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.
A nine month, two arm, parallel, randomised controlled trial was conducted in adults with poorly controlled diabetes between June 2015 and August 2017. The study received ethical approval from the Health and Disability Ethics Committee (14/STH/162), and the protocol was published30 and registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614001232628). Trial development and reporting was guided by the CONSORT31 and CONSORT EHEALTH32 statements.
Contributors: RW obtained funding for this trial. All coauthors had input into the study protocol. RD, RW, RMu, and MS contributed to the development of the intervention content. RD managed the day-to-day running of the trial and delivery of the intervention. RD and RW collected the data. YJ and RD did the data analyses. All coauthors were involved in the interpretation of the results. RD wrote the article with input from all coauthors. All authors, external and internal, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. All authors approved the final version of this manuscript. RD is guarantor. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

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]
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.
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.

In contrast with the extensive app problems presented in the literature, over half of the responders with an app reported no problems [5,11-13,15]. This discrepancy may be due to false self-report or responders may have tried multiple apps before finding the one they like. Our study is unable to add significantly to literature about insulin dose calculation problems [15], as only 7 responders reported using their app for insulin calculation. However it is notable that this feature is desired by users and reinforces the importance of having a regulated environment to ensure safety.
This cross-sectional observational study used two surveys (see Multimedia Appendices 1 and 2), one for people with diabetes attending a secondary care diabetes outpatient clinic and the second for HPs (who treat people with diabetes) attending a national diabetes conference. Both surveys were multi-choice format, collected, and managed using REDCap electronic data capture tools. REDCap (Research Electronic Data Capture) is a secure, Web-based app designed to support data capture for research studies [24]. The survey questions were derived from criteria in the Mobile app rating scale [25] to address attitudes and practices of both the people with diabetes and HPs. The list of apps was compiled by searching Apple and Android App stores and included the first consecutive ten diabetes apps. We eliminated any apps not specific to diabetes by reviewing app store descriptions. We reviewed the main features from these apps to develop the list of app features. The patient survey asked responders to select any useful app features from a list. Responders could select more than one useful app feature. The HP survey listed app features and used a scale to assess usefulness of app features (from 1 [not at all useful] to 5 [extremely useful]) and their confidence in recommending apps (from 1 [not at all confident] to 5 [extremely confident]).
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
The control group also experienced a decrease in HbA1c from baseline to the nine month follow-up, and experienced improvements in secondary outcomes, which could indicate trial effects. Previous research has shown that recruitment to a clinical trial alone can result in improvements in HbA1c,43 but it is not expected that these improvements would be sustainable past the initial few months without intervention.
It’s heart-wrenching to watch all that people go through as natural disasters play out on our television screens. Tucked away, along with sympathy for those in the midst of a hurricane, earthquake, flood or other catastrophic events, is the very understandable thought, “I’m so glad that’s not happening to me!”. The truth is, however, that we are all susceptible to major life-changing events, and they can happen with very little notice. Those with a chronic medical condition, like diabetes, are especially vulnerable and should take seriously the advice to be prepared.    (more…)

‘I was very pleased to contact your service. I was feeling overwhelmed with my current situation however knew that I needed to get a diabetes test done. While I was waiting for my turn to be tested Susan welcomed me, helped my overwhelming feelings calm down, she was very approachable and understanding. Sandy followed through by assisting me with assurance that things were going to be okay and was very understanding. She encouraged that I seek more medical advice for my blood pressure results. She phoned my manager and found me a local GP that I could visit right away. I was very appreciative of these ladies and all the help, care and advice they gave me. Thank you so much!’
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)).
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.
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Nearly half of American adults have diabetes or prediabetes; more than 30 million adults and children have diabetes; and every 21 seconds, another individual is diagnosed with diabetes in the U.S. Founded in 1940, the American Diabetes Association (ADA) is the nation’s leading voluntary health organization whose mission is to prevent and cure diabetes, and to improve the lives of all people affected by diabetes. The ADA drives discovery by funding research to treat, manage and prevent all types of diabetes, as well as to search for cures; raises voice to the urgency of the diabetes epidemic; and works to safeguard policies and programs that protect people with diabetes. In addition, the ADA supports people living with diabetes, those at risk of developing diabetes, and the health care professionals who serve them through information and programs that can improve health outcomes and quality of life. For more information, please call the ADA at 1-800-DIABETES (1-800-342-2383) or visit diabetes.org. Information from both of these sources is available in English and Spanish. Find us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn)
Diabetes Depot carries a full line insulin pump supplies, including all major insulin infusions sets, insulin reservoirs and cartridges available in Canada, all at significant discounts below the manufacturer's list price. Our product line of diabetic supplies, required daily by people living with diabetes, include blood glucose meters, glucose test strips, lancets, insulin pen needles, insulin products, Dex-4 glucose tablets and Emla anesthetic cream. We also carry accessories such as pump clips, pump cases & pouches, prep pads, battery caps, diabetic socks, and helpful books on diabetes… everything an insulin pump user would require. Plus, because the Diabetes Depot is located within Stutt's Pharmacy, we also offer a complete prescription service.
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…)

Funding: The development of SMS4BG was funded by Waitemata District Health Board. The randomised controlled trial was funded by the Health Research Council of New Zealand in partnership with the Waitemata District Health Board and Auckland District Health Board (through the Research Partnerships for New Zealand Health Delivery initiative), and the New Zealand Ministry of Health. The funders were not involved in any way in the preparation of the manuscript or analysis of the study results. No payment has been received for writing this publication.
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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).
We saw no significant interaction between the treatment group and any of the prespecified subgroups: type 1 versus type 2 diabetes (P=0.82), non-Māori/non-Pacific versus Māori/Pacific ethnicity (P=0.60), high urban versus high rural/remote region (P=0.38). Adjusted mean differences on change in HbA1c from baseline to nine months for patients with type 1 and type 2 diabetes were −5.75 mmol/mol (95% confidence interval −10.08 to −1.43, P=0.009) and −3.64 mmol/mol (−7.72 to 0.44, P=0.08), respectively. Adjusted mean differences for non-Māori/non-Pacific and Māori/Pacific people were −4.97 mmol/mol (−8.51 to −1.43, P=0.006) and −3.21 mmol/mol (−9.11 to 2.70, P=0.28), respectively. Adjusted mean differences for participants living in high urban and high rural/remote areas were −4.54 mmol/mol (−8.40 to −0.68, P=0.02) and −3.94 mmol/mol (−9.00 to 1.12, P=0.13), respectively (table 3).
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].
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.
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.
I am passionate about diabetes education, so when you purchase from the Diabetes Depot, you also have at your disposal the resources of a pharmacist, a Certified Diabetes Educator and a fellow pumper. I am a member of a Peterborough Family Health Team, where I have the opportunity to help clients manage their diabetes. I have given many lectures on the management and prevention of diabetes complications to both patient groups and health care professionals throughout Canada, and am the proud recipient of numerous awards for this work. I hope my effort to provide lower-cost insulin pump supplies to Canadians will help you, and I again invite you to contact me with your specific diabetes questions.
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.
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.

Height and weight were recorded for 660 patients at their required first post-diagnostic clinic (on average 15 weeks from diagnosis) from 1994 onwards. Annual mean BMI SDS of newly diagnosed type 1 diabetes did not alter (average non-significant change smaller than ±0.02 SDS/year) over the period for the entire population, or for any gender, age, or ethnicity sub-group. There was no association between BMI SDS and age at diagnosis.
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