New Zealand Europeans had a significantly higher incidence rate than Non-Europeans, which is consistent with other studies [21], [22]. There was a marked decrease in the proportion of Europeans in Auckland over the study period, so that the increase in type 1 diabetes incidence was not due to a shift in ethnic distribution. Furthermore, the incidence has been increasing in both Europeans and non-Europeans. A number of studies have shown that immigrant groups display higher rates of type 1 diabetes than in their countries of origin, particularly those that move into societies with a westernised lifestyle [23], [24]. For example, although type 1 diabetes in Polynesia is extremely rare, an abrupt increase in incidence occurs in Pacific Island peoples who migrate to New Zealand [25]. Our study provides evidence that the factors leading to an increase in incidence are operating across all ethnicities. Indeed, the incidence of type 1 diabetes has been remarkably similar over time for the indigenous Maori and the largely newly immigrant Pacific Island and Other ethnic groups.
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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This study shows the potential of SMS4BG to provide a low cost, scalable solution for increasing the reach of diabetes self management support. It showed that a text messaging programme can increase a patient’s feelings of support without the need for personal contact from a healthcare professional. Half of the intervention group reported sharing the messages with others. Traditional education for diabetes self management is delivered to individual patients, but there is benefit of support from other people being involved.45 This is particularly pertinent to ethnic populations such as Māori groups, in whom family have an important role in supporting diabetes self management.46
SMS4BG was delivered in the English language (with the exception of some Māori, Samoan, and Tongan words). With high rates of diabetes in ethnic minority groups, delivery of this type of intervention in languages native to these groups could provide greater benefit. It is likely that some people were not referred to the study, or were unable to take part, due to the criteria that they must be able to read English. SMS health programmes have been translated into other languages such as Te Reo;44 thus, further research needs to look at whether such translations would be of benefit in SMS4BG.
Overall, all five potential app features were considered useful, with more than 60% of responders selecting that these features were useful, very useful, or extremely useful on the scale of scale 1 (not at all useful) to 5 (extremely useful). Equally, the mean usefulness score was higher than 3 for all 5 features. Blood glucose and carbohydrate intake diaries were rated as being the most useful app feature (Figure 1), with the highest mean score of 3.64 (SD 0.948) for usefulness (Table 7).
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.
The good news is that there are things you can do to prevent these diabetes-related problems, no matter your age. Taking action now will help with your later years, so you can live a healthy life and see your grandchildren grow into beautiful and healthy men and women. And, it’s the perfect time to think about this because National Grandparents Day is on Sunday.
Data were imported into SPSS version 24 (IBM). Incomplete responses were included in the analysis. In the patient survey, independent sample t tests were conducted to compare mean clinical variables (age, BP, C:HDL, LDL, HbA1c) by type of diabetes, method of recruitment, and whether the responder used a diabetes mobile phone app. Adjustment was made for unequal variances. Normal distribution was assumed for all variables, apart from urinary microalbumin to creatinine for which a Wilcoxin test was used. No statistically significant differences in these variables or in mobile phone app use were found between patients with recorded email addresses and patients phoned for their email address. Therefore, all 189 responses were combined for further analysis. Chi-square tests were used to compare medications and survey responses by type of diabetes. Statistical significance was determined by exact 2-sided P values less than .05. In the HP survey, mean values on the usefulness and confidence Likert scales were calculated to compare app features.
24. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009 Apr;42(2):377–81. doi: 10.1016/j.jbi.2008.08.010. http://linkinghub.elsevier.com/retrieve/pii/S1532-0464(08)00122-6. [PMC free article] [PubMed] [CrossRef]
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!
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