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Technology Improving Health in Diabetes

LG is a 35-year-old Latina woman with type II diabetes, BMI of 31.5 and HbA1C averaging 9.5. Despite implementing a meal plan recommended by the dietitian and walking 30 min every day, her lab values remain in an unacceptable range. At times she forgets to take her oral hypoglycemic agent. She is highly motivated to change her behavior and is open to new ideas. She has a cell phone and has been testing her blood glucose in the morning several times a month.

The nurse in the primary care clinic meets with her to understand her goals and her barriers to achieving her goals. They agree to try new strategies for a month-long trial. Given LG’s goals to increase her physical activity and improve her dietary intake of fruits and vegetables, they select the following tools, all connecting to her iPhone and using iHealth to collect and summarize the data:

• app to track dietary intake

• app to track medications

• activity tracker to record steps, sleep and activity patterns

• blood glucose monitor for paired glucose testing before and after planned exercise and selected meals

Each week they meet to review the data together and to discuss trends and patterns. At the end of a month, they identify the impact of specific dietary choices and patterns and type of physical activity on her blood glucose patterns and prioritize her strategies going forward.