Effects of mobile phone application combined with or without self-monitoring of blood glucose on glycemic control in patients with diabetes: A randomized controlled trial

Abstract

Aims/introduction: There is potential for mobile applications to deliver new self-management interventions for chronic disease, especially in diabetes. The aim of the present study was to evaluate the effects of a mobile phone application (MPA) combined with or without self-monitoring of blood glucose (SMBG) on glycemic control in patients with diabetes.

Materials and methods: The study was a 24-week period, four-arm parallel group, non-blinded, randomized trial. A total of 185 patients with mean age of 52 years were randomized to group A (no MPA and no SMBG), group B (SMBG only), group C (MPA only) and group D (both MPA and SMBG were used). Changes in glycated hemoglobin (HbA1c), fasting plasma glucose and 1,5-anhydroglucitol from baseline to week 24 were analyzed.

Results: At 24 weeks, the HbA1c levels in patients of all groups decreased significantly from baseline. There were significant differences in the proportions of patients that achieved HbA1c <7% between groups, especially in group C and group D, compared with group A at week 24 (60.4%, 62.2% vs 25.5%, all P < 0.05). 1,5-Anhydroglucitol changes were obvious in group A and group C at week 24 from baseline (all P < 0.05 within groups). Factorial analysis of anova showed that MPA intervention was the main effective factor for HbA1c change (F = 4.59, P = 0.034), and there was no effect on HbA1c change for SMBG intervention (P = 0.975).

Conclusions: Implementation of the MPA, Diabetes-Carer, is effective in improving the proportion of HbA1c <7% in patients with type 2 diabetes.

Keywords: Diabetes mellitus; Mobile applications; Self-monitoring of blood glucose.

Figure 1

Study design and participant flow diagram for the present study. MPA, mobile phone application; SMBG, self‐monitoring of blood glucose.

Figure 2

Glycemic control during 24 weeks in four groups. Group A: no mobile phone application (MPA) and no self‐monitoring of blood glucose (SMBG); Group B: SMBG only; Group C: MPA only; Group D: both MPA and SMBG were used. (a) Glycated hemoglobin (HbA1c) levels during 24 weeks in four groups. All P < 0.01 for comparisons of changes of HbA1c levels within groups at week 24. (b) The proportions of patients that achieved HbA1c <7.0% during 24 weeks in four groups. P < 0.01 for comparisons of the proportions of patients that achieved HbA1c <7.0% between groups for group C and group D at week 24.