Results The reduction in HbA1c at nine months was significantly greater in the intervention group (mean −8.85 mmol/mol (standard deviation 14.84)) than in the control group (−3.96 mmol/mol (17.02); adjusted mean difference −4.23 (95% confidence interval −7.30 to −1.15), P=0.007). Of 21 secondary outcomes, only four showed statistically significant improvements in favour of the intervention group at nine months. Significant improvements were seen for foot care behaviour (adjusted mean difference 0.85 (95% confidence interval 0.40 to 1.29), P<0.001), overall diabetes support (0.26 (0.03 to 0.50), P=0.03), health status on the EQ-5D visual analogue scale (4.38 (0.44 to 8.33), P=0.03), and perceptions of illness identity (−0.54 (−1.04 to −0.03), P=0.04). High levels of satisfaction with SMS4BG were found, with 161 (95%) of 169 participants reporting it to be useful, and 164 (97%) willing to recommend the programme to other people with diabetes.

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.


This study showed that a tailored and automated SMS self management support programme has potential for improving glycaemic control in adults with poorly controlled diabetes. Although the clinical significance of these results is unclear, and the full duration of these effects is yet to be determined, exploration of SMS4BG to supplement current practice is warranted.
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).
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The SMS4BG (self management support for blood glucose) intervention was developed to address the need for innovative solutions to support self management in adults with poorly controlled diabetes.28 The individually tailored intervention provides information and support designed to motivate a person to engage in the behaviours required to manage their diabetes effectively for long term health improvement. The development of SMS4BG followed the mHealth Development and Evaluation Framework29 (including extensive formative work and end user engagement to ensure that it met the needs of the population it was designed to reach) is evidence based and theoretically grounded. A previous pilot study found SMS4BG to be acceptable and perceived it as useful.28 This study aimed to determine the effectiveness of the mHealth diabetes self management support programme—SMS4BG in adults with poorly controlled type 1 or type 2 diabetes, in addition to their usual diabetes care.

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.


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.”
There are three forms of the disease. People with Type 1 Diabetes typically make none of their own insulin and therefore require insulin injections for survival. People with Type 2 Diabetes, the form that comprises the majority of all cases, usually produce their own insulin, but not enough or they are unable to use it properly. Then there is Gestational Diabetes; globally, 1 in 7 births is affected by gestational diabetes. While maternal blood glucose levels usually return to normal after the baby is born, there is an increased risk of both mother and child developing Type 2 Diabetes later in life.

-Learn to eat well-balanced meals that include healthful food choices (vegetables, fruits, whole grains, etc.) and watch your portion sizes. Even foods that are good for you can add pounds to your waistline, if you consume too much of them. Losing those extra pounds will help you manage not only your diabetes, but also other health problems you may have.
Some of the most vocal diabetes stories come from blogs and other social media platforms which create a broad online community of people who have diabetes or whose loved ones are living with the disease.  “By means of this blog,” noted Hausner, “we hope to add our voice to this dialogue and further engage with those who may be well aware of the effects diabetes can have on their lives.”
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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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This study found that a tailored, theoretically based, SMS based, diabetes self management support programme led to modest improvements in glycaemic control. The effects of intervention were also seen in four of 21 secondary outcomes, including foot care behaviour and ratings of diabetes support. The programme showed a high level of acceptability with the overwhelming majority of participants finding the intervention useful and willing to recommend it to others.
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!

This study found that a tailored, theoretically based, SMS based, diabetes self management support programme led to modest improvements in glycaemic control. The effects of intervention were also seen in four of 21 secondary outcomes, including foot care behaviour and ratings of diabetes support. The programme showed a high level of acceptability with the overwhelming majority of participants finding the intervention useful and willing to recommend it to others.


In Type 1 Diabetes, symptoms are often sudden and can be life-threatening; therefore it is usually diagnosed quite quickly. In Type 2 Diabetes, many people have no symptoms at all, while other signs can go unnoticed, being seen as part of ‘getting older’. Therefore, by the time symptoms are noticed, complications of diabetes may already be present.
However, there are concerns about the appropriateness and safety of apps for diabetes self-management [5,11-13,15]. In 2013 only 1 of 600 diabetes apps reviewed in the USA had received FDA clearance [11]. Similarly a review, specifically of insulin dose calculator apps, determined that only one of 46 calculators was clinically safe. The most common issue was that calculators accepted implausible values for blood glucose readings (eg, negative values), yet would still provide an advised insulin dose [15]. HPs are also concerned about app safety [19] and are advised to take care when advising apps to patients [15]. In the United Kingdom, The Royal College of Physicians Health Informatics Unit (London) has developed a checklist for assessing app quality [19]. However, the multitude of factors HPs must consider while recommending apps, including patient familiarity with technology, app features, ease of use, and FDA approval [19] may be burdensome and not practical in day to day clinical care.

I act as a care giver for my grandparents who both suffer from type 2 diabetes. This article is right on point with having to make changes to one’s diet to help control blood glucose and overall health such as heart disease as well as staying active and exercising. The two naturally go hand in hand, but many diabetics like my grandparents have foot complications with swelling and neuropathy, requiring proper fitting footwear that is hard to find if you don’t know where to look. I found this guide on shoes for diabetics that helps explain what they are and their importance, especially for diabetics. Hopefully others find it as helpful as I did when caring for those diagnosed with diabetes.
Only children aged <15 yr were included. Type 1 diabetes was diagnosed based on clinical features. All patients had elevated blood glucose at presentation: either a random measurement of ≥11.1 mmol/l and presence of classical symptoms, or fasting blood glucose ≥7.1 mmol/l. In addition, all patients met at least one of the following criteria: a) diabetic ketoacidosis; b) presence of at least two type 1 diabetes antibodies (to glutamic acid decarboxylase, islet antigen 2, islet cell, or insulin autoantibodies); or c) ongoing requirement for insulin therapy. Clinical and demographic data were prospectively recorded on all patients at each outpatient visit.
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