This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The project is an expanded clinical study of a new type of monitoring device intended to assist in patient-centered management of type II diabetes (T2DM). The Assisted Self-Management Monitor (ASMM) device is able to collect information from the glucometer of a diabetic participant, convey the information to a centralized computer station, and compare it to individually defined goals for glycemic control. If blood sugar readings fall outside certain parameters, the system can provide appropriate and immediate feedback to ul bothulnone the care staff and patient. The patient will be notified with a personalized prerecorded voice message pertaining to the particular deviation, selected by the system from a variety of audio clips to match the downloaded information. The central station can also convey reminder messages to diabetic participants if they fail to provide glucometer information at a particular time on a particular day. By significantly changing health behavior, the device may lead to clinical improvement in disease control, a reduction in disease complications, and a reduction in staff time needed for patient care. The following hypotheses are being tested: H1. Appropriate self-monitoring of blood glucose (SMBG) in T2DM will result in improved disease control and reduce disease complications. H1A. Audio reminders will improve frequency and accuracy of timing of SMBG H2.0 Compliance with medication regimens for T2DM will result in improved disease control. H2A. Audio reminders will improve medication compliance, especially for those following complex medication regimens. H3.When immediate feedback on SMBG is sent to the patient only, instead of the patient and the health care staff, they will develop a greater sense of responsibility, autonomy and control over T2DM, and will display better long-term adherence. H3A. Patients reporting a fear of hypoglycemia, sense of poor control over their disease, or high in anxiety/neuroticism may become increasingly concerned and anxious if they are the only one receiving plainf3fs18 immediate feedback. Such individuals would do better if they know that health care staff is reviewing information from the ASMM. Future plans include using data from this project to guide development of a series of educational modules on different aspects of self-management (diet, exercise, etc.), and using the system to provide feedback tying self-management behaviors to improved glycemic control on a real-time basis.
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