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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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.
This patient sample came from patients in secondary care diabetes clinics, and therefore, app use may be different amongst patients managed in primary care. Similarly, findings may not generalize to patients with poorer glycemic control as responders had statistically significantly lower HbA1c than non-responders. This was a cross-sectional survey that is useful to assess app use at one point in time, but it is likely that people vary their app use and recommendations over time. It was therefore not possible to assess whether the introduction of an app has significant effect on clinical outcomes. Our study did not address the difference in needs in app features between responders on insulin and those not on insulin. Overall the response rates for both surveys were low and responses were limited by self-report and therefore liable to responder bias.
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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.
Māori Health Services at Tauranga and Whakatāne hospitals delivers health initiatives under the philosophy of Tangata Whenua Realities, Ngā Pou Mana o Io. The health model of Mana Atua, Mana Tūpuna, Mana Whenua, Mana Tangata, operates alongside clinical and rehabilitation services, Mental Health & Addiction Services and Regional Community Services.