Martha SparksSociety Editor
September 16, 2012
CHAPMANVILLE — According to the Centers for Disease Control and Prevention, Diabetes affects 25.8 million people or 8.3 percent of the U.S. population. Among U.S. residents aged 65 years and older, 10.9 million, or 26.9 percent had diabetes in 2010. It is the seventh leading cause of death in the United States.
West Virginia has been reported to have the highest incidence of diabetes and obesity nationwide with significant increases reported throughout the Appalachian region.
There several classifications of diabetes, but the most common is Type 1 Diabetes, which requires insulin injections to control sugar levels, and Type 2 Diabetes that can be treated by eating right, exercising on a regular basis and testing blood sugar.
Education is key in the management of diabetes and provides a better understanding of related conditions with the progression of disease. How to best provide diabetes education is what University Physicians and Surgeons Inc. will be researching in the ADVANCE (Advancing Diabetes Care through Awareness, Compliance and Education) Diabetes Project.
The incidence of obesity and Type 2 diabetes mellitus is increasing worldwide at an alarming rate. Abid Yaqub, MD, FACP, FACE, FCPS, the principal investigator of the project, says Type 2 Diabetes is a disease significantly associated with life style factors.
“Counseling and education aimed at modification of these life style factors and designed to empower patients with knowledge and skills for self management of diabetes is an integral part of disease management,” said Yaqub.
The ADVANCE project is aimed toward identifing an effective way to deliver diabetes education through available and expanding technologies in innovative ways that can contribute to better management of diabetes through behavior modification and through targeted education, provide a better understanding of related conditions with the progression of disease.
“We believe health care providers are not effectively delivering the educational message about the complications of diabetes due to multiple competing issues during office visits with this population of patients,” said Mary Beth Cordle, Principal Research Coordinator. “Patients need to receive both verbal and written communication with the opportunity to ask questions to enhance their understanding, knowledge and self-management. To provide patients with the necessary information to better manage their diabetes, we deliver an abundance of information that is often more than the patient can absorb in one setting. We propose a more targeted approach with focused educational counseling on one aspect of the disease. Several studies done in other settings suggest that there is additional benefit when the educational counseling also includes family or peer support.”
Researchers with the ADVANCE project plan to enroll patients who are currently seen or can be seen at the Coalfield Health Center clinic practice on Airport Road in Chapmanville. About 64 people will take part in this project. Participation in the study is voluntary and there is no costs involved.
“All project participants will see their regular doctor or nurse and receive the same standard of care they routinely receive,” said Cordle. “Patients are encouraged to bring a family member or friend to regular clinic visits who can help or encourage them.”
Patients participating in the research will be divided into two groups. One group will use their cell phone to text a fasting blood sugar and weight each week as directed for six months. One group won’t do any texting to the project team. Everyone will receive some texts, either educational or appointment reminders.
These two groups will also be divided into two more groups. One group will go to the clinic for an extra visit in between their regular visits for the first six months of the project for additional education. Patients will complete short questionnaires about diabetes and diabetes education, both at the beginning and end of project. Information will be collected from the patient’s medical records about their medical history, diabetes, treatments, lab values, and other information such as blood pressures and weight changes.
“We will ask about collecting extra blood for further analysis if the patient is willing and agrees but patients don’t have to agree to any extra blood to be in the project,” said Cordle. “The blood will be obtained at patient’s regular lab visits so it won’t involve any additional blood draw procedures, or needle sticks, for the patients.”
The plan is to compare those people who receive extra education and who text information weekly to the project team to another group of people with diabetes who just receive the same care as usual.
“It’s our hope that since this project uses tools that are readily available and accessible in any clinic practice, these same things can be implemented into any clinic practice to improve diabetic health care for this population,” said Cordle.
Cordle said there is little or no risk if patients agree to participate in this project. Patients may even benefit from additional education and attention with the goal of making behavioral changes toward taking better care of their diabetes.
Patients are eligible to participate if they have Type 2 Diabetes Mellitus, are age 18 and older, have a cell phone with the ability to receive and send text messages, and are willing to participate in all aspects of the project. Patients are excluded for any of the following: intensive insulin treatment, active cancer with systemic effects, active hepatitis, cirrhosis, malnutrition, dementia, psychiatric disease, or cognitive deficits causing impaired judgment, severe chronic obstructive pulmonary disease, chronic steroid treatment, immunosuppressive therapy, hemodialysis or peritoneal dialysis, significant visual impairment, impaired manual dexterity, pregnancy and HIV.
“We sincerely hope that this technology based intervention research will give an ideal opportunity for our patients with diabetes to embrace such strategy and hence play an active role in management of their diabetes,” said Yaqub.
If you would like to volunteer for the study, or would like more information, call the Coalfield Health Center at 304-855-1200 or Robin Ashford, Research Coordinator, at 304-691-1082.