Use of Tactile Techniques for Self-Monitoring of Blood Glucose in Visually Impaired Patients with Diabetes Mellitus

Abstract

Twenty-eight patients with type I diabetes mellitus, legally blind as a result of proliferative retinopathy, were recruited into a program designed to teach and evaluate tactile methods for self-monitoring of blood glucose (SMBG). Vision ranged from "blind" to "able to read large print." Techniques with wipe-off strips (Chemstrip bG or BM Test BG, Boehringer-Mannheim, Canada Ltd., Dorval, Quebec, Canada) use the opposite hand as a guide, operation of timing devices by touch, and special methods for labeling and storing strips. Methods with wash-off strips (Dextrostix, Ames Division, Miles Laboratories, Rexdale, Ontario, Canada) employ the fingers as a guide in directing the wash water. The accuracy of tactile methods was documented. Clinical parameters of glucose control improved in patients with adequate data after 6 mo of tactile SMBG. Glycosylated hemoglobin in 17 patients decreased from 11.3 +/- 2.1% to 9.4 +/- 1.5% (P = 0.005). Patients experienced significantly fewer reactions and low blood sugar readings as well as lowering of mean blood glucose values from 158 +/- 56 to 141 +/- 51 (P = 0.025).

Diabetes self‐care behaviors in adults with disabilities: A systematic review

“…According to the five quasi‐experimental articles, interventions, including group therapy, tactile techniques for blood glucose self‐monitoring, blood glucose self‐monitoring training, the 12‐week model clinical program, and psychoeducational group therapy, positively impacted improvements in diabetes self‐care behaviors (Bernbaum et al, ; Oehler‐Giarratana & Fitzgerald, ; Prior et al, ; Trozzolino et al, ; Windecker et al, ).…”

“…In the interest of preventing additional complications, some diabetes self‐care management programs reported the use of self‐care facilitators for people with visual impairments. Intervention to enhance blood glucose self‐monitoring using other senses, including touch and hearing, were helpful in maintaining appropriate glucose levels or in increasing the quality of blood glucose monitoring (Prior et al, ; Windecker et al, ). The model clinical program and psychoeducational group therapy program improved glucose control, exercise, diabetes knowledge, and psychological parameters (Bernbaum et al, ; Trozzolino et al, ).…”

“…In terms of study designs, seven articles used a qualitative design (Cardol et al, 2012;Hale et al, 2011;Kaminsky et al, 2014;Livingstone et al, 2011;Rouse & Finlay, 2016;Whitehead et al, 2016;Williams, 2002) and 12 used a quantitative design including quasi-experimental studies (Bernbaum et al, 1989;Carrington et al, 2001;Oehler-Giarratana & Fitzgerald, 1980;Prior et al, 1984;Trozzolino et al, 2003;Windecker et al, 1997), retrospective cohort studies (Patel et al, 2016;Reichard et al, 2012;Shireman et al, 2010;Tseng et al, 2006), and cross-sectional studies (Pham et al, 1996;Taggart et al, 2013). One article used participatory action research (Williams, 2005).…”

“…Factors reported as facilitators of diabetes self-care behaviors included behavioral changes to adapt to the blind environment and using other senses such as sound, touch, and smell. Assistive devices, modifications to the physical environment, low-vision services, voice-recorded versions of educational materials, guidelines to enhance accessibility, and instructions to improve medical professionals' understanding of people with visual impairments were also regarded as facilitators (Kaminsky et al, 2014;Williams, 2005 According to the five quasi-experimental articles, interventions, including group therapy, tactile techniques for blood glucose self-monitoring, blood glucose selfmonitoring training, the 12-week model clinical program, and psychoeducational group therapy, positively impacted improvements in diabetes self-care behaviors (Bernbaum et al, 1989;Oehler-Giarratana & Fitzgerald, 1980;Prior et al, 1984;Trozzolino et al, 2003;Windecker et al, 1997).…”

Effectiveness of Glucose Monitoring Systems Modified for the Visually Impaired

“…Acquiring adaptive techniques for diabetes self-management is essential for maintaining independence, a good quality of life, and stable glycemic control. Manufacturers of glucose monitoring systems have modified existing glucose meters with speech synthesizers and tactile mechanisms for use by the visually impaired (1)(2)(3)(4). These meters should allow individuals with diabetes to become active participants in their own health care, improve glycemic control, and reduce fear of unanticipated hypoglycemia.…”