Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 5, 2025
Date Accepted: Jan 30, 2026
Long-term Mobile-based glycemic intervention for secondary prevention in patients with diabetes undergoing surgical revascularization: A multi-center randomized controlled trial
ABSTRACT
Background:
Despite the growing amount of patients who underwent coronary artery bypass grafting (CABG) in developing countries like China, their glucose control was suboptimal, likely due to poor adherence to healthy lifestyles and preventive medications. MHealth tools facilitating secondary prevention seem promising, but evidence focusing on this high-risk population is scarce.
Objective:
Evaluating the Significance of Mobile Health Tools in Long-Term Glycemic Management for Post-Coronary Artery Bypass Grafting Patients with Comorbid Diabetes Mellitus.
Methods:
GUIDEME is a multi-center, open-label, randomized controlled trial, in which 1066 patients with diabetes who had recently undergone CABG were enrolled and allocated into two groups. Patients in the control group received conventional health education before discharge, whereas those in the intervention group additionally received automatic delivery of bite-size health education and medication reminders through a smartphone APP during the 6 months after discharge. The primary endpoint was a change in Hemoglobin A1C (HbA1C) from baseline to 6 months.
Results:
Among the 1066 eligible participants enrolled, a total of 1038 (97.4%) had completed the follow-up, while 1000 (93.8%) had six-month HbA1C results available. A greater reduction of HbA1C in the intervention group was observed (-0.7% vs -0.5%, P = 0.037). The intervention group also had a high proportion of good medication adherence (96.1% vs 93.2%, P = 0.047). There was no difference between the two groups regarding the secondary endpoints.
Conclusions:
Health education and medication reminders based on smartphone APP improve glycemic management after CABG in patients with diabetes significantly. Clinical Trial: ClinicalTrials (NCT 04192409).
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