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).

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).

Cost effectiveness as well as healthcare use was assessed during the study period compared with the nine months before randomisation (presented separately). We measured patient engagement and satisfaction with the intervention using semistructured interviews and data from the content management system. The secondary outcomes health related quality of life and perceived social support were not included in the initial trial registration but added before commencing the trial.
There are a variety of mobile apps for people with diabetes. They can be a useful way to learn about and take control of your diabetes. Many apps have features that enable you to record your blood glucose levels, food, medication and physical activity. By looking for patterns or trends in your results and discussing them with your healthcare team, you can learn how to make changes to your diabetes management plan and better manage your diabetes. The Health Navigator team have reviewed some diabetes apps that you might to consider.   
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!
Participants were referred to the study by healthcare professionals at their primary and secondary care centres across New Zealand. Additionally, participants could self refer to the study. Eligible participants were English speaking adults aged 16 years and over with poorly controlled type 1 or 2 diabetes (defined as glycated haemoglobin (HbA1c) concentration ≥65 mmol/mol or 8% in the preceding nine months). The initial protocol required HbA1c concentration above the cutoff level within the past three months, but after feedback from patients and clinicians, this period was extended to nine months to ensure a greater reach across those people not having regular tests. Participants required access to a mobile phone and needed to be available for the nine month study duration.

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.

Phoenix Health Centre carries out pre employment medical assessments for several large employers in Whakatane. These give a base line recording of an employee’s health status at the time they were employed. It is then possible to monitor the employee’s health in relation to the hazards they may be exposed to in the workplace. If required we also undertake monitored urine sampling for ESR drug testing.