Analysis of glucose changes in adults with type 1 diabetes mellitus within 1 year after using mobile APP decision support system

Abstract

Objective: To analyze the changes in glucose after using a decision support system (DSS) of a smartphone mobile application (APP) in adults with type 1 diabetes mellitus (T1DM). Methods: In the intervention study, the data (including general information at the time of registration) of adult T1DM patients enrolled in the Chinese T1DM Registration Management Project and registered with TangTangQuan® APP were collected. Within 1 year after registration, fasting blood glucose, pre-prandial and postprandial blood glucose at the three meals, blood glucose before bedtime and in nocturnal time were collected every 3 months. Frequencies of total recorded glucose values and proportion of different ranges of glycemia were also collected and analyzed, including the range between 3.9-7.8 mmol/L (Euglycemia), ranged below 3.9 mmol/L (Hypoglycemia) and range above 13.9 mmol/L (hyperglycemia). The patients were divided into 3 groups according to the daily use frequency of DSS (Low/Moderate/High frequency groups). The changes in point blood glucose, the proportion of hyperglycemia and hypoglycemia over time were compared among different groups, as well as the baseline characteristics and glucose characteristics of patients. Results: A total of 629 eligible T1DM patients were included, including 216 (34.3%) males and 413 (65.7%) females, aged (31.5±10.8) years, and disease duration [M(Q1, Q3)] of 1.2 (0.1, 7.4) years. There were 239, 189 and 201 patients in the low, moderate and high frequency groups, respectively. Significant differences were observed among the three groups in all timepoints of self-monitoring blood glucose except for the glucose before bedtime from 10 to 12 months after registration (all P values<0.05), and the glucose level at each point in the high frequency group was lower than that in the other two groups. In the first three months after registration, there was no difference in the proportion of hypoglycemia among the three groups (P>0.05). However, from 10 to 12 months after registration, the proportion [M(Q1, Q3)] of hypoglycemia [3.34% (0.85%, 7.40%), 3.00% (0.78%, 6.17%), 1.81% (0.37%, 4.69%)] (P=0.022) between groups (from low to high frequency groups) and hyperglycemia [4.04% (0, 12.16%), 1.88% (0, 7.80%), 0.81% (0, 3.87%)] (P=0.001) were significantly different. Conclusions: The DSS function of mobile APP is helpful to the glucose management of adult patients with T1DM within 1 year after registration. The average blood glucose in adults with T1DM decreased, and the proportions of hyperglycemia and hypoglycemia were also reduced.