Endocrine Abstracts

Successful management of diabetes requires an empowered patient/family that is well-educated about their condition and feels confident to self-manage with the support of their medical team. The linchpin to assessment and effective change is the quality of available information. Most patients/families have no way of pulling all their diabetes information together efficiently, and consequently often feel helpless and do not take charge of making their therapy adjustments. Diasend allows upload of all devices, creates easy to read reports and allows a productive dialogue between healthcare professionals and patient/family. We put a team together to onboard 50% of our type 1 diabetes cohort to Diasend in 2017. The audit produced some surprising results for 2016 (no diasend) vs. 2017 (home diasend):

• For all patients (n=103), HbA1c did not change: 64.5 mmol/mol vs. 64.9 mmol/l.

• For the Pro-Diasend Group, those who uploaded at home twice or more every three months (n=52), HbA1c dropped: 67.2 mmol/mol vs. 61.9 mmol/mol.

• For the No-Diasend, those who uploaded one time or less every three months (n=51), HbA1c increased: 61.7 mmol/mol vs. 68.1 mmol/mol.

Qualitative inquiry suggested that the No-Diasend group stopped reviewing diabetes results because it was easier to upload once before clinic and ‘Let the diabetes team do it!’ – Disempowerment. Whereas the Pro-Diasend group increased the frequency of review of diabetes results because it was ‘quicker than keeping a diary and easier to see patterns.’ Following this audit, we have created a new policy. Patients wanting to use Diasend must upload before every clinic and in-between clinics. Also, they must take proactive steps to review diabetes results, identify patterns and consider changes. If not, we ask them to keep a written diary. Our next step is to review this policy.