Using Conversational Computer Technology To Improve Diabetes Management: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$708,606.00
Summary
The diabetes epidemic is a growing challenge for the Australian health care system with over 1 million Australians living with diabetes. The impact on individuals' lives and the whole of Australian society is very substantial indeed. There is very good evidence that this impact would be reduced by developing new approaches to manage the disease and facilitate improved self-management. Recent developments in information and communications technologies offer some promising new ways and tools for a ....The diabetes epidemic is a growing challenge for the Australian health care system with over 1 million Australians living with diabetes. The impact on individuals' lives and the whole of Australian society is very substantial indeed. There is very good evidence that this impact would be reduced by developing new approaches to manage the disease and facilitate improved self-management. Recent developments in information and communications technologies offer some promising new ways and tools for achieving this. This research will evaluate a computer-controlled, interactive telephone system for improving the management and self-management of Type 2 diabetes in addition to routine care. Patients with Type 2 diabetes will be recruited from Brisbane and each patient will be randomly assigned to receive either this new program or just their usual care from their doctor or Diabetes Clinic. The first group will call the system weekly for six months using a regular phone or a mobile phone if they wish. During the call, they will answer questions by speaking into the phone, listen to feedback and strategies for improving management of their diabetes and then discuss their next targets and behavioural actions. They will receive systematic and tailored advice on blood glucose testing, nutrition and physical activity, as well as medication taking and foot care. The system individualises conversations according to the user s answers and responses over all the interactive sessions. The trial will formally evaluate the clinical impact on blood glucose control and the adoption and maintenance of the targeted health habits, as well as the intervention s cost-effectiveness and users satisfaction with the system. This project s significance lies in the excellent potential of using this new technology to provide a 'low cost' but effective program to help people better manage Type 2 diabetes.Read moreRead less
TELEPHONE COUNSELLING FOR MAINTENANCE OF PHYSICAL ACTIVITY, WEIGHT LOSS And GLYCAEMIC CONTROL IN TYPE 2 DIABETES
Funder
National Health and Medical Research Council
Funding Amount
$1,285,894.00
Summary
Regular exercise, a healthy diet and weight loss are key to managing type 2 diabetes, yet these are major challenges for most people with diabetes. This study will evaluate the impact of a telephone counselling program to assist people with type 2 diabetes to exercise, eat a healthy diet and lose weight, with the goal of helping them to sustain these changes over the long-term. It is expected that these lifestyle changes will also result in improved blood glucose control and quality of life.
Insulin resistance (the inability of ordinarily insulin-sensitive tissues such as muscle and adipose tissue to respond to insulin) contributes to a number of diseases including diabetes and obesity. A key metabolic step in these tissues is the uptake of glucose from the blood stream. This step is accelerated by insulin thus allowing efficient clearance of glucose from the bloodstream after a meal. Our laboratory has played a major role in showing that insulin regulates glucose uptake into muscle ....Insulin resistance (the inability of ordinarily insulin-sensitive tissues such as muscle and adipose tissue to respond to insulin) contributes to a number of diseases including diabetes and obesity. A key metabolic step in these tissues is the uptake of glucose from the blood stream. This step is accelerated by insulin thus allowing efficient clearance of glucose from the bloodstream after a meal. Our laboratory has played a major role in showing that insulin regulates glucose uptake into muscle and adipose tissue by stimulating the movement of a glucose transport protein from inside the cell to the cell surface (see http:--www.imb.uq.edu.au-groups-james-glut4 for an animated description of this process). The purpose of this proposal is to dissect the molecular mechanisms by which this glucose transporter can be held inside the cell in the absence of insulin and then allowed to be released from this site moving to the surface in the presence of insulin. Our studies over the past 5 years have brought us much closer to understanding this process in detail. The identification of the molecules responsible for this regulatory step will not only aid our understanding of this process but it will also provide a valuable target for development of therapeutic agents that can be used to combat insulin resistance.Read moreRead less
Implementation And Evaluation Of A Diabetes Intervention Program In Indigenous Australian Communities.
