Diabetes, Metabolic Syndrome and Obesity (Apr 2020)
Achieving Effective and Efficient Basal Insulin Optimal Management by Using Mobile Health Application (APP) for Type 2 Diabetes Patients in China
Abstract
Xiaoling Cai,1 Fang Zhang,1 Chu Lin,1 Xiaomei Zhang,2 Zhufeng Wang,3 Huifang Xing,4 Lin Nie,5 Xueyao Han,1 Linong Ji1 1Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, People’s Republic of China; 2Department of Endocrinology and Metabolism, Peking University International Hospital, Beijing, People’s Republic of China; 3Department of Endocrinology and Metabolism, Guanganmen Traditional Medicine Hospital, Beijing, People’s Republic of China; 4Department of Endocrinology and Metabolism, Beijing Mentougou Hospital, Beijing, People’s Republic of China; 5Department of Endocrinology and Metabolism, Beijing Airport Hospital, Beijing, People’s Republic of ChinaCorrespondence: Linong Ji Email [email protected]: To evaluate the effectiveness of the mobile health application (APP) education in basal insulin optimal management program for insulin-naive type 2 diabetes (T2D) patients in China.Methods: The basal insulin optimal management program was launched in 297 hospitals in China, throughout the six main regions of China. A total of 17,208 insulin-naive patients with T2D who started to use basal insulin were screened. The mobile health APP was downloaded in each recruited patient’s mobile phone and the doctor’s mobile phone. Then, according to the instructions and education materials in the APP, these patients began their self-management of insulin dosage titrations and contacted their doctors by APP if they need help.Results: Overall, 12,530 patients with T2D were finally included in the analysis. The average age was 51.97± 12.76 years, and 58% of them were males. The average body mass index is 24.46± 3.83 kg/m2, and the average HbA1c at baseline was 8.33± 2.11% with 24% of the subjects reaching the target of HbA1c< 7.0% at baseline. After 3 months of treatment and educations through the APP, HbA1c decreased significantly from baseline (− 1.02± 1.72%), with 59% of the patients reaching HbA1c< 7.0%. After 6 months, the glycemic control of HbA1c also decreased from baseline significantly (− 1.01± 1.67%). Dosage of insulin daily was 0.23± 0.09 IU/kg at baseline, and 0.23± 0.23 IU/kg after 6 months of treatment. Regarding the profiles of hypoglycemia treatment, 3145 patients received basal insulin in combination with mono oral anti-diabetic drug (OAD), 1204 patients with dual OADs, 208 patients with triple OADs, and 17 patients with quarter OADs.Conclusion: Patients could benefit from the basal insulin optimal management program in self-management by using mobile health APP educations. For T2D patients who are going to start insulin treatment, mobile health APP can help them to reach the target of glycemic control with appropriate dosage of insulin.Keywords: basal insulin, HbA1c, insulin-naive, type 2 diabetes
