Diabetes Support: Can A Coaching App Help You Manage Your Blood Sugar?

Having a virtual coach may be just what the in-real-life doctor ordered to improve your diabetes control and your life.

Virtual Health Screen with Finger PointingVirtual support for diabetes may be the most effective intervention designed for human performance, experts say.

Maybe you remember with fondness a coach from your high school athlete days, or a favorite school counselor who steered you to the perfect career. These days, coaching has extended far beyond the school years.

Consider this quote from Atul Gawande, MD, a surgeon, author, health leader, endocrine surgeon at Brigham & Women's Hospital in Boston and a faculty member at Harvard Medical School: "Coaching done well may be the most effective intervention designed for human performance."

In agreement with Dr. Gawande are business leaders, thought leaders, researchers and yes, probably your certified diabetes educator (CDE) and your endocrinologist.

While a CDE is a great coach, seeing a CDE in person is rare for most people with diabetes, says Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE, program coordinator for the Teen and Adolescent Transition Program at the University of Chicago's Kovler Diabetes Center. She is also an OnTrackDiabetes editorial board member. But all is not lost, thanks to a boom in virtual coaching apps that can be downloaded onto your smartphone for easy access.

"Any method of having people living with diabetes gain more knowledge to enable better self-care will help," she says, adding "Diabetes [control] is a constant fight. Having as many tools as possible for ongoing support is crucial."

Hess-Fischl also notes that the National Standards for Diabetes Self Management and Education, the certified diabetes educators' blueprint for quality diabetes education programs, requires a plan of ongoing support. That makes these programs a perfect choice, she says.

"All of the programs allow the person living with diabetes to be involved as little or a much as they want," Hess-Fischl says, which is another important point.

What the Research Finds

While new apps are constantly appearing, many apps have been around a while, allowing for some solid research on how well they work. In a 2017 review of 25 studies focused on using technology in diabetes self-management education and support services, researchers concluded: "Technology-enabled diabetes self-management solutions significantly improve A1C." 1

The measure was the most commonly studied outcome. Reductions ranged from 0.1% to 0.8%. In general, those with type 2 diabetes got more improvement than those with type 1.

Incorporating multiple modalities, such as text messaging or other interventions and web-based tools in combination, was more effective than singular interventions, the review found.

Four concepts emerged as effective, the researchers found. They include two-way communication, analyses of patient-generated health information, tailored education and individualized feedback.

How to Choose?

Hess-Fischl recommends including the four key elements found as effective. An app that meets all those would be ideal, the research suggests. Then factor in your own preferences.

Options are currently changing, but as of late 2018, among the choices are:

  • One DropFor $149.95 billed every 3 months, OneDrop includes a starter kit (Bluetooth glucose meter, lancing device, 25 test strips, 10 lancets, carrying case, testing supplies, personal coaching, mobile app, American Diabetes Association recognized education and support. Coaches available 24/7 on your mobile device. Check out other plans for your needs, such as Overcoming Diabetes Burnout, at the site.
  • MySugrFor under $40 a month ($39.99), you can jump in with MySugr's starter kit. It includes unlimited test strips (delivered to your door), access to a CDE, upgraded to MySugr Pro app, automatic logging of blood glucose values. You can sync blood glucose values, estimate A1C, log food, meds and exercise, print PDF reports for your doc. You can set personal goals with CDEs' help. You can view some testimonials at the site.
  • Livongo—Known as the Family Care Plan, the package includes an advanced glucose meter with a cellular chip that uploads readings and offers instant insights, unlimited test strips, text messages to update family and friends, live outreach to diabetes specialists when needed and expert suggestions. It's $64.99 a month with a 3-month commitment; for more details visit the site.
  • Well Doc for Samsung Users—Samsung Health users can access a consumer version of WellDoc's digital platform, the Diabetes Wellness Program. It's a 12-week health and wellness program, with input from, among others, the American Association of Diabetes Educators. It launched in March 2018 and has personalized info, including quizzes, videos, food monitoring and tracking of exercise, sleep, meds, and blood glucose readings the generate instant feedback. Users simply select "Programs" within the three dots menu in the upper right of the Health app and pick "Diabetes Wellness Program" under the "Disease Management" section. More info is available on the website. 

Costs

Costs for virtual coaching vary—from free to pricey. "Before paying out of pocket, confirm if your employer has it as a benefit," Hess-Fischl suggests.

Regardless of cost and coverage, remember that most apps include a variety of options, based on how long you sign up, how extensive a package you buy, and other features.

Hess-Fischl is a consultant for Abbott Diabetes Care, a stock/shareholder with Roche Diagnostics and on the speakers' bureau for Sanofi Aventis and Eli Lilly.

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