Effectiveness of Smartphone App-Based Interactive Management on Glycemic Control in Chinese Patients With Poorly Controlled Diabetes: Randomized Controlled Trial

Lei Zhang, Xingxing He, Yun Shen, Haoyong Yu, Jiemin Pan, Wei Zhu, Jian Zhou, Yuqian Bao, Lei Zhang, Xingxing He, Yun Shen, Haoyong Yu, Jiemin Pan, Wei Zhu, Jian Zhou, Yuqian Bao

Abstract

Background: In recent years, the rapid development of mobile medical technology has provided multiple ways for the long-term management of chronic diseases, especially diabetes. As a new type of management model, smartphone apps are global, convenient, cheap, and interactive. Although apps were proved to be more effective at glycemic control, compared with traditional computer- and Web-based telemedicine technologies, how to gain a further and sustained improvement is still being explored.

Objective: The objective of this study was to investigate the effectiveness of an app-based interactive management model by a professional health care team on glycemic control in Chinese patients with poorly controlled diabetes.

Methods: This study was a 6-month long, single-center, prospective randomized controlled trial. A total of 276 type 1 or type 2 diabetes patients were enrolled and randomized to the control group (group A), app self-management group (group B), and app interactive management group (group C) in a 1:1:1 ratio. The primary outcome was the change in glycated hemoglobin (HbA1c) level. Missing data were handled by multiple imputation.

Results: At months 3 and 6, all 3 groups showed significant decreases in HbA1c levels (all P<.05). Patients in the app interactive management group had a significantly lower HbA1clevel than those in the app self-management group at 6 months (P=.04). The average HbA1c reduction in the app interactive management group was larger than that in the app self-management and control groups at both months 3 and 6 (all P<.05). However, no differences in HbA1c reduction were observed between the app self-management and control groups at both months 3 and 6 (both P>.05). Multivariate line regression analyses also showed that the app interactive management group was associated with the larger reduction of HbA1c compared with groups A and B at both months 3 and 6 (all P>.05). In addition, the app interactive management group had better control of triglyceride and high-density lipoprotein cholesterol levels at both months 3 and 6 compared with baseline (both P<.05).

Conclusions: In Chinese patients with poorly controlled diabetes, it was difficult to achieve long-term effective glucose improvement by using app self-management alone, but combining it with interactive management can help achieve rapid and sustained glycemic control.

Trial registration: ClinicalTrials.gov NCT02589730; https://ichgcp.net/clinical-trials-registry/NCT02589730.

Keywords: app; diabetes; glycated hemoglobin A1c; guidance; interactive management; self-management.

Conflict of interest statement

Conflicts of Interest: None declared.

©Lei Zhang, Xingxing He, Yun Shen, Haoyong Yu, Jiemin Pan, Wei Zhu, Jian Zhou, Yuqian Bao. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 09.12.2019.

Figures

Figure 1
Figure 1
Study design and participant flow diagram.

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