Accepted for/Published in: JMIR Diabetes
Date Submitted: Jun 28, 2022
Open Peer Review Period: Jun 28, 2022 - Jul 17, 2022
Date Accepted: Aug 18, 2022
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited.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.
Effects of a digital patient empowerment and communication tool on metabolic control in people with type 2 diabetes: DeMpower Study
ABSTRACT
Background:
Diabetes is a major health care problem, reaching epidemic numbers worldwide. Reducing glycated hemoglobin (HbA1c) levels to recommended targets is associated with a marked decrease in the risk of T2DM-related complications. The implementation of new technologies, particularly telemedicine, may be helpful to facilitate self-care and empowerment of people with T2DM leading to an improved metabolic control of the disease.
Objective:
To analyze the effect of a home digital patient empowerment and communication tool (DeMpower App) on metabolic control in people with inadequately-controlled type 2 diabetes mellitus (T2DM).
Methods:
The DeMpower study was multicenter with a retrospective (observational: 52 weeks of follow-up) and prospective (interventional: 52 weeks of follow-up) design that included people with T2DM, aged ≥18 and ≤80 years, with HbA1c levels ≥7.5% to ≤9.5%, receiving treatment with non-insulin antihyperglycemic agents and able to use a smartphone App. Individuals were randomly assigned (2:1) to the DeMpower App-empowered group or control group. We describe the effect of empowerment on the proportion of patients achieving the study glycemic target, defined as HbA1c ≤7.5% with a reduction in HbA1c ≥0.5% at week 24.
Results:
Due to the COVID-19 pandemic, the study was stopped prematurely, and 50 patients (33 and 17, respectively) were analyzed. There was a trend towards a higher proportion of patients achieving the study glycemic target (46% vs 18%; P=0.07) in the DeMpower App group, that was statistically significant when the target was HbA1c ≤7.5% (64% vs 24%; P=0.02) or HbA1c ≤8.0% (85% vs 53%; P=0.02).The mean HbA1c was significantly reduced at week 24 (−0.81±0.89 vs −0.15±1.03; P=0.03) and trends for improvement of other cardiovascular risk factors, medication adherence, and satisfaction were observed.
Conclusions:
The results suggest that patient empowerment through home digital tools has a potential effect on metabolic control, which might be even more relevant during the COVID-19 pandemic and in a digital health scenario.
Citation
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