Diabetes App-Related Text Messages From Health Care Professionals in Conjunction With a New Wireless Glucose Meter With a Color Range Indicator Improves Glycemic Control in Patients With Type 1 and Type 2 Diabetes: Randomized Controlled Trial

Mike Grady, Laurence Barry Katz, Hilary Cameron, Brian Leonard Levy, Mike Grady, Laurence Barry Katz, Hilary Cameron, Brian Leonard Levy

Abstract

Background: Mobile diabetes apps enable health care professionals (HCPs) to monitor patient progress, offer remote consultations, and allow more effective and informed treatment decisions between patients and HCPs. The OneTouch Reveal app aggregates data from a blood glucose meter and provides analytics to help patients and HCPs visualize glycemic trends and patterns, enabling more informed treatment and lifestyle decisions. The app also allows patients and HCPs to keep connected by exchanging text messages (short message service [SMS]) or progress reports via email.

Objective: The primary objective of our study was to assess changes in glycemic control and overall experiences of patients and HCPs using the app in conjunction with the wireless OneTouch Verio Flex blood glucose meter.

Methods: We randomly assigned 137 adults with type 1 (T1DM) or type 2 diabetes mellitus (T2DM) and a glycated hemoglobin (HbA1c) level of ≥7.5% and ≤11.0% to use the glucose meter alone or glucose meter plus the app for 24 weeks. The meter + app group were scheduled to receive diabetes-related text messages from their HCP every 2 weeks (total of 12 texts). Clinical measures and self-reported outcomes were assessed during face-to-face clinic visits between the participant and a diabetes nurse at baseline, week 12, and week 24.

Results: In 128 completed participants, HbA1c decreased after 12 and 24 weeks in both the meter-only (n=66) (0.56% and 0.55%, respectively) and meter + app groups (n=62) (0.78% and 0.67%, respectively) compared with baseline (each P<.001). The difference in HbA1c reduction between the 2 groups was not statistically significant at 12 or 24 weeks (P=.12 and P=.45, respectively). However, the decrease in HbA1c was greater in T2DM participants using the meter + app after 12 weeks (1.04%) than in T2DM participants using the meter alone (0.58%; P=.09). In addition, decrease in HbA1c in participants using the meter + app who received at least 10 diabetes-related text messages (1.05%) was significantly greater than in meter-only participants (P<.01).

Conclusions: Use of the OneTouch Verio Flex glucose meter alone or in combination with the OneTouch Reveal diabetes app was associated with significant improvements in glycemic control after 12 and 24 weeks. Improvements using the app were greatest in participants with T2DM and those participants who received the highest number of HCP text messages. This study suggests that real-time availability of patient data and the ability to send personalized diabetes-related text messages can assist HCPs to improve glycemic control in patients between scheduled visits.

Trial registration: Clinicaltrials.gov NCT02429024; https://ichgcp.net/clinical-trials-registry/NCT02429024 (Archived by WebCite at http://www.webcitation.org/6sCTDRa1l).

Keywords: blood glucose monitor, wireless; color range indicator; diabetes app; text message.

Conflict of interest statement

Conflicts of Interest: MG and HC are employees of LifeScan Scotland, Ltd. BLL and LBK are employees of LifeScan Inc.

©Mike Grady, Laurence Barry Katz, Hilary Cameron, Brian Leonard Levy. Originally published in JMIR Diabetes (http://diabetes.jmir.org), 07.08.2017.

Figures

Figure 1
Figure 1
Study data flow. All participants used the OneTouch Verio Flex meter to conduct self-monitoring of blood glucose (SMBG). SMBG data were transmitted wirelessly from the meter to the smartphone containing the diabetes management app OneTouch Reveal. SMBG data were automatically uploaded via the cloud to a Web-based version of the app accessible by site health care professionals (HCPs) on their office computers. HCPs reviewed the 14-day app report for each participant to assist in formulating diabetes-related text messages sent to the participant’s smartphone.
Figure 2
Figure 2
Glycated hemoglobin (HbA1c) at baseline and after 12 and 24 weeks of home use for participants using the meter only or the meter + app. Data shown are mean (SEM). Differences from baseline were significant in each group at 12 and 24 weeks (P<.001). Differences between the meter-only and meter + app groups were not statistically significant at 12 or 24 weeks.
Figure 3
Figure 3
Decrease from baseline in glycated hemoglobin (HbA1c) after 12 and 24 weeks of home use in participants with type 1 (T1DM) or type 2 diabetes mellitus (T2DM) in the meter-only and meter + app groups. Data shown are mean (SEM) changes. Differences from baseline were significant in each group at 12 and 24 weeks (P<.001). The reduction in HbA1c from baseline was more pronounced in the meter + app group than in the meter-only group, especially at 12 weeks (P=.09).
Figure 4
Figure 4
Decrease from baseline in glycated hemoglobin (HbA1c) after 12 and 24 weeks of home use for participants who received 10 to a maximum of 12 text messages versus the meter-only group (no text messages). Data shown are mean (SEM) changes. * P<.05; ** P<.01. Results in the meter + app group were statistically different from the corresponding meter-only group at 12 weeks (P<.01) and 24 weeks (P<.05).

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Source: PubMed

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