Participants could choose to receive blood glucose monitoring reminders to which they could reply by sending in their result by text message. They could then view their results graphically over time on a password protected website. If they were identified as not having access to the internet at baseline they were mailed their graphs once a month. All messages were delivered in English although the Māori version included keywords in Te Reo Māori and the Pacific version had keywords in either Samoan or Tongan dependent on ethnicity. Examples of SMS4BG messages can be seen in the box. Participants were able to select the timing of messages and reminders, and identify the names of their support people and motivations for incorporation into the messages. The duration of the programme was also tailored to individual preferences. At three and six months, participants received a message asking if they would like to continue the programme for an additional three months, and had the opportunity to reselect their modules receiving up to a maximum nine months of messages. Participants could stop their messages by texting the word “STOP” or put messages on hold by texting “HOLIDAY.”
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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
The control group also experienced a decrease in HbA1c from baseline to the nine month follow-up, and experienced improvements in secondary outcomes, which could indicate trial effects. Previous research has shown that recruitment to a clinical trial alone can result in improvements in HbA1c,43 but it is not expected that these improvements would be sustainable past the initial few months without intervention.
The message delivery was managed by our content management system, with messages sent and received through a gateway company to allow for participants to be registered with any mobile network. Sending and receiving messages was free for participants. The system maintained logs of all outgoing and incoming messages. Further details of the intervention can be seen in the published pilot study,28 and protocol.30
We thank the participants who took part in this study as well as the staff at the primary care practices and diabetes clinics across New Zealand who referred their patients to the study; the National Institute for Health Innovation’s IT team for their work on the text message delivery system, and all those involved in the study design and set up; Coral Skipper, Louise Elia, Erana Poulsen, and Hamish Johnstone (Māori Advisory Group members); Aumea Herman (Pacific adviser); Joanna Naylor and Michelle Garrett (content development advisers); Richard Edlin (health economist); Mahalah Ensor (assistance with recruitment); Hannah Bartley, Rachel Sullivan, Anne Duncan, and Gillian Lockhart (research assistants); Michelle Jenkins and John Faatui (data management support); and Karen Carter and Angela Wadham (project management support).
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.
The incidence of type 1 diabetes was higher in New Zealand Europeans than other ethnic groups throughout the study period (Figure 2, p<0.0001). There was little difference in incidence among non-European ethnic groups. The annual incidences (per 100,000) by 2009 were: Europeans 32.5 (95% CI 23.8–43.3), Non-Europeans 14.4 (95% CI 9.2–21.4), Maori 13.9 (95% CI 5.2–29.7), Pacific Islanders 15.4 (95% CI 7.3–28.5), and Other 13.5 (95% CI 5.8–26.8). The rate of increase in incidence over the study period was very similar across all ethnicities, as illustrated by the slopes in Figure 2. However, while the average increase in incidence was higher for Europeans than Non-Europeans in children of all age groups (Table 1), the increase was proportionally lower in Europeans (2-fold) than Non-Europeans (3-fold) due to a lower baseline incidence in the latter group (Figure 2). Nonetheless, in both ethnic groups type 1 diabetes incidence in children 10–14 yr increased at a higher rate than in the youngest 0–4 yr group, with a >2-fold difference observed among both Europeans and Non-Europeans (Table 1). Age at diagnosis across the study period was similar in both ethnic groups (p = 0.47).
Diabetes Stops Here will provide snap shots of the people who are committed to putting an end to this disease, from inspiring volunteer stories to moving staff experiences to celebrity stories about how to be successful while living with diabetes. The stories, interviews and news will be shared by the blog’s author, a staff member at the American Diabetes Association, who has lived with type 1 diabetes for nearly ten years.
Subway® is celebrating World Sandwich Day today and we're helping feed the hungry in our community! Last year, we donated over 90,000 meals to KiwiHarvest. With your help, we can feed even more this year. So, join the Subway® Live Feed and head to your local participating Subway® in Bay of Plenty. Buy a Sub. Get one FREE. AND Subway® will donate a meal to charity. Because everyone deserves a good feed. Find out more!