Waki Kayo, Fujita Hideo, Uchimura Yuji, Omae Koji, Aramaki Eiji, Kato Shigeko, Lee Hanae, Kobayashi Haruka, Kadowaki Takashi, Ohe Kazuhiko
Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
J Diabetes Sci Technol. 2014 Mar;8(2):209-215. doi: 10.1177/1932296814526495. Epub 2014 Mar 13.
Numerous diabetes-management systems and programs for improving glycemic control to meet guideline targets have been proposed, using IT technology. But all of them allow only limited-or no-real-time interaction between patients and the system in terms of system response to patient input; few studies have effectively assessed the systems' usability and feasibility to determine how well patients understand and can adopt the technology involved. DialBetics is composed of 4 modules: (1) data transmission module, (2) evaluation module, (3) communication module, and (4) dietary evaluation module. A 3-month randomized study was designed to assess the safety and usability of a remote health-data monitoring system, and especially its impact on modifying patient lifestyles to improve diabetes self-management and, thus, clinical outcomes. Fifty-four type 2 diabetes patients were randomly divided into 2 groups, 27 in the DialBetics group and 27 in the non-DialBetics control group. HbA1c and fasting blood sugar (FBS) values declined significantly in the DialBetics group: HbA1c decreased an average of 0.4% (from 7.1 ± 1.0% to 6.7 ± 0.7%) compared with an average increase of 0.1% in the non-DialBetics group (from 7.0 ± 0.9% to 7.1 ± 1.1%) (P = .015); The DialBetics group FBS decreased an average of 5.5 mg/dl compared with a non-DialBetics group average increase of 16.9 mg/dl (P = .019). BMI improvement-although not statistically significant because of the small sample size-was greater in the DialBetics group. DialBetics was shown to be a feasible and an effective tool for improving HbA1c by providing patients with real-time support based on their measurements and inputs.
人们已经提出了许多利用信息技术来改善血糖控制以达到指南目标的糖尿病管理系统和项目。但就系统对患者输入的响应而言，所有这些系统在患者与系统之间仅允许有限的——或者根本没有——实时交互；很少有研究有效地评估这些系统的可用性和可行性，以确定患者对所涉及技术的理解程度和采用能力。DialBetics由4个模块组成：（1）数据传输模块，（2）评估模块，（3）通信模块，以及（4）饮食评估模块。一项为期3个月的随机研究旨在评估远程健康数据监测系统的安全性和可用性，尤其是其对改变患者生活方式以改善糖尿病自我管理从而改善临床结局的影响。54名2型糖尿病患者被随机分为2组，27名在DialBetics组，27名在非DialBetics对照组。DialBetics组的糖化血红蛋白（HbA1c）和空腹血糖（FBS）值显著下降：HbA1c平均下降0.4%（从7.1±1.0%降至6.7±0.7%），而非DialBetics组平均上升0.1%（从7.0±0.9%升至7.1±1.1%）（P = 0.015）；DialBetics组FBS平均下降5.5mg/dl，而非DialBetics组平均上升16.9mg/dl（P = 0.019）。尽管由于样本量小，体重指数（BMI）的改善无统计学意义，但DialBetics组的改善更大。通过根据患者的测量结果和输入为患者提供实时支持，DialBetics被证明是一种改善HbA1c的可行且有效的工具。
