High engagement in mobile peer support is associated with better glycemic control in type 1 diabetes: A real-world study.

Abstract

Peer support for diabetes has become convenient and interactive after the emergence of mobile health (mHealth). We aimed to evaluate the association between engagement in peer support through the mHealth app and glycemic control in type 1 diabetes patients. This retrospective study included adults with type 1 diabetes who had joined the mobile community "TangTangQuan" since May 2018 for at least 1 year. "Like", "comment" and "share" were the major interaction indicators of the mobile community and were used to assess engagement in peer support. The patients were divided into four engagement groups by quartile. The primary outcome was the change in glycosylated hemoglobin (HbA1c ), mean fasting blood glucose (FBG) and postprandial blood glucose (PBG) from baseline to the 12th month. Other outcomes included the change of self-monitoring of blood glucose frequency, hypoglycemia frequency and the proportion of reaching optimal glycemic control. Among the 693 individuals, the HbA1c , mean FBG and PBG improved in the 12th month. Multiple regression analysis showed that higher engagement in peer support was associated with a greater reduction of HbA1c (β = -0.45, P < 0.001) and mean FBG (β = -0.82, P < 0.001). In the subgroup of poor glycemic control, the association between engagement in peer support and glycemic improvement still remained (HbA1c : β = -0.86, P = 0.002; FBG: β = -1.36, P = 0.001). The engagement in mobile peer support was positively correlated with educational level (odds ratio 1.42, P = 0.042), household income (odds ratio 1.43, P = 0.013) and the use of continuous subcutaneous insulin infusion (odds ratio 1.73, P = 0.009). High engagement in mobile peer support was associated with better glycemic control in adults with type 1 diabetes.