Abstract
BackgroundIn 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.ObjectiveThe 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.MethodsThis 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 (HbA1c) level. Missing data were handled by multiple imputation.ResultsAt months 3 and 6, all 3 groups showed significant decreases in HbA1c levels (all P<.05). Patients in the app interactive management group had a significantly lower HbA1clevel than those in the app self-management group at 6 months (P=.04). The average HbA1c 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 HbA1c 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 HbA1c 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).ConclusionsIn 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.Trial RegistrationClinicalTrials.gov NCT02589730; https://clinicaltrials.gov/ct2/show/NCT02589730.
Highlights
Effectiveness of Smartphone Apps on Glycemic ControlThe rapid development of mobile medical technology has provided multiple ways for the long-term management of chronic diseases, especially diabetes [1]
Gender, W, Body mass index (BMI), diabetes duration, systolic blood pressure, diastolic blood pressure, total cholesterol (TC), TG, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c), the results showed whether at months 3 or 6, group C was associated with the larger reduction of HbA1c, compared with groups A and B
This study found that the app interactive management group had a greater improvement in HbA1c levels compared with both the app self-management and control groups
Summary
Effectiveness of Smartphone Apps on Glycemic ControlThe rapid development of mobile medical technology has provided multiple ways for the long-term management of chronic diseases, especially diabetes [1]. Welltang, designed in Chinese language, is the most widely used app for diabetes management in China It was previously reported in a 3-month randomized controlled trial that diabetes patients using the Welltang app achieved statistically significant improvements in HbA1c, with an average decrease of 1.95%, whereas the reduction in HbA1c was just 0.79% in the control group [9]. Apps were proved to be more effective at glycemic control, compared with traditional computerand Web-based telemedicine technologies, how to gain a further and sustained improvement is still being explored. 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.
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