The emerging role of electronic diaries in the management of diabetes mellitus.

Diabetes mellitus affects an estimated 17 million people in America. A cornerstone to the treatment of this population is appropriate glycemic control, which has been associated with better patient outcomes and cost savings from lack of diabetes complications needing treatment. The patient diary serves as the primary means used by patients and care providers to monitor and ensure glycemic control among this population and as a key component to effective diabetes management. Diabetic patients are encouraged to track continually, in a systematic way, blood glucose levels, dietary intake, activity level, and insulin dose if applicable for use in guiding appropriate care decisions. Traditionally, the recording of such patient experience data has occurred in paper-based diaries. More recently, with the advent of personal digital assistant (PDA) technology, electronic diaries are demonstrating promising benefits over paper-based diaries. To take advantage of this technology, patients must be able to use PDA devices accurately and providers must be knowledgeable about their capabilities. Advanced practice nurses (APNs) in general, and nurse practitioners in the outpatient setting more specifically play a key role in assessing the appropriateness of PDA technology for individual patients, educating patients in various software applications, and ensuring the documentation and trending of data. This article provides an overview of traditional diabetes management record-keeping techniques followed by a review of current PDA technologies and resources that aim to improve the state of diabetic documentation by patients.