Funder
National Health and Medical Research Council
Funding Amount
$173,625.00
Summary
Approximately 700,000 Australians have type 2 diabetes (also termed maturity-onset diabetes or non-insulin dependent diabetes), which is a condition associated with reduced lifespan, eye disease, heart disease, renal disease, stroke, and foot complications leading to amputation. Indigenous Australians are at particularly high risk, with over 30% of adults affected by this condition in a number of communities, associated with significant morbidity and mortality. Early diagnosis, healthy lifestyle ....Approximately 700,000 Australians have type 2 diabetes (also termed maturity-onset diabetes or non-insulin dependent diabetes), which is a condition associated with reduced lifespan, eye disease, heart disease, renal disease, stroke, and foot complications leading to amputation. Indigenous Australians are at particularly high risk, with over 30% of adults affected by this condition in a number of communities, associated with significant morbidity and mortality. Early diagnosis, healthy lifestyle modification and tight control of the blood sugar levels, blood pressure and cholesterol are the keys to preventing the complications of diabetes. Self-management is central to success, and education, support and encouragement play an important role. This research project incorporates an education program that has been developed in partnership with the indigenous health team at Cherbourg. Particular strengths include the emphasis on family involvement and community support. The central role of the indigenous health team will ensure continuity of benefit to the community. If proven to be effective, the program could be used as a model for interventions in other community settings to reduce the burden from type 2 diabetes in the indigenous Australian population.Read moreRead less
Understanding The Acute And Cumulative Metabolic Effects Of Prolonged Sitting In Adults
Funder
National Health and Medical Research Council
Funding Amount
$416,597.00
Summary
Sedentary behaviour (sitting time) has been linked to an increased risk of chronic illnesses, including type 2 diabetes and obesity, but recent evidence suggests that light-intensity activity (non-exercise activities of daily living) is associated with reduced risk. These studies will examine whether breaking up sitting time with frequent short periods of activity can overcome the negative effects of prolonged sitting on blood glucose and blood fats in overweight older adults.
A Behavioural Intervention For The Adoption & Maintenance Of Physical Activity In Type 2 Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$334,955.00
Summary
For people with type 2 diabetes (T2DM) it is essential that blood glucose levels are managed well to reduce the risk of developing complications. Physical activity is essential for maintaining glucose levels because it helps make the muscles use glucose more effectively. In particular, being active through strength training not only improves blood glucose levels, but can be very effective for maintaining good physical functioning, which is known to be reduced by having T2DM. This study builds on ....For people with type 2 diabetes (T2DM) it is essential that blood glucose levels are managed well to reduce the risk of developing complications. Physical activity is essential for maintaining glucose levels because it helps make the muscles use glucose more effectively. In particular, being active through strength training not only improves blood glucose levels, but can be very effective for maintaining good physical functioning, which is known to be reduced by having T2DM. This study builds on our earlier research which demonstrated significantly improved blood glucose levels from a strength training program for older adults with T2DM. The strength training program is to be administered nationally in a research to practice trial (Lift for Life); however, the original research found that those who did not complete the program as it was intended (ie, poor adherence) did not show significant improvements in blood glucose levels. Furthermore, maintenance of strength training exercises after completion of the program was poor and resulted in return of blood glucose levels back to pre-starting levels. In people without diabetes, we have collected pilot data that shows that the use of behavioural strategies based on behavioural theories whereby each person's motivations and barriers are taken into consideration is more effective than the traditional one-treatment-fits-all approach. This study will evaluate the effectiveness of using behavioural strategies for improving adherence and maintenance to the Lift for Life strength training program (Enhanced L4L) for older adults with T2DM compared with the Standard L4L program. It will also follow-up participants 6 months later to determine the extent to which the changes in behaviour can be maintained. The study will provide information that will assist in the design, delivery and uptake of programs to improve treatment strategies in older adults with T2DM through the maintenance of healthier behaviours and lifestyles.Read moreRead less