Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 20, 2019
Date Accepted: Oct 20, 2019
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effectiveness of smartphone application interactive-management on glycaemic control in Chinese patients with poorly controlled diabetes: A randomized controlled trial
ABSTRACT
Background:
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 mobile applications (APPs) are global, convenient, cheap, and interactive. Although APP was proved to be more effective at glycaemic control compared with traditional computer-based and web-based telemedicine technologies, how to gain a further and sustained improvement is still being explored.
Objective:
The aim of this study was to investigate the effectiveness of an APP-based interactive-management model by a professional healthcare team on glycemic control in Chinese patients with poorly controlled diabetes.
Methods:
This study was a 6-month, single-centre, prospective, randomized controlled trial. A total of 276 type 1 or type 2 diabetes patients were enrolled and randomized to control group, APP self-management group, and APP interactive-management group in a 1:1:1 ratio. The primary outcome was the change in glycated haemoglobin A1c (HbA1c) level and the proportions of patients achieving HbA1c < 7.0%.
Results:
At months 3 and 6, all three groups showed significant decreases in HbA1c levels (all P<.05). There was a significant improvement in the HbA1c level among patients in the APP interactive-management group as well as the proportion of patients achieving HbA1c < 7% compared with the control group at both months 3 and 6 (all P<.05). The proportion of patients achieving HbA1c < 7% in the APP self-management group was higher than that in control group at month 3 (P=.05); however, at month 6, no significant difference was observed for both HbA1c level and proportions of patients achieving HbA1c < 7% (all P>.05). In addition, a significant difference in HbA1c reduction at month 6 was observed between the APP interactive-management group and APP self-management group (P=.037).
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 with interactive-management can help to achieve rapid and sustained glycaemic control. Clinical Trial: This study was registered at ClinicalTrials.gov, number NCT02589730.
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