Jacob Molyneux, senior editor

bloodglucosetestingType 2 diabetes is challenging for those trying to meet blood glucose target ranges, often requiring one or more daily medications, increases in exercise, changes in eating habits, and self-monitoring of glucose level. Those who are willing and able to learn about factors affecting their glucose level and to make small daily efforts in one or more areas have the potential to radically improve their sense of control over their diabetes.

This month’s Diabetes Under Control column, “Better Type 2 Diabetes Self-Management Using Paired Testing and Remote Monitoring” (free until April 1), presents a successful story of patient engagement in diabetes self-management. It describes the case of a participant in a clinical trial who, with clinician support, incorporated paired glucose testing (self-testing before and after meals) and telehealth (remote patient monitoring, or RPM).

The article is easy to follow and gives a series of biweekly updates on the patient’s progress. Before the study starts, she’s not very engaged in self-management. For example, she’s only testing her own glucose level three to four times a month. To get a sense of how much more empowered she’s come to feel by week 12 of the protocol, consider this brief excerpt:

Week 12. MI looked back and reflected on how she’d benefited and what she’d learned during the past 12 weeks. “I can’t believe where I started and where I’m at today, thankfully in better health. I have learned so much about me and diabetes, and along the way I became better; now being active is a way of my daily life, eating healthier is normal, and making time each week to prepare for my workweek has probably been my success. I came to this study to lower my A1C [HbA1c], but I came out winning so many great things that I didn’t foresee happening. A friend has challenged me to a 10K and I’m taking that challenge. I’m also going to focus on bringing my weight down. I am now down one full pants size, but that has not been my main focus; it’s been how I eat and what I eat, and how I stay active and how it all comes together.”

Since we’re hearing more and more about patient engagement in the management of chronic conditions, as well as the various uses of telehealth, it’s important to better understand the factors that are necessary for success with such an approach, as well as potential barriers to success. The article increases our understanding of these as well.

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