Decrease In Glycosylated Hemoglobin Research Articles

Internet of medical things-based real-time digital health service for precision medicine: Empirical studies using MEDBIZ platform.

The aim of this study was to introduce the implemented MEDBIZ platform based on the internet of medical things (IoMT) supporting real-time digital health services for precision medicine. In addition, we demonstrated four empirical studies of the digital health ecosystem that could provide real-time healthcare services based on IoMT using real-world data from in-hospital and out-hospital patients. Implemented MEDBIZ platform based on the IoMT devices and big data to provide digital healthcare services to the enterprise and users. The big data platform is consisting of four main components: IoMT, core, analytics, and services. Among the implemented MEDBIZ platform, we performed four clinical trials that designed monitoring services related to chronic obstructive pulmonary disease, metabolic syndrome, arrhythmia, and diabetes mellitus. Of the four empirical studies on monitoring services, two had been completed and the rest were still in progress. In the metabolic syndrome monitoring service, two studies were reported. One was reported that intervention components, especially wearable devices and mobile apps, made systolic blood pressure, diastolic blood pressure, waist circumference, and glycosylated hemoglobin decrease after 6 months. Another one was presented that increasing high-density lipoprotein cholesterol and triglyceride levels were prevented in participants with the pre-metabolic syndrome. Also, self-care using healthcare devices might help prevent and manage metabolic syndrome. In the arrhythmia monitoring service, during the real-time monitoring of vital signs remotely at the monitoring center, 318 (15.9%) general hikers found abnormal signals, and 296 (93.1%) people were recommended for treatment. We demonstrated the implemented MEDBIZ platform based on IoMT supporting digital healthcare services by acquiring real-world data for getting real-world evidence. And then through this platform, we were developing software as a medical device, digital therapeutics, and digital healthcare services, and contributing to the development of the digital health ecosystem.

Making her MTM vision reality

Making her MTM vision reality

Risk factors for frequent and severe hypoglycemia in type 1 diabetes.

To determine the risk of frequent and severe hypoglycemia and the associated demographic and clinical risk factors. Demographic and diabetes self-management factors were measured in 415 subjects followed prospectively for 4-6.5 years of type 1 diabetes duration as participants in a population-based incident cohort. Blood samples were collected up to three times yearly to test glycosylated hemoglobin (GHb) levels. Reports of frequent (2-4 times/week) and severe (lost consciousness) hypoglycemia as well as other diabetes self-management data were collected by questionnaires. Frequent hypoglycemia was common (33 and 35% of participants reported this on the 4- and 6.5-year questionnaires, respectively), whereas severe hypoglycemia occurred much less often. Better glycemic control (odds ratio [OR] 1.3 per 2% decrease in GHb, 95% CI 1.1-1.5) and more frequent self-monitored blood glucose (1.5 per blood glucose check, 1.3-1.7) were independently related to frequent hypoglycemia. The association of frequent hypoglycemia with intensive insulin therapy increased with age. Better glycemic control (1.5 per 2% decrease in GHb, 1.2-2.0) and older age were related to severe hypoglycemic reactions. No sociodemographic factors other than age increased the risk of hypoglycemia. Frequent hypoglycemia was common in a population representing the full range of glycemic control in the community. Intensive insulin management and blood glucose monitoring independently predicted frequent but not severe hypoglycemia. This information may be useful for updating patients such that minor changes in diabetes management might decrease the daily burden of this condition while maintaining intensive insulin therapy.

Effects of intensified practitioner-patient communication on control of diabetes mellitus.

Control of diabetes mellitus requires active participation of patients in self-care and ongoing support from medical professionals. This study examines the hypothesis that control of diabetes can be improved by more frequent communication between patients and medical professionals. We instructed 233 insulin-requiring diabetic patients to mail the results of home blood glucose monitoring to the physician's office at least every two weeks. Feedback from office nurse practitioners followed receipt of these reports, providing frequent two-way communication between regularly scheduled office appointments. In the group of patients who mailed reports more than 26 weeks during the year, the mean glycosylated hemoglobin (GHb) value was 10.4% at baseline, and there was a mean decrease in GHb of 1.0% during the succeeding year (P = .001). In patients who mailed reports less than 26 weeks during the year, mean GHb was 10.2% at baseline, and there was no significant change during the succeeding year. Since mean GHb was virtually identical in the two groups at baseline, mailing the reports of home-determined blood glucose levels and receiving feedback between office visits resulted in improved control of diabetes.