Feasibility of a Patient-Centered, Smartphone-Based, Diabetes Care System: A Pilot Study.
BACKGROUND
We developed a patient-centered, smartphone-based, diabetes care system (PSDCS). This study aims to test the feasibility of glycosylated hemoglobin (HbA1c) reduction with the PSDCS.


METHODS
This study was a single-arm pilot study. The participants with type 2 diabetes mellitus were instructed to use the PSDCS, which integrates a Bluetooth-connected glucometer, digital food diary, and wearable physical activity monitoring device. The primary end point was the change in HbA1c from baseline after a 12-week intervention.


RESULTS
Twenty-nine patients aged 53.9±9.1 years completed the study. HbA1c and fasting plasma glucose levels decreased significantly from baseline (7.7%±0.7% to 7.1%±0.6%, P<0.0001; 140.9±39.1 to 120.1±31.0 mg/dL, P=0.0088, respectively). The frequency of glucose monitoring correlated with the magnitude of HbA1c reduction (r=-0.57, P=0.0013). The components of the diabetes self-care activities, including diet, exercise, and glucose monitoring, were significantly improved, particularly in the upper tertile of HbA1c reduction. There were no severe adverse events during the intervention.


CONCLUSIONS
A 12-week application of the PSDCS to patients with inadequately controlled type 2 diabetes resulted in a significant HbA1c reduction with tolerable safety profiles; these findings require confirmation in a future randomized controlled trial.
International Healthcare Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Eun Ky
EK
Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Soo Heon
SH
Kwak
Health Connect Co. Ltd., Seoul, Korea.
Seungsu
S
Baek
Health Connect Co. Ltd., Seoul, Korea.
Seung Lyeol
SL
Lee
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Hak Chul
HC
Jang
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Kyong Soo
KS
Park
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. ymchomd@snu.ac.kr.
Young Min
http://orcid.org/0000-0002-2331-6126
YM
Cho
Delivery of health care; Diabetes mellitus; Smartphone