JMIR Publications

ABSTRACT

Background:

Self-monitoring of blood glucose (SMBG) is recommended in clinical practice guidelines, including those in China, as part of patient education, self-management, and empowerment. With technological advancements, telecommunication technologies are now used for telemonitoring in healthcare. Mobile apps have become a practical tool for SMBG among patients with type 2 diabetes mellitus (T2DM). However, the long-term effectiveness of this approach in real-world practice requires further exploration.

Objective:

The study aimed to determine the effectiveness of mobile app-assisted SMBG in improving glycemic control in patients with T2DM at 12 months, in addition to standard care, in Ningbo, China.

Methods:

This retrospective cohort study used data from the National Metabolic Management Center (MMC) in Ningbo. Adults with T2DM who registered at this MMC for the first time between 1st September 2019 and 30th June 2022 and received standardized diabetes management were included. The study compared two groups: those who opted for mobile app-assisted SMBG and those who did not. Propensity score matching matched the mobile app-assisted SMBG group with the control group based on similar baseline characteristics. Glycemic control-related outcomes were compared at 12-month follow-up. Linear and logistic regression models were used to estimate mean differences (MDs) and odds ratios (ORs) along with 95% confidence intervals (CIs), respectively, and adjustments were made for baseline characteristics.

Results:

160 patients (80 in each group) were included in the study. Compared to the control, fasting blood glucose and HbA1c levels were lower in the mobile app-assisted SMBG group, but the differences were statistically insignificant (MD -0.17 mmol/L, 95% CI -0.85 to 0.51 and -0.12%, -0.58 to 0.33, respectively). However, compared to the control, the proportion of patients achieving or maintaining fasting blood glucose <7mmol/L and HbA1c <7% were lower in the mobile app-assisted SMBG group, but the differences were statistically insignificant (OR 0.89, 95% CI 0.46 to 1.73 and 0.91, 0.44 to 1.88, respectively).

Conclusions:

While some glycemic control outcomes improved in patients with T2DM using mobile app-assisted SMBG alongside standard care in Ningbo, China, at 12 months, these improvements were not statistically significant. A larger sample size would be needed to provide more definitive conclusions.