JMIR Publications

ABSTRACT

Background:

Chronic kidney disease (CKD) is a common comorbidity of type 2 diabetes mellitus (T2DM). Data on the determination of CKD-related biomarkers in a real-life setting in patients with T2DM in Germany are limited.

Objective:

We aimed to determine the prevalence of CKD and risk factors, availability of urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) values, treatment satisfaction, and quality of life in patients with T2DM in Germany.

Methods:

SMART-Finder is a retrospective and prospective, observational, digital, patient-centered cohort study performed as part of the routine use of an adherence-supporting app. This baseline analysis was conducted from August to November 2023. Patients with T2DM in Germany actively using the MyTherapy app, allowing push notifications, and documenting use of diabetes medications, renin-angiotensin system inhibitors, finerenone, and/or blood glucose test strips were eligible for inclusion. Study materials (background information, electronic consent form, laboratory and electronic questionnaires) were provided directly to eligible patients via push notifications in the app. Participants completed an electronic case report form (eCRF) including questions on their blood pressure, most recent UACR, eGFR, and glycated hemoglobin (HbA1c) values in the past 12 months, the EQ-5D-5L, and the Diabetes Treatment Satisfaction Questionnaire (DTSQ). The primary outcome was the proportion of patients with UACR ≥30 mg/g.

Results:

Of 9527 invited eligible patients, 101 completed the eCRF (61 male and 40 female; mean age: 54.2 years). Of the 101 patients, only 6 patients reported UACR values (3 had UACR ≥30 mg/g) and 9 patients reported eGFR values. Ninety patients provided HbA1c values. Forty-six patients had systolic blood pressure ≥130 mm Hg. The mean EQ-5D-5L index score was 0.7 (range, –0.1 to 1.0; 50 patients) and the mean DTSQ score was 28.8 (range: 9.0-36.0; 49 patients).

Conclusions:

Patients with T2DM using an adherence-supporting app in Germany showed a lack of awareness of CKD-related biomarkers but high knowledge of HbA1c values. Future goals for diabetes management must include guideline-compliant testing of CKD-related biomarkers and open physician-patient communication.