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Yu, Kim, Kim, Choi, Lim, Chang, Lee, Park, and Jang: Effects of 'Ubiquitous Healthcare' on the Ability of Self-Management in Elderly Diabetic Patients
Original Article
Korean Diabetes Journal

Korean Diabetes Journal 2009; 33(1): 58-64.

Published online: 28 February 2009

DOI: https://doi.org/10.4093/kdj.2009.33.1.58

Effects of 'Ubiquitous Healthcare' on the Ability of Self-Management in Elderly Diabetic Patients

Sung Hoon Yu1, 2, Sun Hee Kim3, So Yeon Kim3, Sung Hee Choi1, 2, Soo Lim1, 2, Yoon Seok Chang1, 2, Hak Jong Lee4, Young Joo Park1, 2, Hak Chul Jang1, 2

1Department of Internal Medicine, Seoul National University College of Medicine, Seoul.Korea.

2Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul, Korea.

3Department of Medical Informatics, Seoul National University Bundang Hospital, Seoul, Korea.

4Department of Radiology, Seoul National University Bundang Hospital, Seoul, Korea.

janghak@snu.ac.kr

Received 26 November 2008       Accepted 11 February 2009

Copyright © 2009 Korean Diabetes Association

Abstract

Background

The need for a new healthcare system is growing due to the paradigm shift from health supervision to health maintenance. Previously, we performed a pilot study that examined the effectiveness of a ubiquitous healthcare (U-healthcare) diabetes management program which consists of self-monitoring of blood glucose (SMBG) and mobile phone services for elderly patients with type 2 diabetes mellitus. In this study, we investigated the effect of a diabetes management program using U-healthcare based on the self-care skills of elderly patients with diabetes mellitus.

Methods

From July to October 2005, 17 patients were recruited and provided with a blood glucometer with the ZigBee module and a mobile phone. In addition, the patients' understanding of diabetes self-care skills was examined at the beginning and end of the study. At the end of the study, we determined the level of patient satisfaction regarding U-healthcare services.

Results

The patients' test scores on their understanding of diabetes mellitus improved from 57.2 ± 20.7 to 72.7 ± 13.4%. Specifically, patient knowledge of the basic principles for a proper diabetic diet (52.9% vs. 82.4%, P = 0.046), foods that influence blood sugar level (41.2% vs. 76.5%, P = 0.007) and the influence of beverage choice (41.2% vs. 64.7%, P = 0.007), all increased. In addition, a significant increase in knowledge of living standards regarding diabetes mellitus was observed (64.7% vs. 88.2%, P = 0.0032).

Conclusion

We conclude that the U-healthcare incorporating SMBG could be promising, as it improves self-management skills of diabetes mellitus patients, as well as their understanding of the disease.

Keywords: Aged, Diabetes mellitus, Self care, Blood glucose self-monitoring, Health services research

Figures and Tables

Fig. 1
A schematic drawing of ubiquitous healthcare services using ZigBee module. The data measured were transferred to web-server via ZigBee protocol. The clinicians can assess their patients by logging on the server.
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Fig. 2
According to the test results, the patients' self-management of diabetes mellitus improved with the use of ubiquitous healthcare system.
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Fig. 3
The patients' knowledge of diabetes mellitus were higher in the post-test than the pre-test. The questions included nutritional therapy (7), exercise (1), complication (1), hypoglycemia (2) and self measurement of blood glucose (SMBG) (3). (number of questions).
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Fig. 4
The average glucose levels in the study with HbA1c remained unchanged in both groups.
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Table 1
Demographics and metabolic characteristics of subjects
kdj-33-58-i001

*n.s., not significant. All data are expressed as the mean ± SD. HDL, high density lipoprotein; LDL, low density lipoprotein.

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