associated with treating or managing the complications.89101112
This study shows app usage is relatively low among people with diabetes, while 60.2% of HPs have recommended an app to patients. There is, however, interest amongst people with diabetes and HPs to use diabetes apps, with strong interest in an insulin dose calculator. Apps with this feature have the potential to improve diabetes control. However, the critical problem of app safety remains a barrier to the prescription and use of insulin dose calculators. Further work is needed to ensure apps are safe and provided in a regulated environment. An app assessment process would provide HPs with confidence in the apps they recommend and would ultimately ensure app quality and safety for app users. At present, however, app users and HPs must remain cautious with diabetes apps, especially those in the insulin dose calculator category.
One of the most important aspects of diabetes management is to maintain a healthy body weight. Being overweight not only increases your risk of heart disease, stroke and some cancers, it also makes your diabetes harder to manage. Small changes in your diet such as reducing your portion sizes and swapping to low-fat dairy products can help you to achieve a healthy body weight and manage your diabetes.
The {Dario} device has been perfect, I love it. I love that it’s small and discreet enough. I can now test my sugars within 20 seconds, all from the bottom of my iPhone and no one around is none the wiser… I also love that it’s “all in one”. I’ve been using it now for around 4 – 5 months. The app is great at logging and motivation with its % scoring system.
For example, adjusting to having diabetes; difficulty in making the life changes necessary to stay well; difficulty managing anger, conflict and other emotions related to your health; depression, sadness and grief; anxiety, worries, panic and phobias related to your health; eating difficulties; and difficulty with coping with the complications of diabetes.
Another goal of this blog is to give you a behind-the-scenes look at what the Association does on a daily basis to fulfill its mission: To prevent and cure diabetes and improve the lives of all people living with diabetes.  Our staff’s dedication – combined the stories that provide them with inspiration through the day – is a critical part of the Stop Diabetes movement.
The HPs’ survey was completed by 115 out of 286 HPs (40.2% response rate, 78 online, 37 paper). Table 6 shows the characteristics of responders. Almost all HPs (96.5%, 111/115) owned a mobile phone and of the 113 who answered, 60.2% (68/113) had recommended an app for diabetes management to a patient. Dieticians were most likely to have recommended an app (83%, 10/12), followed by nurses (66%, 42/64), (P=.006). There was no relationship between app recommendation and the number of years of treating diabetes (P=.48) or the responder’s age (P=.49).

Stutt's Diabetes Depot carries all the well-known brands of insulin pump supplies, including Accu-check infusion sets, Deltec Cozmo insulin cartridges/reservoirs, Animas infusion sets, Lantus Solostar Pens, Medtronic MiniMed Paradigm infusion sets, pen needle tips, Lifesource blood pressure monitors and ErecAid vacuum devices for erectile dysfunction.
Like my customers, I use an insulin pump to control my diabetes because it allows me to be spontaneous and flexible in managing my diabetes while reducing hypoglycemia. Reaching target blood glucose levels is not always easy, but being a Pharmacist, as well as a Certified Diabetes Educator and Certified Pump Trainer, I know the importance of managing my blood glucose to reduce long-term complications. You are welcome to contact me about any aspect of insulin pump therapy or with any questions about specific insulin pump supplies.
Having a healthy lifestyle includes daily physical activity which can prevent or delay Type 2 Diabetes. There are plenty of organised activities you can take part in such as Walk to Work, but you can also do your own thing and get moving with family and friends in any way you like. It’s most important to remember that activity is for life, not just one day. Regular physical activity could include walking, riding a bike, dancing or swimming.
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Blood glucose tracking is the most common feature of diabetes apps [5,14], with other features including record of medications, dietary advice, and tracking, such as carbohydrate content calculation, and weight management support [5,11,12,14-16]. Additionally some apps recommend insulin dosing based on users inputs of glucose levels and estimated meal carbohydrate. Meta-analysis of 22 trials including 1657 patients in which use of mobile phone apps supporting diabetes management was compared to usual care or other Web-based supports showed that app use led to a mean reduction in HbA1c of 6mmol/mol that is 0.5% [9]. This compares favorably with the glucose lowering of lifestyle change, namely diet [17] and oral diabetes medication [18].
The main effect of the intervention on secondary outcomes are presented in table 4. No significant differences were observed between the two groups for self efficacy (SEDM). A significant improvement in foot care behaviour was seen in the intervention group compared with the control group (adjusted mean difference 0.85 (95% confidence interval 0.40 to 1.29), P<0.001) but no significant group differences were observed for diet (general or specific), exercise, blood glucose testing, and smoking behaviours (SDSCA). No significant group differences were observed for diabetes distress (DDS2).
This study contributes to the evidence around the use of SMS to support diabetes management.131415 The improvements in HbA1c seen in this study are similar to those reported in meta-analyses of SMS interventions in diabetes not limited to those with poor control.141641 Unlike previous studies that typically focus on a particular population defined by diabetes type, age, or treatment, the current study provided an intervention for all adults with either type 1 or type 2 diabetes under any treatment regimen, enhancing potential reach and generalisability. The only limit on the population was the requirement that participants had to have poor diabetes control. This criterion was particularly important given associated costs and debilitating complications of poorly controlled diabetes. Although few trials so far have examined the effectiveness of mHealth interventions in this population,42 this study provides evidence to support the use of this modality to provide diabetes education and support to individuals with poor control.
Patients were involved in all stages of the study, including the initial conceptualisation and formative work leading to the development of SMS4BG (for more information, see the development paper28). Patient feedback informed the intervention modality, purpose, and structure, and patients reviewed intervention content before it was finalised. Patient feedback on the acceptability of SMS4BG through the pilot study28 led to improvements to the intervention including additional modules, the option for feedback graphs to be posted, additional tailoring variables, and a longer duration of intervention. Patient feedback also informed the design of this trial—specifically its duration, the inclusion criteria, and recruitment methods. Additionally, patients contributed to workshops of key stakeholders held to discuss interpretation, dissemination of the findings, and potential implementation. We have thanked all participants for their involvement and they will be given access to all published results when these are made publicly available.
Patients were involved in all stages of the study, including the initial conceptualisation and formative work leading to the development of SMS4BG (for more information, see the development paper28). Patient feedback informed the intervention modality, purpose, and structure, and patients reviewed intervention content before it was finalised. Patient feedback on the acceptability of SMS4BG through the pilot study28 led to improvements to the intervention including additional modules, the option for feedback graphs to be posted, additional tailoring variables, and a longer duration of intervention. Patient feedback also informed the design of this trial—specifically its duration, the inclusion criteria, and recruitment methods. Additionally, patients contributed to workshops of key stakeholders held to discuss interpretation, dissemination of the findings, and potential implementation. We have thanked all participants for their involvement and they will be given access to all published results when these are made publicly available.

