Several Aspects of Internet and Web-Based Technology in Diabetes Management
As evidenced by a large number of well-conducted randomized trials, the complications and confounding conditions that can result from mismanagement of diabetes can be reduced or prevented with appropriate medical care (1–5). Observational studies to ascertain the level of glycemic control, blood pressure control, and cholesterol control in people with diabetes provide evidence of poor adherence to established self-management protocols (6–9). Although diabetes shares characteristics with other chronic lifelong diseases that require a model of continuous care, successful management of diabetes is primarily based on patients’ ability to maintain consistency in self-care–related behaviors (10–14). Diabetes care requires long-term self-management and a willingness to adapt to a new lifestyle, which includes changes in eating habits, regular exercise, and adherence to medication schedules (15–19). Thus, diabetes health care providers have limited control over the actual development and treatment of the disease (20–24).
Challenges in Diabetes Treatment and Management
Lack of adherence to diabetes self-care protocols is multifaceted but includes factors such as perceived lack of time for check-ins and follow-ups with primary care providers (PCPs), treating providers, and specialist (25). In addition to patient complexities, some strategies used by treating providers and specialists for providing self-management classes or interventions have shown promise but are limited by costs to both education/intervention providers and patients. For providers, costs may include staffing, conducting classes, and securing locations for them; for patients, costs may include transportation, missed time from work, and childcare services. An additional barrier is providers’ inability to provide frequent, long-term contact with patients who have completed such interventions; there are limited available resources to devote to sustaining lifelong intervention to encourage adherence to effective self-management practices (26,27).
PCPs normally serve as the central point of care and arrange for patient appointments with other specialists such …