Internet Diabetic Patient Management Using a Short Messaging Service Automatically Produced by a Knowledge Matrix System

Abstract

Lifelong strict self-care is essential in the management of diabetes, along with easy access to the health care system (1–3). However, there is an evident limitation in fulfilling these conditions in the current health care system, which is oriented toward outpatient care (4–7). Thus, various strategies have been designed to improve the quality and efficiency of treating diabetic patients. Wireless technology is a worldwide communication system that allows a person to contact others anywhere at any time. Therefore, doctor-patient communication becomes possible anywhere with the use of this system (8). Currently, in civilized countries, nearly all adults and adolescences have their own cellular phones and use short message services (SMSs) in their daily lives. Moreover, numerous people are using ultra-fast Internet services at work or in the home. We designed an Internet-based diabetic patient management system using SMS that was automatically produced by a knowledge matrix. Subsequently, we compared biochemical profiles and clinical status between diabetic patients who used our system for 12 weeks and those who received the conventional outpatient management over the same time period. We developed a knowledge matrix containing information on proper diet and exercise for diabetic patients based on the Korea Staged Diabetes Management Guideline (Table 1). Moreover, with the technical assistance from ISU UBCare, we created a Web site program (http://yds.healthkorea.net) that was used to formulate appropriate messages through an automated algorithm. We also designed a device that had the dual function of a glucometer and a pedometer. By connecting this device to the …