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Randomized Controlled Trial
. 2025 May;31(4):523-533.
doi: 10.1177/1357633X231203490. Epub 2023 Sep 27.

Effectiveness of an algorithm-driven home telemonitoring system on the metabolic control and self-care behaviour of Asian adults with type-2 diabetes mellitus: A randomised controlled trial

Ngiap Chuan Tan  1   2 , Shilpa Tyagi  3 , Cia Sin Lee  1   2 , Eileen Yi Ling Koh  1 , Kuan Liang Shawn Goh  1 , Pei Pei Gong  1 , Seng Bin Ang  3   4 , Choon Huat Gerald Koh  3   5
Affiliations
Randomized Controlled Trial

Effectiveness of an algorithm-driven home telemonitoring system on the metabolic control and self-care behaviour of Asian adults with type-2 diabetes mellitus: A randomised controlled trial

Ngiap Chuan Tan et al. J Telemed Telecare. 2025 May.

Abstract

AimHealthcare professionals are leveraging on telehealth to manage patients with type-2 diabetes mellitus (T2DM). This study aimed to determine the clinical outcomes of patients using a novel tele-monitoring system (OPTIMUM) as compared to the standard of care.MethodsAn open-labelled randomised controlled trial involving 330 Asian patients with T2DM, aged 26-65 years, and suboptimal glycaemic control (HbA1c = 7.5-10%) was conducted in a Singapore public primary care clinic. The patients were assigned in a 1:1 ratio by block randomization to the intervention group to receive: in-app video-based tele-education, tele-monitoring of the blood pressure (BP), capillary glucose and weight via Bluetooth devices and mobile application, followed by algorithm-based tele-management by the OPTIMUM telehealth care team for abnormal parameters. Patients received usual care in the control group. Clinical assessments and self-care-related questionnaires were administered for both groups at baseline and 6 months.ResultsComplete data of 159 (intervention) and 160 (control) patients with comparable demographic profiles were analysed. Those in the intervention group showed significantly lower HbA1c by 0.34% (95%CI = -0.57 to -0.11; p = 0.004); first measurement of systolic BP decreased by 2.98 mmHg (95%CI:-5.8 to -0.08; p = 0.044) and diastolic BP by 4.24 mmHg (95%CI = -6.0 to -2.47; p = 0.001); and total cholesterol by 0.18 mmol/L (95%CI: -0.34 to -0.01; p = 0.040) compared to the control group, after adjusting for baseline variables. Questionnaire scores showed significant improvements in medication adherence and self-care behaviour in the intervention group. No significant weight change was noted between groups.ConclusionThe OPTIMUM tele-monitoring system improved the glycaemic, BP and total cholesterol control in patients with suboptimal T2DM control by enhancing their medication adherence and self-care over 6 months.

Keywords: Tele-monitoring; cholesterol; hypertension; primary care; self-care; telehealth; type-2 diabetes mellitus.

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Conflict of interest statement

Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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