Study Finds Glucose Self-Monitoring Does Not Improve Glycemic Control for Diabetics | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Study Finds Glucose Self-Monitoring Does Not Improve Glycemic Control for Diabetics

June 13, 2017
by Heather Landi
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Incorporating technology into self-management activities has been touted as potentially transformative for patients, yet one recent study found that diabetic patients who self-monitored their blood glucose levels at home did not control their conditions any better than patients who did not self-monitor.

The study, titled “Glucose Self-Monitoring in Non-Insulin-Treated Patients with Type 2 Diabetes in Primary Care Settings,” was published in JAMA Internal Medicine. For the study, physician researchers at the University of North Carolina at Chapel Hill School of Medicine, examined the value of self-monitoring of blood glucose levels in patients with non-insulin-treated type 2 diabetes and examined three approaches of self-monitoring for effects on hemoglobin A1c levels and health-related quality of life.

The study involved 450 patients at 15 primary care practices in central North Carolina with type 2 non-insulin-treated diabetes and with glycemic control (hemoglobin A1c) levels higher than 6.5 percent but lower than 9.5 percent within the six months preceding screening.

For the study, which was conducted over year, a third of patients did not self-monitor, one-third of patients conducted standard once-daily self-monitoring and one-third of patients self-monitored and received automated, tailored messaging.

After one year, the researchers found no evidence that self-monitoring led to improved glycemic control and no significant differences found in health-related quality of life between patients who performed once-daily self-monitoring with those who did not self-monitor.

“The addition of instant tailored feedback messages via a meter did not improve glycemic control. This null result occurred despite training participants and primary care clinicians on the use and interpretation of the meter results. These findings align with earlier studies and a group that reinforce the limited utility of self-monitoring of blood glucose (SMBG) in patients with non–insulin-treated T2DM,” the study authors wrote.

Further, the study authors wrote, “Surprisingly, SMBG has remained a cornerstone in the clinical management of non–insulin-treated T2DM, in part fueled by other studies and groups supporting glycemic control with SMBG. As the first large pragmatic US trial of SMBG, our findings provide evidence to guide patients and clinicians making important clinical decisions about routine blood glucose monitoring.”

Incorporating technology into self-management activities has been touted as potentially transformative for patients, and to date some smaller studies support this notion,” the study authors wrote, adding, “However, our findings do not.”

The study authors also theorize that the use the enhancement of self-monitoring with one-way messaging back to the patient does not adequately engage patients. A more interactive approach or the use of 2-way messaging between the patient and physician may improve the durability of this approach, the study authors wrote.

The study authors also concluded, “Based on these findings, patients and clinicians should engage in dialogue regarding SMBG with the current evidence suggesting that SMBG should not be routine for most patients with non–insulin-treated T2DM.”

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LabCorp Joins Apple Health Records Project

November 5, 2018
by Rajiv Leventhal, Managing Editor
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LabCorp, a provider of clinical laboratory and end-to-end drug development services, has announced that it has enabled Apple’s Health Records feature for its patients.

This iPhone feature aims to make it easier for LabCorp patients to access their LabCorp laboratory test results, along with other available medical data from multiple providers, whenever they choose, according to officials.

In January, Apple announced that it would be testing the Health Records feature out with 12 hospitals, inclusive of some of the most prominent healthcare institutions in the U.S. Since that time, more than 100 new organizations have joined the project,  according to Apple.

LabCorp test results are viewable in the Apple Health app for LabCorp patients who have an account with the company, and enable integration with the Health Records app. In addition to their LabCorp test results, patients will have information from participating healthcare institutions organized into one view, covering allergies, medical conditions, immunizations, lab results, medications, procedures and vitals.

Patients will receive notifications when their data is updated, and the Health Records data is encrypted and protected with the user’s iPhone passcode, Touch ID or Face ID, according to officials.

“LabCorp on Health Records will help provide healthcare consumers with a more holistic view of their health. Laboratory test results are central to medical decision making, and broadening access to this information will help patients take charge of their health and wellness, and lead to more informed dialogues between patients and their healthcare providers,” David P. King, chairman and CEO of LabCorp, said in a statement.

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HIMSS Analytics Introduces Infrastructure Adoption Model for Health Systems

October 25, 2018
by Rajiv Leventhal, Managing Editor
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HIMSS Analytics, the research arm of the Healthcare Information and Management Systems Society, announced the introduction of the Infrastructure Adoption Model, or INFRAM, which is designed to measure the technical infrastructure used within a health system.

The INFRAM focuses on five technical subdomains, allowing organizations to benchmark how their infrastructure operates within the following areas: mobility; security; collaboration; transport; and data center.

Similar to HIMSS Analytics’ well-known Electronic Medical Record Adoption Model, or, EMRAM, the INFRAM is an eight-stage model (0 – 7) that allows healthcare IT leaders to map the technology infrastructure capabilities required to reach their facility’s clinical and operational goals, while meeting industry benchmarks and standards.  The final stage, Stage 7, guides organizations towards optimized information integration, contextualization and orchestration essential for the delivery of higher order local and virtualized care processes.

For reference purposes, Stage 0 on the model represents that an organization does not have a VPN, intrusion detection/prevention, security policy, data center or compute architecture. Stage 3 signifies that an organization has an advanced intrusion prevention system, while Stage 5 represents having video on mobile devices, location-based messaging, firewall with advanced malware protection, and real-time scanning of email hyperlinks.

HIMSS officials note that by identifying specific benchmarks for organizations to reach before they go live with EMR, systems, the INFRAM aims to ensure that a health system’s infrastructure is stable, manageable and extensible. Through this, organizations can ideally improve care delivery and create a pathway for infrastructure development tied to business and clinical outcomes.

 “The INFRAM is a welcome addition to our maturity model suite and addresses a longstanding need – guiding healthcare organizations in securely implementing the infrastructure with which their EMRs are built upon,” Blain Newton, executive vice president, HIMSS Analytics, said in a statement. “We have seen health systems engage with advanced clinical applications, only for them to ‘glitch’ under infrastructure that isn't powerful enough to support their tools. With the INFRAM, healthcare providers can develop a detailed, strategic technology plan that defines their organization's current state, desired future state, and each stage in between to achieve their clinical and operational goals.”

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Clinical Team Communication and Data Access in the Palm of Your Hand

Thursday, October 25, 2018 | 1:00 p.m. ET, 12:00 p.m. CT

Eisenhower Health, a west coast-based Magnet Hospital, implemented an enterprise-wide solution enabling mobile communications and collaboration across all care teams, linking the entire enterprise, advancing its communications capabilities, creating access to an enterprise directory, and improving care team response and turnaround times.

Additionally, the system provided extensive and comprehensive reporting with data analytics showing where and to what extent response improvements were made, but also providing the information the hospital needed to better utilize the system and make adjustments to improve results.

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