Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Apr 01, 2024)
Date Submitted: Mar 17, 2023
Open Peer Review Period: Mar 17, 2023 - May 12, 2023
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Adherence to Blood Glucose Self-Monitoring Guidance and Glycemic Control in Chinese Patients with Type 2 Diabetes Mellitus Initiating Basal Insulin: An mHealth-Based Prospective Cohort Study
ABSTRACT
Background:
Diabetes has become a severe health threat in China, owing to its increasing prevalence, long-term morbidity, and mortality.
Objective:
This study evaluated the association between adherence to blood glucose self-monitoring guidance and glycemic control among patients with T2DM A 12-week mHealth-based prospective cohort study was conducted. Patients received recommendations on self-monitoring of blood glucose (SMBG) testing frequencies and uploaded testing results through smart glucose monitoring devices. initiating basal insulin in China.
Methods:
A 12-week mHealth-based prospective cohort study was conducted. Patients received recommendations on self-monitoring of blood glucose (SMBG) testing frequencies and uploaded testing results through smart glucose monitoring devices.
Results:
A total of 14,084 patients from 242 hospitals were enrolled. Most patients (73.3%) had <4 times SMBG testing per week, and these patients were significantly older, mostly males, had a longer duration of diabetes, lower income and received less education than patients with better adherence. Larger HbA1c reduction was observed in patients with 4-7 and ≥7 times of SMBG testing per week compared to patients with <4 times of SMBG testing per week (LS mean difference [95% CI]: -0.10 [-0.18, -0.02], and -0.17 [-0.26, -0.08], respectively, and this was more prominent in patients with baseline HbA1c >9%. The benefit of improving adherence to SMBG guidance was consistently found for FBG reduction, HbA1c, and FBG target rate.
Conclusions:
The study demonstrated a positive relationship between adherence and glycemic control and identified patient characteristics with poorer adherence for further customization of mHealth.
Citation
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