Abstract
Digital technologies are gaining an important role in the management of patients with diabetes. We assessed clinical outcomes and user satisfaction of incorporating a digital diabetes care system in diabetes clinics of a developing country. The system integrated a wireless blood glucose monitor that communicates data to any smartphone utilizing a patented acoustic data transfer method, a mobile-app, and cloud-based software that stores, analyzes, and presents data. Five hospital endocrinology clinics in Vietnam sequentially recruited all patients willing to join the study, providing they had a smartphone and access to internet connectivity. Face-to-face visits were conducted at baseline and at 12 weeks, with monthly digital visits scheduled in the interim and additional digital visits performed as needed. HbA1c levels were measured at baseline and at 12 weeks (±20 days). The study included 300 patients of whom 279 completed the evaluation. Average glucose levels declined from 170.4 ± 64.6 mg/dL in the first 2 weeks to 150.8 ± 53.2 mg/dL in the last 2 weeks (n = 221; p < 0.001). HbA1c levels at baseline and 12 weeks declined from 8.3% ± 1.9% to 7.6% ± 1.3% (n = 126; p < 0.001). The digital solution was broadly accepted by both patients and healthcare professionals and improved glycemic outcomes. The durability, scalability, and cost-effectiveness of this approach merits further study.
Highlights
Patients with diabetes generate substantial amounts of clinically significant data on a daily basis.Self-monitoring of blood glucose (SMBG) levels along with automated or patient-reported recordings of food intake, physical activity, medication, and insulin timing and doses can form an entire metabolic kaleidoscope [1,2,3]
Striving for glucose levels that are as low as can be safely attained reduces long term complications [4]. This can be achieved by monitoring glucose levels—at individually dictated intervals—and adjusting diet, medication, or insulin doses [4]
We demonstrated the feasibility of incorporating digital technology in the care of patients with diabetes in a developing country
Summary
Self-monitoring of blood glucose (SMBG) levels along with automated or patient-reported recordings of food intake, physical activity, medication, and insulin timing and doses can form an entire metabolic kaleidoscope [1,2,3]. These data often go unobserved, and the prevailing challenge is collecting and using these data to improve patient care, as well as achieving lower glucose levels. Striving for glucose levels that are as low as can be safely attained reduces long term complications [4] This can be achieved by monitoring glucose levels—at individually dictated intervals—and adjusting diet, medication, or insulin doses [4].
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