scholarly journals Use of a Meter With Color-Range Indicators and a Mobile Diabetes Management App Improved Glycemic Control and Patient Satisfaction in an Underserved Hispanic Population: “Tu Salud”—a Randomized Controlled Partial Cross-Over Clinical Study

2021 ◽  
Author(s):  
Maria Aparicio ◽  
Laurence B. Katz ◽  
Hilary Cameron ◽  
Frederico Ceppa
Keyword(s):  
Glycemic Control ◽  
Treatment Satisfaction ◽  
Diabetes Management ◽  
Mobile App ◽  
Spanish Language ◽  
Control Group ◽  
Hispanic Population ◽  
Diabetes Treatment ◽  
Language Version ◽  
Control Subjects

To demonstrate the clinical value of OneTouch (OT) Verio Flex glucose meter used in combination with a Spanish-language version of the OT Reveal mobile application (app) to support diabetes care and improve glycemic control in an underserved Hispanic population with type 2 diabetes. Test subjects (<i>n </i>= 81) used the meter and app for 12 weeks, while a randomized control group (<i>n </i>= 39) used their own glucose meters without connection to an app. Thereafter, test subjects continued the same regimen for an additional 12 weeks to determine the durability of effect, and control subjects crossed over to use the new meter and app.<b> </b>Test subjects experienced a mean reduction in A1C of 1.0% after 12 weeks (<i>P </i><0.001), a statistically significant greater reduction than in control subjects (<i>P </i>= 0.045). The improvement in A1C in test subjects was sustained over the next 12 weeks. Crossed-over subjects also demonstrated significant improvements in A1C (<i>P </i><0.001). Mean blood glucose was reduced significantly without an increase in hypoglycemia and results in range increased over 12 weeks of meter and mobile app use. Results were independent of subjects’ numeracy skills. Subjects using the new meter and app reacted favorably to the tools and expressed improvements in their diabetes treatment satisfaction based on Diabetes Treatment Satisfaction Questionnaire–Change scores. Use of the OT meter and a Spanish-language version of its diabetes management app in an underserved population helped participants achieve a sustained improvement in glycemic control. The tools were well received by the subjects and may have important utility in other low-numeracy, low-literacy populations. <div><br></div>

scholarly journals Use of a Meter With Color-Range Indicators and a Mobile Diabetes Management App Improved Glycemic Control and Patient Satisfaction in an Underserved Hispanic Population: “Tu Salud”—a Randomized Controlled Partial Cross-Over Clinical Study

2021 ◽  
Author(s):  
Maria Aparicio ◽  
Laurence B. Katz ◽  
Hilary Cameron ◽  
Frederico Ceppa
Keyword(s):  
Glycemic Control ◽  
Treatment Satisfaction ◽  
Diabetes Management ◽  
Mobile App ◽  
Spanish Language ◽  
Control Group ◽  
Hispanic Population ◽  
Diabetes Treatment ◽  
Language Version ◽  
Control Subjects

To demonstrate the clinical value of OneTouch (OT) Verio Flex glucose meter used in combination with a Spanish-language version of the OT Reveal mobile application (app) to support diabetes care and improve glycemic control in an underserved Hispanic population with type 2 diabetes. Test subjects (<i>n </i>= 81) used the meter and app for 12 weeks, while a randomized control group (<i>n </i>= 39) used their own glucose meters without connection to an app. Thereafter, test subjects continued the same regimen for an additional 12 weeks to determine the durability of effect, and control subjects crossed over to use the new meter and app.<b> </b>Test subjects experienced a mean reduction in A1C of 1.0% after 12 weeks (<i>P </i><0.001), a statistically significant greater reduction than in control subjects (<i>P </i>= 0.045). The improvement in A1C in test subjects was sustained over the next 12 weeks. Crossed-over subjects also demonstrated significant improvements in A1C (<i>P </i><0.001). Mean blood glucose was reduced significantly without an increase in hypoglycemia and results in range increased over 12 weeks of meter and mobile app use. Results were independent of subjects’ numeracy skills. Subjects using the new meter and app reacted favorably to the tools and expressed improvements in their diabetes treatment satisfaction based on Diabetes Treatment Satisfaction Questionnaire–Change scores. Use of the OT meter and a Spanish-language version of its diabetes management app in an underserved population helped participants achieve a sustained improvement in glycemic control. The tools were well received by the subjects and may have important utility in other low-numeracy, low-literacy populations. <div><br></div>

scholarly journals Effect of 6 months flash glucose monitoring in youth with type 1 diabetes and high-risk glycemic control – a randomized controlled trial

