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Effectiveness of Smartphone App-Based Interactive Management on Glycemic Control in Chinese Patients With Poorly Controlled Diabetes: Randomized Controlled Trial.
- Source :
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Journal of medical Internet research [J Med Internet Res] 2019 Dec 09; Vol. 21 (12), pp. e15401. Date of Electronic Publication: 2019 Dec 09. - Publication Year :
- 2019
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Abstract
- Background: In recent years, the rapid development of mobile medical technology has provided multiple ways for the long-term management of chronic diseases, especially diabetes. As a new type of management model, smartphone apps are global, convenient, cheap, and interactive. Although apps were proved to be more effective at glycemic control, compared with traditional computer- and Web-based telemedicine technologies, how to gain a further and sustained improvement is still being explored.<br />Objective: The objective of this study was to investigate the effectiveness of an app-based interactive management model by a professional health care team on glycemic control in Chinese patients with poorly controlled diabetes.<br />Methods: This study was a 6-month long, single-center, prospective randomized controlled trial. A total of 276 type 1 or type 2 diabetes patients were enrolled and randomized to the control group (group A), app self-management group (group B), and app interactive management group (group C) in a 1:1:1 ratio. The primary outcome was the change in glycated hemoglobin (HbA <subscript>1c</subscript> ) level. Missing data were handled by multiple imputation.<br />Results: At months 3 and 6, all 3 groups showed significant decreases in HbA <subscript>1c</subscript> levels (all P<.05). Patients in the app interactive management group had a significantly lower HbA <subscript>1c</subscript> level than those in the app self-management group at 6 months (P=.04). The average HbA <subscript>1c</subscript> reduction in the app interactive management group was larger than that in the app self-management and control groups at both months 3 and 6 (all P<.05). However, no differences in HbA <subscript>1c</subscript> reduction were observed between the app self-management and control groups at both months 3 and 6 (both P>.05). Multivariate line regression analyses also showed that the app interactive management group was associated with the larger reduction of HbA <subscript>1c</subscript> compared with groups A and B at both months 3 and 6 (all P>.05). In addition, the app interactive management group had better control of triglyceride and high-density lipoprotein cholesterol levels at both months 3 and 6 compared with baseline (both P<.05).<br />Conclusions: In Chinese patients with poorly controlled diabetes, it was difficult to achieve long-term effective glucose improvement by using app self-management alone, but combining it with interactive management can help achieve rapid and sustained glycemic control.<br />Trial Registration: ClinicalTrials.gov NCT02589730; https://clinicaltrials.gov/ct2/show/NCT02589730.<br /> (©Lei Zhang, Xingxing He, Yun Shen, Haoyong Yu, Jiemin Pan, Wei Zhu, Jian Zhou, Yuqian Bao. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 09.12.2019.)
- Subjects :
- Asian People
Blood Glucose
China
Diabetes Mellitus, Type 1 blood
Diabetes Mellitus, Type 2 blood
Female
Glycated Hemoglobin analysis
Humans
Male
Middle Aged
Prospective Studies
Software
Treatment Outcome
Diabetes Mellitus, Type 1 prevention & control
Diabetes Mellitus, Type 2 prevention & control
Self-Management
Smartphone
Telemedicine
Subjects
Details
- Language :
- English
- ISSN :
- 1438-8871
- Volume :
- 21
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Journal of medical Internet research
- Publication Type :
- Academic Journal
- Accession number :
- 31815677
- Full Text :
- https://doi.org/10.2196/15401