通过在中国为2型糖尿病患者使用移动健康应用程序（APP）实现有效且高效的基础胰岛素优化管理

Achieving Effective and Efficient Basal Insulin Optimal Management by Using Mobile Health Application (APP) for Type 2 Diabetes Patients in China.

作者信息

Cai Xiaoling, Zhang Fang, Lin Chu, Zhang Xiaomei, Wang Zhufeng, Xing Huifang, Nie Lin, Han Xueyao, Ji Linong

机构信息

Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, People's Republic of China.

Department of Endocrinology and Metabolism, Peking University International Hospital, Beijing, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2020 Apr 23;13:1327-1338. doi: 10.2147/DMSO.S244826. eCollection 2020.

AIM

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/m, 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.

目的

评估移动健康应用程序（APP）教育在中国初治2型糖尿病（T2D）患者基础胰岛素优化管理方案中的有效性。

方法

基础胰岛素优化管理方案在中国六个主要地区的297家医院开展。共筛选出17208例开始使用基础胰岛素的初治T2D患者。在每位招募患者的手机以及医生的手机中下载移动健康APP。然后，这些患者根据APP中的说明和教育资料开始自行调整胰岛素剂量，并在需要帮助时通过APP与医生联系。

结果

总体而言，最终12530例T2D患者纳入分析。平均年龄为51.97±12.76岁，其中58%为男性。平均体重指数为24.46±3.83kg/m²，基线时平均糖化血红蛋白（HbA1c）为8.33±2.11%，24%的受试者在基线时达到HbA1c<7.0%的目标。通过APP进行3个月的治疗和教育后，HbA1c较基线显著下降（-1.02±1.72%），59%的患者HbA1c<7.0%。6个月后，HbA1c的血糖控制也较基线显著下降（-1.01±1.67%）。基线时每日胰岛素剂量为0.23±0.09IU/kg，治疗6个月后为0.23±0.23IU/kg。关于低血糖治疗情况，3145例患者接受基础胰岛素联合单种口服降糖药（OAD），1204例患者接受两种OAD，208例患者接受三种OAD，17例患者接受四种OAD。