2020 ◽  
Author(s):  
Sara E Boucher ◽  
Andrew R Gray ◽  
Esko J Wiltshire ◽  
Martin I de Bock ◽  
Barbara C Galland ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
High Risk ◽  
Glycemic Control ◽  
Treatment Satisfaction ◽  
Glucose Monitoring ◽  
Diabetes Treatment ◽  
Glucose Testing ◽  
Randomized Controlled ◽  
Freestyle Libre

OBJECTIVE <p>To investigate whether intermittently scanned continuous glucose monitoring (isCGM) significantly improves glycemic control compared with capillary self-monitored blood glucose (SMBG) in youth with type 1 diabetes and high-risk glycemic control.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>This multi-center 6-month randomized, controlled, parallel-arm trial included 64 participants aged 13 to 20 years with established Type 1 diabetes and glycated hemoglobin (HbA1c) ≥9% (≥75mmol/mol). Participants were allocated to 6-month intervention (isCGM, FreeStyle Libre, Abbott; n = 33) or control (SMBG; n = 31) using minimization. The primary outcome was the difference in change in HbA1c from baseline to 6 months. </p> <p>RESULTS</p> <p>There was no evidence of a difference between groups for changes in HbA1c at 6 months (adjusted mean 0.2% greater improvement for isCGM, 95% CI -0.9% to 0.5% [-2.1 mmol/mol, 95% CI -9.6 to 5.4], p = 0.576). However, glucose monitoring frequency was 2.83 (95% CI 1.72 to 4.65, p < 0.001) times higher in the isCGM group compared to that in the SMBG group at 6 months. The change in the Diabetes Treatment Satisfaction Questionnaire mean item score also favored isCGM at 6 months (p=0.048), with no significant differences between groups for fear of hypoglycemia and quality of life (both general and diabetes-specific) all p>0.1.</p> <p>CONCLUSIONS</p> <p>For youth with high-risk glycemic control, isCGM led to improvements in glucose testing frequency and diabetes treatment satisfaction. However, these did not translate to greater improvement in glycemic control over usual care with SMBG at 6 months. </p>

scholarly journals The Effects of Continuous Usage of Diabetes Management App on Glycemic Control in Real-world Clinical Practice: Retrospective Analysis (Preprint)

2020 ◽  
Author(s):  
Yu-Zhen Tu ◽  
Ya-Ting Chang ◽  
Hung-Yi Chiou ◽  
Ken Lai
Keyword(s):  
Clinical Practice ◽  
Glycemic Control ◽  
Real World ◽  
Mixed Model ◽  
Diabetes Management ◽  
Mobile App ◽  
Bonferroni Correction ◽  
Retention Group ◽  
Level Of Use ◽  
One Year

BACKGROUND The efficacy of digital technology in improving diabetes management has typically been demonstrated through studies based on randomized controlled trials (RCTs), showing steeper decrease of hemoglobin A1c (HbA1c) values for patients who adopted a digital solution. However, evidence from real-world clinical practice is still limited. OBJECTIVE To evaluate the effectiveness of digital interventions by tracking HbA1c improvement over one year in real-world clinical settings. METHODS The Health2Sync mobile app was used by patients to track self-measured outcomes and communicate with health care professionals (HCPs). The web-based Patient Management Platform was used by HCPs to monitor patient data, view test results from clinical labs, and communicate with patients. Patients that have been onboarded for at least 13 months and had consecutive HbA1c results for five quarters were included in the analysis. They were then stratified into three groups (high, mid, and low retention) according to their level of use of the mobile app in the first six months after onboarding. A mixed model was built to compare the slopes of HbA1c percentage decreases between the groups. In addition, these patients’ stickiness on the app from the seventh to the twelfth month was verified with multiple comparisons. RESULTS A sample of 2036 users was included in the analysis. With the mixed model coefficient estimates, we found that app users had significant HbA1c percentage decreases as the passed quarter count increased (t = -9.869, P < .001), and that effectiveness was enlarged in high and mid retention groups as the interaction effects were significantly negative compared with the low retention group (t = -6.620, P < .001 for passed quarter count * mid retention; t = -5.173, P < .001 for passed quarter count * high retention). The low retention group also had the highest average HbA1c value in the end of the 13 months [mean (SD): 7.01 (1.02) %, 6.99 (1.00) %, and 7.17 (1.14) % for high, mid, and low retention groups, respectively, P = .07, .02, and 1.00 for high-low, mid-low, and high-mid difference comparison after Bonferroni correction]. The level of use of the app remained consistent in the seventh to the twelfth month after onboarding [mean (SD): 5.23 (1.37) months, 2.43 (1.68) months, and 0.41 (0.97) months for high, mid, and low retention groups, respectively, P < .001 for all comparison pairs after Bonferroni correction]. CONCLUSIONS Our analysis showed that continuous usage of the diabetes management app is associated with better glycemic control in real-world clinical practice. Further studies can be performed to reveal the efficacy for specific diabetes types and to observe the effects beyond one year.

scholarly journals Effect of 6 months flash glucose monitoring in youth with type 1 diabetes and high-risk glycemic control – a randomized controlled trial

2020 ◽  
Author(s):  
Sara E Boucher ◽  
Andrew R Gray ◽  
Esko J Wiltshire ◽  
Martin I de Bock ◽  
Barbara C Galland ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
High Risk ◽  
Glycemic Control ◽  
Treatment Satisfaction ◽  
Glucose Monitoring ◽  
Diabetes Treatment ◽  
Glucose Testing ◽  
Randomized Controlled ◽  
Freestyle Libre

OBJECTIVE <p>To investigate whether intermittently scanned continuous glucose monitoring (isCGM) significantly improves glycemic control compared with capillary self-monitored blood glucose (SMBG) in youth with type 1 diabetes and high-risk glycemic control.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>This multi-center 6-month randomized, controlled, parallel-arm trial included 64 participants aged 13 to 20 years with established Type 1 diabetes and glycated hemoglobin (HbA1c) ≥9% (≥75mmol/mol). Participants were allocated to 6-month intervention (isCGM, FreeStyle Libre, Abbott; n = 33) or control (SMBG; n = 31) using minimization. The primary outcome was the difference in change in HbA1c from baseline to 6 months. </p> <p>RESULTS</p> <p>There was no evidence of a difference between groups for changes in HbA1c at 6 months (adjusted mean 0.2% greater improvement for isCGM, 95% CI -0.9% to 0.5% [-2.1 mmol/mol, 95% CI -9.6 to 5.4], p = 0.576). However, glucose monitoring frequency was 2.83 (95% CI 1.72 to 4.65, p < 0.001) times higher in the isCGM group compared to that in the SMBG group at 6 months. The change in the Diabetes Treatment Satisfaction Questionnaire mean item score also favored isCGM at 6 months (p=0.048), with no significant differences between groups for fear of hypoglycemia and quality of life (both general and diabetes-specific) all p>0.1.</p> <p>CONCLUSIONS</p> <p>For youth with high-risk glycemic control, isCGM led to improvements in glucose testing frequency and diabetes treatment satisfaction. However, these did not translate to greater improvement in glycemic control over usual care with SMBG at 6 months. </p>

scholarly journals DIABETES MANAGEMENT AND CURRENT PROSPECTS FOR SELF-MONITORING OF BLOOD GLUCOSE

2017 ◽  
pp. 17-21
Author(s):  
E. V. Goncharova ◽  
N. A. Petunina
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Diabetes Treatment ◽  
Self Monitoring ◽  
Essential Component ◽  
Attending Physician

Diabetes mellitus implies the need for self-monitoring under the supervision of the attending physician. In the conditions of increasing prevalence of diabetes, the physician’s key task is to properly educate the patient in applying the main principles of self-monitoring. Learning the principles of glycemic control with a portable glucometer is an essential component of diabetes treatment.

scholarly journals Implementation of a multi-level community-clinical linkage intervention to improve glycemic control among south Asian patients with uncontrolled diabetes: study protocol of the DREAM initiative

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sahnah Lim ◽  
Laura C. Wyatt ◽  
Shinu Mammen ◽  
Jennifer M. Zanowiak ◽  
Sadia Mohaimin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Glycemic Control ◽  
South Asian ◽  
Diabetes Management ◽  
Control Group ◽  
Local Health ◽  
Uncontrolled Diabetes ◽  
Multi Level

