As the holidays draw to a close, 29 million Americans with type 2 diabetes had to navigate the minefield of treats, drinks, and dinners. Many patients have stepped up to meet the challenge of moderating their diet, but fewer embrace the benefits of physical activity in controlling their blood sugar.
A research team led by scientists at University of Utah Health has developed an online interactive app to help motivate patients to be more physically activity to manage their disease. The results are published in the Jan. 9 issue of the Journal of Medical Internet Research.
According to Nancy Allen, Ph.D., ANP-BC, assistant professor in the College of Nursing at U of U Health and co-author on the paper, there is an emotional component to behavior change. Convincing patients to increase their physical activity to maintain their blood sugar levels is easier said than done. In addition, this disease commonly co-occurs with obesity, which sets off a dangerous cycle. Overweight patients experience joint pain, limiting their ability or desire to engage in physical activity. As patients limit their physical activity, they gain more weight, worsening their disease.
To overcome these hurdles, the research team developed the interactive app to gauge participant understanding of the effect of physical activity in managing their disease and motivate them toward this important behavioral change.
At the start, the user enters their blood sugar (A1c) value and some basic vital information. Using this input, the program draws an average blood sugar curve, which is based on the patient’s A1c value. The participant then uses a mouse to draw a line along the rising and falling blood sugar curve to illustrate how they expect their blood sugar would change following 30 minutes of exercise, like walking.
Next, the user controls slider that change the duration of exercise or time of day exercise occurs. The program reveals how blood sugar actually changes from the average blood sugar curve following a period of physical activity. The participant can see the difference between their expected and the actual curves. The results are often dramatically different.
The patient can run the app multiple times to explore how the time of day and length of physical activity affect blood sugar levels. Through this process, they can pinpoint the optimal time for their exercise to reap the most benefits.
The researchers found the app provided an effective way to change patients’ attitude toward physical activity and shift their beliefs to incorporate more exercise into their daily routine. In fact, the participants on average increased their plans to walk for exercise in the next week by more than 30 minutes (from 67.1 minutes pre-study to 100.5 minutes post-study).
Of the 2,019 participants who visited the website, 1,335 (566 male; 765 female) submitted completed data. Of which, 77% were Caucasian and 15% were Hispanic, African American, American Indian or Native American, and Pacific Islander. According to Oakley-Girvan, the next project will include a participation pool that more closely mirrors the U.S. population managing this disease.
In the future, the research team hopes to adapt this approach to personalize the app by creating patient-specific blood sugar curves using a glucose monitor and an activity monitor rather than rely on average blood sugar curves. In addition, they hope to integrate this work into the clinical care setting to give providers additional tools to help educate their patients. The team also wants to leverage the power of social engagement by integrating the app into a supportive group setting.