Effects of Digitization of Self-monitoring of Blood Glucose Records using a Mobile Application and the Cloud System on Outpatient Management of Diabetes: Single-armed Prospective Study
ABSTRACT
Background:
The application–cloud cooperation system consisting of a mobile application linked to blood glucose meters to digitize self-monitoring of blood glucose (SMBG) records and to cloud-computing services could support sharing of SMBG and other health data with physicians.
Objective:
We evaluated the impact of an application–cloud cooperation system with feedback from the attending physician during face-to-face visits on outpatient management of diabetes.
Methods:
In this multicenter, open-label, single-armed prospective study, 48 patients with diabetes (including type 1 and type 2) treated with insulin or GLP-1 receptor agonists and performing SMBG at three hospitals in Japan used the application–cloud cooperation system for 24 weeks. The SMBG data were automatically uploaded to the cloud via the application. The patients could check their data, and their attending physicians reviewed the data through the cloud prior to the patients’ regular visits. The primary outcome was changes in HbA1c levels.
Results:
While HbA1c levels did not change significantly in total patients, it significantly decreased at 12 weeks in 21 patients whose antidiabetic medication had not been adjusted during the intervention period (−0.26%, 95% confidence interval [CI], −0.47 to −0.05; P = .018). The frequency of SMBG after inducing the system was significantly higher than before induction at 12 (+0.60/day, 95%CI, 0.19–1.00; P = .002) and 24 (+0.43/day, 95%CI, 0.02–0.84; P = .039) weeks. The Diabetes Treatment Satisfaction Questionnaire total score and “Q4; convenience” and “Q5; flexibility” scores significantly improved after using the Smart e-SMBG system, and 71.7% patients and 76.1% physicians reported that the application–cloud cooperation system helped them adjust insulin doses.
Conclusions:
In conclusion, digitization of SMBG records and sharing the data by patients and attending physicians during face-to-face visits improved glycemic control and self-management in patients with diabetes. Clinical Trial: jRCTs042190057
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