title: Insulin dose titration system in diabetes patients using a short messaging service automatically produced by a knowledge matrix.
abstract: BACKGROUND
  We designed a system for diabetes patients treated with glargine, a long-acting insulin, to make an automatic adjustment of insulin dose based on glucose level data and to provide the patients with the needed insulin dose by using a short message service (SMS). We also compared diabetes patients who used our system with patients who received the conventional titration scheme.
  
  
  METHODS
  Included were 100 type 2 diabetes patients whose blood glucose was suboptimally controlled on their previous antidiabetes treatment. Each participant was assigned to either the intervention or control group, each with 50 patients, using adaptive randomization. We applied our system to the intervention group for 12 weeks, whereas the control group received a conventional titration scheme, seeking a target fasting blood glucose of <120 mg/dL.
  
  
  RESULTS
  The fasting and postprandial glucose levels of the intervention group declined earlier than those of the control group. Lastly, a greater (P = 0.023) reduction in hemoglobin A(1C) from baseline to the end point was observed in the intervention group (from 9.8 +/- 1.3% to 7.4 +/- 0.7%) than in the control group (from 9.8 +/- 1.2% to 7.8 +/- 0.8%). The incidence of symptomatic, asymptomatic, and nocturnal hypoglycemia was similar in both groups. There was a small increase in body weight from baseline to the end point with both the intervention (2.4 +/- 3.0 kg) and control (2.2 +/- 2.8 kg) groups.
  
  
  CONCLUSIONS
  This study demonstrated that SMS based on our specialized Internet-supported system is an effective and safe approach to long-acting insulin dose adjustments in patients with type 2 diabetes.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical College, Dongan-gu, Anyang, Republlic of Korea. ironeat@hallym.ac.kr
authors.forename: Chul Sik
authors.initials: CS
authors.lastname: Kim
authors.forename: So Young
authors.initials: SY
authors.lastname: Park
authors.forename: Jun Goo
authors.initials: JG
authors.lastname: Kang
authors.forename: Seong Jin
authors.initials: SJ
authors.lastname: Lee
authors.forename: Sung Hee
authors.initials: SH
authors.lastname: Ihm
authors.forename: Moon Gi
authors.initials: MG
authors.lastname: Choi
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yoo
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period / Q000502:physiology; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007328:Insulin; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine