Glucose Control, Disease Burden, and Educational Gaps in People With Type 1 Diabetes: Exploratory Study of an Integrated Mobile Diabetes App.

Autor: Tack CJ; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands., Lancee GJ; Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, Netherlands., Heeren B; Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, Netherlands., Engelen LJ; Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, Netherlands., Hendriks S; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands., Zimmerman L; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands., De Massari D; Royal Philips, Eindhoven, Netherlands., van Gelder MM; Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, Netherlands.; Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands., van de Belt TH; Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, Netherlands.
Jazyk: angličtina
Zdroj: JMIR diabetes [JMIR Diabetes] 2018 Nov 23; Vol. 3 (4), pp. e17. Date of Electronic Publication: 2018 Nov 23.
DOI: 10.2196/diabetes.9531
Abstrakt: Background: Self-monitoring and self-management, crucial for optimal glucose control in type 1 diabetes, requires many disease-related decisions per day and imposes a substantial disease burden on people with diabetes. Innovative technologies that integrate relevant measurements may offer solutions that support self-management, decrease disease burden, and benefit diabetes control.
Objective: The objective of our study was to evaluate a prototype integrated mobile phone diabetes app in people with type 1 diabetes.
Methods: In this exploratory study, we developed an app that contained cloud-stored log functions for glucose, carbohydrates (including a library), insulin, planned exercise, and mood, combined with a bolus calculator and communication functions. Adults with diabetes tested the app for 6 weeks. We assessed the feasibility of app use, user experiences, perceived disease burden (through questionnaires), insulin dose and basal to bolus ratio, mean glucose level, hemoglobin A 1c , and number of hypoglycemic events.
Results: A total of 19 participants completed the study, resulting in 5782 data entries. The most frequently used feature was logging blood glucose, insulin, and carbohydrates. Mean diabetes-related emotional problems (measured with the Problem Areas in Diabetes scale) scores decreased from 14.4 (SD 10.0) to 12.2 (SD 10.3; P=.04), and glucose control improved, with hemoglobin A 1c decreasing from 7.9% (mean 62.3, SD 8 mmol/mol) to 7.6% (mean 59.8, SD 7 mmol/mol; P=.047). The incidence of hypoglycemic events did not change. Participants were generally positive about the app, rating it as "refreshing," and as providing structure by reinforcing insulin-dosing principles. The app revealed substantial knowledge gaps. Logged data enabled additional detailed analyses.
Conclusions: An integrated mobile diabetes app has the potential to improve diabetes self-management and provide tailored educational support, which may decrease disease burden and benefit diabetes control.
(©Cornelis J Tack, Gerardus J Lancee, Barend Heeren, Lucien JLPG Engelen, Sandra Hendriks, Lisa Zimmerman, Daniele De Massari, Marleen MHJ van Gelder, Tom H van de Belt. Originally published in JMIR Diabetes (http://diabetes.jmir.org), 23.11.2018.)
Databáze: MEDLINE
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