Taking diabetes medicine on schedule, whether injecting insulin or swallowing a pill, can be annoying, and sometimes difficult. You know taking your diabetes mediation consistently means good news for your blood sugar, but follow up can be a problem as life gets in the way.
Your doctor has probably nagged when haven’t been able to stick to your schedule for a dozen different reasons.
Now there is something to make its easier and more likely that you can do better. Based on findings of a study presented at the World Congress on Insulin Resistance, Diabetes & Cardiovascular Disease in Universal City, California, when you join a support program—one that you ''click'' with—it can help you manage your medication routine much better.1 It may also help you improve your diet, exercise and other behaviors that impact your diabetes management.
And, you probably don't even need to leave home.
In this study,1 men and women who were enrolled in an online support program were nearly twice as likely to take their medication as prescribed and less likely to discontinue it, says Timothy Reid, MD, a family medicine physician from Janesville, Wisconsin and senior author of the poster who presented the results of the study.
Dr. Reid examined the impact of a program called COACH on patients taking Toujeo insulin, but he says many other programs are offered to patients depending upon their needs and in all cases the support works, and not just for the medicine in the study.1
The idea, Dr. Reid says, is that patients who feel supported by their health care professionals via structured support programs do better at taking their medication as advised, which is especially important "since diabetes is a difficult disease to manage," he tells EndocrineWeb, especially when trying to juggle many other responsibilities such as children, a job, and aging parents. “The best chance to succeed occurs when you have support," he says.
Implementing the COACH Study
Dr. Reid's team compared how well 544 patients enrolled in the COACH program took their insulin as instructed and how well the same number of patients who were not enrolled managed their medication. The men and women ranged in age from 18 to over 65 years; the average age was about 56 years old.
The program includes a welcome call, an online portal, regular text messaging, one-on-one phone calls as well as training about the medicine. Coaches reach out to patients to identify their individual needs. The goal of the program is to encourage ''ownership'' of insulin management by the patient.
Patients receive texts and emails as reminders to provide both necessary education and to help motivate them. Coaches can send information on fitness, medicine facts, diet, and other details that a considered useful for each patient.
After six months, Dr. Reid says, those enrolled were nearly twice as likely to be adherent—and better able to follow their medication schedule—as those not enrolled. While more than 85% of those enrolled were able to take their medication as indicated, those not enrolled (77%) managed to keep to their schedule as well. The better news is that the risk of discontinuing the medicine was 48% lower among participants.
Dr. Reid says it's important to like the group you choose—the program and other members. "If it 'clicks,' than it’s more likely to work," he tells EndocrineWeb.
The findings are not surprising, says Elena Christofides, MD, FACE, chief operating officer of Endocrinology Associates in Columbus, Ohio who was not involved with the study.
In reviewing the findings, she tells EndocrineWeb, "Support groups work because humans are social creatures and derive strength from numbers, tribes, and group association. Typically, we do more poorly in many aspects of our lives when we are alone."
As for selecting a group, Dr. Christofides suggests picking one where you feel like you identify with other group members—similar to Dr. Reid's advice to find a group that ''clicks'' for you. For instance, Dr. Christofides says, people who work in a suburban office might do well and gain the most comfort in a group where the members do the same type of work in a similar setting and if you are a midwestern farmer, finding your own ''tribe'' or a “good fit” where other members understand your challenges can help alot, she says.
For assistance in finding a support group, ask personal physician for guidance or check at the American Diabetes Association website,2 which hosts online meetings to boost support.
The study was funded by Sanofi, which makes Toujeo.
Drs. Reid and Christofides indicated no financial disclosures with regard to this study.
Reid T. Teojou COACH program on patient adherence and persistence. Poster presentation at the World Congress on Insulin Resistance, Diabetes & Cardiovascular Disease; November 30—Dececmber 2, 2017, Universal City, California.
2American Diabetes Association. Online Support Community. Available at: https://community.diabetes.org/home Accessed December 3, 2017.