Sexual problems are common in the general population but people with diabetes are at an increased risk. The biological effects of diabetes can affect both men and women although the correlation between diabetes and sexual function in women is poorly understood. It is important to ask both male and female patients if they are experiencing any issues regarding their sexual functioning.
With technology advancing rapidly, there is a call for mHealth to move towards more complex technology. However, this study has shown that text messaging—available on any mobile phone—although simple, is still potentially effective for improving glycaemic control. Equally, this study had very few technical difficulties, which probably contributed to the high satisfaction with the intervention. The individual tailoring of the intervention, and ability for participants to choose varying components and dosages, means that questions remain around the ideal duration for implementation as well as the components most important for effectiveness. Further research is needed to understand the components of this intervention that are most effective and the ideal intervention dosage to further refine this intervention and inform the development of future interventions. With participants highly satisfied with the intervention and largely happy with their intervention dosage, but great variance in the modules, durations, and dosages, SMS4BG may need to remain individually tailored in this way, resulting in a more complex intervention for delivery until further investigation on this can be made.
The majority of responders were not using diabetes apps (80.4%, 152/189), although 60.5% (89/147) reported they would be interested in trying one. Of the 118 people who answered the question, the reasons for not using an app was not knowing they existed (66.9%, 79/118), feeling confident without one (16.9%, 20/118), discontinued use after having used an app previously 16.9% (20/118).
Increase your physical activity. Exercise is a very important tool to help lower your blood glucose. Prior to starting any exercise program, you will need to consult with your doctor. Make exercise routine with activities you enjoy. In addition to helping manage your blood glucose, exercise helps lower blood pressure and improves balance, flexibility and muscle strength. Exercise may even help to reduce anxiety and depression. Go out and play!
Data sharing: The research team will consider reasonable requests for sharing of deidentified patient level data. Requests should be made to the corresponding author. Consent for data sharing was not obtained but the presented data are anonymised and risk of identification is low. The original protocol30 is available from the corresponding author on request.
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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
Strengths of the current study included its sample size, diverse population, very low loss to follow-up, pragmatic design, absence of protocol violations, and objectively measured primary outcome. Although the initial sample size target was not reached, the final sample of 366 participants is larger than previous randomised controlled trials in this area. This study contributes valuable evidence to the literature on the use of text messages in diabetes particularly for individuals with poor control. Considering poorer outcomes are experienced by ethnic minority groups, a strength of this study was its high proportion of participants representing these groups.
The annual incidence of type 1 diabetes in children <15 yr in the Auckland population in 1990–2009 was 16.4/100,000 (95% CI 15.3–17.5). Considering the underlying 36% population growth over the 1990–2009 period, there was still a progressive increase in the incidence of new cases (p<0.0001; Figure 1A). By Poisson regression the type 1 diabetes incidence in children <15 yr in 2009 was 22.5 per 100,000 (95% CI 17.5–28.4), in comparison to 10.9 per 100,000 in 1990 (95% CI 7.0–16.1) (Figure 1A). Overall incidence among males and females across the 20-year period was similar (p = 0.49). The increase in incidence was greatest among children 10–14 yr (average increase of +0.81/year; p<0.0001) and lowest among children 0–4 yr (+0.32/year; p = 0.02); incidences by 2009 were 27.0 (95% CI 18.1–38.8) for children 10–14 yr, 25.4 (95% CI 16.5–37.3; +0.66/year; p = 0.0002) for children 5–9 yr, and 14.9 per 100,000 (95% CI 8.4–24.5) for those aged 0–4 yr (Figure 1B).