Abstract Background A number of studies have identified patient-, provider-, and community-level barriers to effective diabetes management among South Asian Americans, who have a high prevalence of type 2 diabetes. However, no multi-level, integrated community health worker (CHW) models leveraging health information technology (HIT) have been developed to mitigate disease among this population. This paper describes the protocol for a multi-level, community-clinical linkage intervention to improve glycemic control among South Asians with uncontrolled diabetes. Methods The study includes three components: 1) building the capacity of primary care practices (PCPs) to utilize electronic health record (EHR) registries to identify patients with uncontrolled diabetes; 2) delivery of a culturally- and linguistically-adapted CHW intervention to improve diabetes self-management; and 3) HIT-enabled linkage to culturally-relevant community resources. The CHW intervention component includes a randomized controlled trial consisting of group education sessions on diabetes management, physical activity, and diet/nutrition. South Asian individuals with type 2 diabetes are recruited from 20 PCPs throughout NYC and randomized at the individual level within each PCP site. A total of 886 individuals will be randomized into treatment or control groups; EHR data collection occurs at screening, 6-, 12-, and 18-month. We hypothesize that individuals receiving the multi-level diabetes management intervention will be 15% more likely than the control group to achieve ≥0.5% point reduction in hemoglobin A1c (HbA1c) at 6-months. Secondary outcomes include change in weight, body mass index, and LDL cholesterol; the increased use of community and social services; and increased health self-efficacy. Additionally, a cost-effectiveness analysis will focus on implementation and healthcare utilization costs to determine the incremental cost per person achieving an HbA1c change of ≥0.5%. Discussion Final outcomes will provide evidence regarding the effectiveness of a multi-level, integrated EHR-CHW intervention, implemented in small PCP settings to promote diabetes control among an underserved South Asian population. The study leverages multisectoral partnerships, including the local health department, a healthcare payer, and EHR vendors. Study findings will have important implications for the translation of integrated evidence-based strategies to other minority communities and in under-resourced primary care settings. Trial registration This study was registered with clinicaltrials.gov: NCT03333044 on November 6, 2017.

Real world benefits of diabetes management app usage and SMBG on glycemic control (Preprint)

2021 ◽  
Author(s):  
Chang Ya Ting ◽  
Yu-Zhen Tu ◽  
Hung-Yi Chiou ◽  
Ken Lai
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Real World ◽  
Mixed Model ◽  
Diabetes Management ◽  
Mobile App ◽  
Diabetes Duration ◽  
Percentage Change ◽  
User Group ◽  
Management Platform

BACKGROUND Among the self-care measures, self-monitoring of blood glucose (SMBG) is a critical component for checking blood glucose levels. However, for non-insulin-treated DMT2 patients, the value of SMBG was inconsistent among studies. In addition, there is growing evidence suggesting that digital technologies are being adopted as an additional method for healthcare systems to increase patient contact. However, evidence from real-world clinical practice is still limited. OBJECTIVE To assess non-insulin-treated DMT2 patients that were receiving care from the same clinic and analyze whether usage of a diabetes management app and SMBG behavior affect glycemic control in real-world clinical settings. METHODS We collaborated with a large clinic in Taiwan focused on diabetes care that has been using the Health2Sync mobile app and web-based Patient Management Platform to collect the data. The patients were divided into two groups (app-engaged-user, only-data-uploader) according to different activities in the app, and blood glucose was recorded every month from 1 to 6 months after registration in the app. A sample of 420 patients was included in the analysis, and a linear mixed model was built to investigate what factors affect patients' blood glucose percentage change. RESULTS With the mixed model coefficient estimates, we found that the percentage change was significantly negative when the only-data-uploader group was set as the baseline (t = -4.289, P < .001 for the patients of app-engaged-user group).Furthermore, we found that for patients with shorter diabetes duration the blood glucose decreased more ( t = 4.219, P < .001 for the number of diabetes duration). Finally, we also found that the count of blood glucose measured enlarged the decrease along the interaction months (t = -6.911, P < .001 for Nth month * count of blood glucose in Nth month). CONCLUSIONS Our analysis showed that the blood glucose percentage change of the patient who was in the app-engaged-user group dropped more than that of the patient who was in the only-data-uploader group, shorter diabetes duration is associated with steeper decrease in the patient's blood glucose percentage change, and the more frequently patients test SMBG each month, the higher the decrease in the patient's blood glucose percentage. Further studies can be performed to consider the differences in daily behaviors such as exercise, diet across the patients, and these factors could have vital impacts on glycemic control.

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