Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: May 21, 2021
Date Accepted: Feb 20, 2022
Web-based TangPlan and WeChat Combination to Support Self-Management for Patients with Type 2 Diabetes: Randomized Controlled Trial
ABSTRACT
Background:
China is the epicenter with the largest number of type 2 diabetes mellitus (T2DM) patients in the world. However, due to insufficient knowledge of diabetes self-management, blood glucose control is poor. Most of the diabetes-related self-management applications fail to bring significant benefits to T2DM patients because of the low usage rate and difficult operation.
Objective:
This study aims to examine the effectiveness of the combination of self-designed web-based T2DM management software, TangPlan, and WeChat (TWC) on fasting blood glucose (FBG), glycated hemoglobin (HbA1c), body weight, blood pressure (BP) and lipid profiles in T2DM patients for a 6-month period.
Methods:
Participants were recruited from a community healthcare center and randomized into the TWC group or the control group. Participants in the control group received usual care, while the TWC participants received self-management education with the help of TangPlan and WeChat by healthcare professionals, including blood glucose self-monitoring, healthy eating, actively physical exercise, increasing medication compliance, and health education during follow-ups, lectures, or online communication. They were also asked to record and send self-management data to the healthcare professionals by WeChat to obtain timely and effective guidance on diabetes self-management.
Results:
In this study, 156 enrolled individuals completed baseline information collection and 76.9% (120/156) completed the 6-month follow-up visit. After the intervention, FBG (6.51 ± 1.66 mmol/L, P = .048), HbA1c (6.87 ± 1.11 %, P < .001), body weight (66.50 ± 9.51 kg, P = .006), systolic BP (SBP, 127.03 ± 8.00mmHg, P = .005) and diastolic BP (DBP, 75.25 ± 5.88 mmHg, P = .03), serum high-density lipoprotein cholesterol (HDL-C, 1.20 ± 0.25 mmol/L, P = .01), low-density lipoprotein cholesterol (LDL-C, 2.50 ± 0.61 mmol/L, P = .006) and total cholesterol (TC, 4.01 ± 0.83 mmol/L, P = .02) in the TWC group were all significantly lower than those in the control group. Compared with the baseline data, significance was found on the mean change of FBG (95%CI: -0.83 to -0.20; P = .002), HbA1c (95%CI: -1.92 to -1.28; P < .001), body weight (95%CI: -3.13 to -1.68; P < .001), BMI (95%CI: -1.10 to -0.60; P < .001), SBP (95%CI: -7.37 to -3.94; P < .001), DBP (95%CI: -4.52 to -2.33; P < .001), TG (95%CI: -0.16 to -0.03; P = .004), LDL-C (95%CI: -0.54 to -0.30; P < .001) and TC (95%CI: -0.60 to -0.34; P < .001) in the TWC group, but not in the control group (P > .05).
Conclusions:
Compared to the usual care for T2DM patients, the combination of TangPlan and WeChat was effective in improving glycemic control (decrease in HbA1c levels and blood glucose level), and serum lipid profiles, as well as reducing body weight in T2DM patients after a duration of 6 months. Clinical Trial: Chinese Clinical Trial Registry ChiCTR2000028843; http://www.chictr.org.cn/edit.aspx?pid=46668&htm=4
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