Today’s first post is titled “Why ‘Stop Diabetes’?” can be found at www.diabetesstopshere.org. This initial post seeks to explain why the Stop Diabetes movement was created and its goal for engaging the public.  “The goal of the Stop Diabetes movement is to grow to epic proportions, to be bigger than the disease itself,” the blog explains. “In short, it’s the answer to why the Association does the work that it does.”
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.
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).
Most people know that diabetes involves the inability to control glucose, or blood sugar, by not producing enough insulin or not managing it correctly. This leads to elevated levels of glucose in the body, which can result in very serious complications, such as heart attack, stroke, kidney disease, nerve damage, hardening of the arteries, foot and leg amputation and blindness. (more…)
Owing to individual tailoring, participants in the intervention group received varying numbers of messages. Half the participants (92/183) received messages for three months, an additional 18% (33/183) chose to continue the messages for six months, and the remaining 32% (58/183) chose to continue the messages to the maximum nine months. Only three participants chose to stop their messages early. A total number of 76 523 messages were sent by the system to participants (median number of messages per participant 242 (interquartile range 122-511; range 14-2050)), and 16 251 messages of blood glucose results were sent into the system by participants receiving the reminders (68 (1-169; 0-917)).
In the U.S., there are nearly 26 million people living with diabetes, and more seniors have diabetes than any other age group. Currently, one in four Americans (10.9 million, or 26.9 percent) over the age of 60 is living with diabetes. With age comes an increased risk for specific complications that require diligence and care to properly mitigate them.
The 60.2% of HPs in our survey who had recommended a diabetes app is significantly higher than previously documented amongst physicians across a range of specialties [28], although it is similar to HPs’ recommendation for any type of health app [19]. We did not observe any effect of HPs’ age on app recommendation, although it is previously well established that younger HPs are more likely to adopt mHealth for diabetes [28].
The World Health Organisation (WHO) has mandated November 14 as World Diabetes Day, an international event to raise awareness about diabetes. Close to 350 million people in the world have diabetes and WHO reports that a person dies from this disease every 6 seconds – that’s 5 million deaths. Currently 1 in 11 adults have diabetes worldwide and this is predicted to increase to 1 adult in 10 (652 million) by 2040. Sobering statistics indeed.
To assess whether changes in incidence were more marked in certain age groups (as observed overseas [3], [4]), patients were also categorised into three bands according to age at diagnosis: 0–4 yr (children less than 5 yr), 5–9 yr (equal or greater than 5 yr but less than 10 yr), and 10–14 yr (equal or greater than 10 yr but less than 15 yr). These age bands also match national census classifications. The incidence of type 1 diabetes was assessed as the number of new diagnoses per 100,000 age-matched inhabitants on a given year, based on the 5-yearly national census data from Statistics New Zealand [12] and interpolated estimates of the population for the intervening years. Incidence was modelled using the Poisson distribution. Point estimates were calculated with exact Poisson confidence limits, and change in incidence over time were analysed using Poisson regression. Changes in patient numbers, age at diagnosis, and anthropometric data over time were assessed by linear regression. Poisson modelling was undertaken using StatsDirect v2.7.8 (StatsDirect Ltd, UK); other analyses were undertaken using JMP v. 5.1 (SAS Inc, USA).

In a perfect world, the answer to the question “should someone with diabetes take steroids?” would be a simple “no”. Of course, not only do we not live in a perfect world, there are also few simple answers for diabetics. Steroids can play havoc with blood sugar levels, but they can also be the best choice in treating some very serious conditions. So, perhaps the better answer would be “maybe” with the added caveat of making sure you are aware of the consequences and prepared to be proactive in managing them.   (more…)

With technology advancing rapidly, there is a call for mHealth to move towards more complex technology. However, this study has shown that text messaging—available on any mobile phone—although simple, is still potentially effective for improving glycaemic control. Equally, this study had very few technical difficulties, which probably contributed to the high satisfaction with the intervention. The individual tailoring of the intervention, and ability for participants to choose varying components and dosages, means that questions remain around the ideal duration for implementation as well as the components most important for effectiveness. Further research is needed to understand the components of this intervention that are most effective and the ideal intervention dosage to further refine this intervention and inform the development of future interventions. With participants highly satisfied with the intervention and largely happy with their intervention dosage, but great variance in the modules, durations, and dosages, SMS4BG may need to remain individually tailored in this way, resulting in a more complex intervention for delivery until further investigation on this can be made.
In a perfect world, the answer to the question “should someone with diabetes take steroids?” would be a simple “no”. Of course, not only do we not live in a perfect world, there are also few simple answers for diabetics. Steroids can play havoc with blood sugar levels, but they can also be the best choice in treating some very serious conditions. So, perhaps the better answer would be “maybe” with the added caveat of making sure you are aware of the consequences and prepared to be proactive in managing them.   (more…)
Your health professional at the Centre may suggest that they make a referral for you, if there are problems affecting your diabetes management or your overall health and management. Alternatively you can ask your family doctor or nurse to refer you. If you are uncertain about whether it would be helpful to see us, you are most welcome to phone us directly to discuss this. Phone 3640 860 ext 89113.
Almost two-thirds of HPs responding had recommended a diabetes app to patients. Dieticians were more likely to recommend an app than others. Blood glucose and carbohydrate diaries were considered the most useful feature and HPs were most confident to recommend blood glucose diaries. HPs are the least confident recommending insulin dose calculation functions. Over one-third of HPs desire guidance with app recommendations.
ED is a failure to obtain/maintain penile erection sufficient for intercourse is more prevalent in men with diabetes and increases with age.  It is important to distinguish erectile failure from premature ejaculation, decreased libido and other problems as these have different causes and treatment. ED in diabetes is largely due to failure of vascular smooth muscle relaxation secondary to endothelial dysfunction and/or autonomic neuropathy.
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