Self – Management Strategies as a Pillar in Treatment for Patients With Diabetes Mellitus
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Florez Builes, Luisa Fernanda
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Florez Builes, Luisa Fernanda. 2020. Self – Management Strategies as a Pillar in Treatment for Patients With Diabetes Mellitus. Master's thesis, Harvard Medical School.Abstract
As diabetes incidence and prevalence continues to rise, so does the necessity for an efficacious and cost-effective treatment approach that could decrease its complications and mortality rate.Diabetes is one of the most common chronic diseases worldwide. Patients with this condition suffer from sustained hyperglycemia which is associated with acute and chronic complications that could affect multiple body organs. While patients with type 2 diabetes have multiple medications available, many of them eventually require insulin at some point during the course of their disease.
Insulin has no contraindications and high efficacy for lowering blood glucose; nevertheless, patients with type 2 diabetes frequently delay initiation of insulin therapy. We therefore conducted a retrospective observational analysis to better understand the clinical course of patients with type 2 diabetes who decline insulin therapy. Our results suggest that there are specific patient characteristics and therapeutic actions that could predict the clinical outcome of this population by leading them to either, a better or a worse glycemic control.
It is also important to note that patients with both type 1 and type 2 diabetes who use insulin commonly experience dangerous hypoglycemic episodes while still facing a risk of a hyperglycemic state when the disease is not properly controlled. We conducted a clinical trial to test whether the Control:Diabetes mobile app can reduce hyper- and / or hypoglycemia in patients with diabetes treated with insulin. The Control:Diabetes mobile app was created to teach users how to treat their disease through repeated self-feedback. Our preliminary results suggest that after 3 weeks of using the Control:Diabetes mobile, participants may be able to reduce frequency of hypoglycemic episodes by also improving their accuracy in blood glucose prediction.
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