Background –Type 2 Diabetes Mellitus amongst Indigenous Australians living in remote communities is at least 3 times that of the general population. Explaining treatment options and the effects of self-management is extremely challenging, compounded by varying literacy levels, language differences and social situations.
Aim – To offer Continuous Glucose Monitoring System (CGMS) technology to remote Indigenous clients, using the graphic information they provide plus diary notes to individualise the diabetes story and encourage behaviour change.
Method – A CGMS package was purchased and Diabetes Educators instructed in its use. These staff then modelled its use to clients in their communities. Those clients who agreed to try the device wore it for up to 6 days. They kept a diary of events including 3-4 finger pricks a day, information on food, exercise and medications. Handouts were adapted to suit their circumstances. At the conclusion of the period, when the device was downloaded, a team involving the Client, Health Worker, Dietitian, Chronic Disease Doctor and Diabetes Educator discussed learnings from the experience and possible changes that could bring about improvements in glycaemic control.
Findings – The information revealed by both the CGMS graphs and the diaries kept by the clients was invaluable. Vast differences existed between each person (their treatment, their understanding of their disease process, their ability to make changes) yet all came away from the experience with at least one change that they wanted to make whether it be with their medications the spreading of their carbohydrate foods, more exercise or regular finger pricks to monitor the effects of changes. Adaptations needed to be made to the diary for client ease of use. Telehealth between some clients and the Diabetes Specialist was initiated with participants able to view the data simultaneously.
Conclusion – CGMS as a teaching tool can work very effectively with Indigenous Clients in remote communities. The graphs provide a unique opportunity to explore blood glucose management. This technology assists people in learning and taking control of diabetes in a setting where health literacy is limited.