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Randomized Controlled Trial
. 2019 Jan 4;7(1):e10664.
doi: 10.2196/10664.

Mobile Phone-Based Telemedicine Practice in Older Chinese Patients with Type 2 Diabetes Mellitus: Randomized Controlled Trial

Chenglin Sun #  1 , Lin Sun #  1 , Shugang Xi #  1 , Hong Zhang  1 , Huan Wang  1 , Yakun Feng  2 , Yufeng Deng  1 , Haimin Wang  1 , Xianchao Xiao  1 , Gang Wang  1 , Yuan Gao  1 , Guixia Wang  1
Affiliations
Randomized Controlled Trial

Mobile Phone-Based Telemedicine Practice in Older Chinese Patients with Type 2 Diabetes Mellitus: Randomized Controlled Trial

Chenglin Sun et al. JMIR Mhealth Uhealth. .

Abstract

Background: Previous studies on telemedicine interventions have shown that older diabetic patients experience difficulty in using computers, which is a barrier to remote communication between medical teams and older diabetic patients. However, older people in China tend to find it easy to use mobile phones and personal messaging apps that have a user-friendly interface. Therefore, we designed a mobile health (mHealth) system for older people with diabetes that is based on mobile phones, has a streamlined operation interface, and incorporates maximum automation.

Objective: The goal of the research was to investigate the use of mobile phone-based telemedicine apps for management of older Chinese patients with type 2 diabetes mellitus (T2DM). Variables of interest included efficacy and safety.

Methods: A total of 91 older (aged over 65 years) patients with T2DM who presented to our department were randomly assigned to one of two groups. Patients in the intervention group (n=44) were provided glucometers capable of data transmission and received advice pertaining to medication, diet, and exercise via the mHealth telemedicine system. Patients assigned to the control group (n=47) received routine outpatient care with no additional intervention. Patients in both groups were followed up at regular 3-month intervals.

Results: After 3 months, patients in the intervention group showed significant (P<.05) improvement in postprandial plasma glucose level. After 6 months, patients in the intervention group exhibited a decreasing trend in postprandial plasma glucose and glycated hemoglobin levels compared with the baseline and those in the control group (P<.05).

Conclusions: Mobile phone-based telemedicine apps help improve glycemic control in older Chinese patients with T2DM.

Trial registration: China Clinical Trial Registration Center ChiCTR 1800015214; http://www.chictr.org.cn/showprojen.aspx?proj=25949 (Archived by WebCite at http://www.webcitation.org/73wKj1GMq).

Keywords: health management; telemedicine; type 2 diabetes.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
The changes in HbA1c levels after follow-up in both groups. After 3 months, HbA1c levels in both groups were significantly improved compared with baseline data (P<.01). Six months later, intervention group HbA1c was lower than baseline (P<.01), as were the control group HbA1c levels (P<.05). "a" indicates P<.05 versus baseline and asterisk indicates P<.05 versus control group.
Figure 2
Figure 2
The comparison of the amplitude of change of HbA1c levels in both groups. The mean change in HbA1c levels from baseline to 6 months in the intervention group was significantly higher than that in the control group (P<.05). Asterisk indicates P<.05 versus control group.
Figure 3
Figure 3
The changes in postprandial blood glucose levels after follow-up in both groups. At the end of 3 and 6 months, the intervention group postprandial blood glucose was significantly lower than the control group postprandial blood glucose (P<.05 and P<.01). "b" indicates P<.01 versus baseline; asterisk indicates P<.05; and # indicates P<.01 versus control group.
See this image and copyright information in PMC

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