JMIR Publications

ABSTRACT

Background:

Among the self-care measures, self-monitoring of blood glucose (SMBG) is a critical component for checking blood glucose levels. However, for non-insulin-treated DMT2 patients, the value of SMBG was inconsistent among studies. In addition, there is growing evidence suggesting that digital technologies are being adopted as an additional method for healthcare systems to increase patient contact. However, evidence from real-world clinical practice is still limited.

Objective:

To assess non-insulin-treated DMT2 patients that were receiving care from the same clinic and analyze whether usage of a diabetes management app and SMBG behavior affect glycemic control in real-world clinical settings.

Methods:

We collaborated with a large clinic in Taiwan focused on diabetes care that has been using the Health2Sync mobile app and web-based Patient Management Platform to collect the data. The patients were divided into two groups (app-engaged-user, only-data-uploader) according to different activities in the app, and blood glucose was recorded every month from 1 to 6 months after registration in the app. A sample of 420 patients was included in the analysis, and a linear mixed model was built to investigate what factors affect patients' blood glucose percentage change.

Results:

With the mixed model coefficient estimates, we found that the percentage change was significantly negative when the only-data-uploader group was set as the baseline (t = -4.289, P < .001 for the patients of app-engaged-user group).Furthermore, we found that for patients with shorter diabetes duration the blood glucose decreased more ( t = 4.219, P < .001 for the number of diabetes duration). Finally, we also found that the count of blood glucose measured enlarged the decrease along the interaction months (t = -6.911, P < .001 for Nth month * count of blood glucose in Nth month).

Conclusions:

Our analysis showed that the blood glucose percentage change of the patient who was in the app-engaged-user group dropped more than that of the patient who was in the only-data-uploader group, shorter diabetes duration is associated with steeper decrease in the patient's blood glucose percentage change, and the more frequently patients test SMBG each month, the higher the decrease in the patient's blood glucose percentage. Further studies can be performed to consider the differences in daily behaviors such as exercise, diet across the patients, and these factors could have vital impacts on glycemic control.