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By David Mendosa

Last Update: July 15, 1999

A new Web site for people with diabetes focuses on helping self-motivated patients lower their blood glucose levels through tight control. It's called MyDiabetes and it went live in July.

“We don’t want a lot of theory.”

"We don't want a lot of theory," says Steve Jolley, president and CEO of Protocol Driven Healthcare in Morristown, New Jersey. "What we have tried to do is to have a site that is practical in terms of helping people look after themselves."

What differentiates MyDiabetes, he maintains, is that other diabetes sites are only one-way. "We are offering two-way, interactive communication."

Each of the three main resources on the site is indeed interactive. A diary lets the motivated person with diabetes enter all sorts of information and be able to graph blood glucose levels. The message area includes e-mail between users and nurses on the site as well as e-mail among the users in six separate forums. Third is a Diabetes Quality of Life Measure, which also is graphed.

"The meat of the site is the Daily Diary under the Date Entry area, where people can track themselves on a regular basis," Jolley says. First, you enter basic demographic information and your disease status, including when you were diagnosed, what your blood glucose target levels are, your resting heart rate, and any disease-related complications you might have.

Then you tell MyDiabetes what ACE inhibitors, insulin, and oral hypoglycemics you use. Following that you enter your care schedule due dates, including your next doctor's visit, foot examination, weight, blood pressure, glycated hemoglobin, microalbumin level, blood lipids, eye exam, and flu shot.

On the Daily Diary itself you type in the time and value of your blood glucose measurements every day. Along with that you enter the number of servings or grams of carbohydrate at each meal, the time, duration, and intensity of your exercise, the time and number of units of insulin, and the medications you take.

Your rewards for being thorough enough to enter all this information are some attractive and informative graphs. Blood glucose levels are organized by time, rather than events like fasting or after exercise. "We standardized on time, because we weren't sure what events to use," Jolley says.

The combined graph for a week is a novel twist. They show this, he says, because "some endocrinologists are interested in seeing how one day's curve compares with another day."

Beyond the diary, "we have our secret weapon," Jolley says. That weapon is a whole range of specialists—including nurses, a diabetes educator, a dietitian, and an exercise therapist—who answer patient questions by e-mail. He says that they answer all their e-mail within 24 hours.

The Diabetes Quality of Life Measure records over time the impact that diabetes is having on day-to-day life and activities. Every month users are to complete the questionnaire, which Dr. Alan Jacobson of the Joslin Diabetes Center in Boston and others developed for the Diabetes Control and Complications Trial. Then MyDiabetes graphs your answers.

Right now the questionnaire asks a lot of questions. I counted 60 of them. Jolley wonders if it is a bit too long, so it may be changed. Another change in the offing, he says, is faster access.

Jolley's company, Protocol Driven Healthcare, is a commercial organization that previously developed the MyAsthma site. Funding for both sites comes from banner advertising, sponsorships, and links to commercial sites for online shopping. Jolley says that he hopes to sell aggregate visitor data to HMOs, which are also interested in recommending the site to their patients in order to help them control their diabetes—and thereby reduce the HMOs' costs.

But what's the protocol for diabetes? Actually, that's not what it's called for diabetes, Jolley says. Instead, MyDiabetes follows the American Diabetes Association's Clinical Practice Recommendations.

For less motivated people with diabetes, the site's data entry requirements would probably be daunting. But for those motivated to maintain tight control, this is a useful and attractively presented new Web site. 

The American Diabetes Association originally published this article on its Web site as one of my “About the Internet” columns.

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