The survey was piloted with the first 30 patients with an email addresses (chronological order of clinic visits). Responses were reviewed after response rate reached 50%. As 4 questions were unanswered by some participants, a “none of the above” option was added. The invitations were sent out to the remaining 540 participants. A further 31 participants were excluded (4 email address errors, 13 gestational diabetes, 10 deceased, 4 did not have diabetes) resulting in a final total of 539 participants. This survey remained open for 3 weeks, with reminders sent to non-responders at one week and two weeks.

‘I was very pleased to contact your service. I was feeling overwhelmed with my current situation however knew that I needed to get a diabetes test done. While I was waiting for my turn to be tested Susan welcomed me, helped my overwhelming feelings calm down, she was very approachable and understanding. Sandy followed through by assisting me with assurance that things were going to be okay and was very understanding. She encouraged that I seek more medical advice for my blood pressure results. She phoned my manager and found me a local GP that I could visit right away. I was very appreciative of these ladies and all the help, care and advice they gave me. Thank you so much!’
Of the 189 responders (35.0% response rate) to the patient survey, 19.6% (37/189) had used a diabetes app. App users were younger and in comparison to other forms of diabetes mellitus, users prominently had type 1 DM. The most favored feature of the app users was a glucose diary (87%, 32/37), and an insulin calculator was the most desirable function for a future app (46%, 17/37). In non-app users, the most desirable feature for a future app was a glucose diary (64.4%, 98/152). Of the 115 responders (40.2% response rate) to the HPs survey, 60.1% (68/113) had recommended a diabetes app. Diaries for blood glucose levels and carbohydrate counting were considered the most useful app features and the features HPs felt most confident to recommend. HPs were least confident in recommending insulin calculation apps.
One of the most important aspects of diabetes management is to maintain a healthy body weight. Being overweight not only increases your risk of heart disease, stroke and some cancers, it also makes your diabetes harder to manage. Small changes in your diet such as reducing your portion sizes and swapping to low-fat dairy products can help you to achieve a healthy body weight and manage your diabetes.
New Zealand celebrates Diabetes Action Month – and the results of last year’s risk factor assessment highlight the importance of getting involved: Last year, more than 3,500 people undertook an assessment of their risk factors during the month, with 68% learning they potentially have a greater propensity for type 2 diabetes. The core purpose of the first Diabetes Action Month was to alert New Zealand that everyone is at risk of diabetes. Activities in November included a national roadshow that visited 33 locations in 14 towns and cities, and the launch of an online version of the risk awareness tool, so everyone could assess their risk
Hi neighbours! Make the perfect pet bed for your furry friend that works with your décor. It's easy to make a handmade rope basket using touches of your favourite Resene colours with Resene testpots. Choose colours to suit your room’s colour scheme and match with your furry best friend! Make the most of your weekend with this easy step by step project idea from Resene. Find out how to create this quick and easy project yourself.
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