Journal Article

Diabetes Self-Management Smartphone Application for Adults With Type 1 Diabetes: Randomized Controlled Trial

Vandelanotte, Corneel, Duncan, Mitch J, Kirwan, Morwenna, Fenning, Andrew

2013

Overview

Persistently poor glycemic control in adult type 1 diabetes patients is a common, complex, and serious problem initiating significant damage to the cardiovascular, renal, neural, and visual systems. Currently, there is a plethora of low-cost and free diabetes self-management smartphone applications available in online stores. The aim of this study was to examine the effectiveness of a freely available smartphone application combined with text-message feedback from a certified diabetes educator to improve glycemic control and other diabetes-related outcomes in adult patients with type 1 diabetes in a two-group randomized controlled trial. Patients were recruited through an online type 1 diabetes support group and letters mailed to adults with type 1 diabetes throughout Australia. In a 6-month intervention, followed by a three-month follow-up, patients (n=72) were randomized to usual care (control group) or usual care and the use of a smartphone application (Glucose Buddy) with weekly text-message feedback from a Certified Diabetes Educator (intervention group). All outcome measures were collected at baseline and every three months over the study period. Patients' glycosylated hemoglobin levels (HbA1c) were measured with a blood test and diabetes-related self-efficacy, self-care activities, and quality of life were measured with online questionnaires. The mean age of patients was 35.20 years (SD 10.43) (28 male, 44 female), 39% (28/72) were male, and patients had been diagnosed with type 1 diabetes for a mean of 18.94 years (SD 9.66). Of the initial 72 patients, 53 completed the study (25 intervention, 28 control group). The intervention group significantly improved glycemic control (HbA1c) from baseline (mean 9.08%, SD 1.18) to 9-month follow-up (mean 7.80%, SD 0.75), compared to the control group (baseline: mean 8.47%, SD 0.86, follow-up: mean 8.58%, SD 1.16). No significant change over time was found in either group in relation to self-efficacy, self-care activities, and quality of life. In adjunct to usual care, the use of a diabetes-related smartphone application combined with weekly text-message support from a health care professional can significantly improve glycemic control in adults with type 1 diabetes. Australian New Zealand Clinical Trials Registry: ACTRN12612000132842; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612000132842 (Archived by WebCite at http://www.webcitation.org/6Kl4jqn5u).

• Publisher: Journal of Medical Internet Research,Gunther Eysenbach MD MPH, Associate Professor,JMIR Publications Inc,JMIR Publications
• Subject: Activities of daily living / Adult / Adults / Application / Blood / Blood tests / Cell Phone / Cellular telephones / Clinical outcomes / Clinical research / Clinical trials / Computer applications / Control groups / Dextrose / Diabetes / Diabetes Mellitus, Type 1 - therapy / Diseases / Feedback / Female / Glucose / Glycemic control / Glycosylated hemoglobin / Health care / Health care reform / Health education / Health services / Hemoglobin / Humans / Insulin / Internet / Intervention / Likert scale / Male / Medical examination / Medical personnel / Medical research / Medicine, Experimental / Middle Aged / Original Paper / Patient education / Patients / Quality of care / Quality of life / Questionnaires / Registration / Self Care / Self-efficacy / Selfmanagement / Smart phones / Smartphones / Software / Statistical analysis / Support groups / Text Messaging / Time use / Type 1 diabetes / Type 1 diabetes mellitus