利用技术支持的干预措施改善开始胰岛素治疗的2型糖尿病患者的血糖自我管理结果：一项回顾性真实世界研究。

Utilizing Technology-Enabled Intervention to Improve Blood Glucose Self-Management Outcome in Type 2 Diabetic Patients Initiated on Insulin Therapy: A Retrospective Real-World Study.

作者信息

Lin Jian, Li Xia, Jiang Shan, Ma Xiao, Yang Yuxin, Zhou Zhiguang

机构信息

National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.

Lilly (Shanghai) Management Co., Ltd, No. 288 Shimen No. 1 Road, Jingan District, Shanghai 200041, China.

出版信息

Int J Endocrinol. 2020 Nov 10;2020:7249782. doi: 10.1155/2020/7249782. eCollection 2020.

DOI:10.1155/2020/7249782

PMID:33224195

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7671790/

Abstract

BACKGROUND

The aim of this study was to assess the benefits of a mobile-enabled app through Lilly Connected Care Program (LCCP) in achieving blood glucose control and adhering to self-monitoring of blood glucose in patients with type 2 diabetes mellitus (T2DM).

METHODS

This retrospective study included T2DM patients who were initiated on insulin therapy (mostly premixed insulin) after failure to respond to oral antidiabetic drugs. Patients were provided with glucometers enabled with synchronous data transmission to healthcare providers and family members. The primary objective was to assess the benefits of LCCP based on changes in fasting blood glucose (FBG) and postprandial glucose (PPG) levels from baseline to 12 weeks. Paired -test was used to assess the change in blood glucose (BG) from baseline to week 12.

RESULTS

In total, 14,085 T2DM patients were recruited. Compared with baseline, significant reductions in FBG and PPG were evident at week 12 (FBG: -0.39 mmol/L; PPG: -0.79 mmol/L; both < 0.001). Furthermore, at week 12, the proportion of patients attaining a target glucose level of FBG <7.0 mmol/L and PPG <10.0 mmol/L was 25.37% and 59.68%, respectively, with a statistically significant increase compared with that at baseline (6.74% and 45.59%, respectively, both < 0.001). The frequent monitoring of patients could gain a higher target achievement of FBG (28.1% vs 24.2%) and PPG (64.4% vs 55.1%) than the occasional monitoring patients. Additionally, the incidence of hypoglycemia gradually decreased and was significantly lower than the baseline level.

CONCLUSIONS

In T2DM patients with poor glycemic control, the application of mobile enabled intervention (LCCP) along with insulin significantly reduced the hypoglycemia while improving glycemic control during period of naïve initiating insulin therapy. Additionally, the high frequency of BG self-monitoring was associated with better glycemic control.

摘要

背景

本研究旨在评估通过礼来互联关爱计划（LCCP）启用的移动应用程序在实现2型糖尿病（T2DM）患者血糖控制和坚持血糖自我监测方面的益处。

方法

这项回顾性研究纳入了在口服抗糖尿病药物治疗无效后开始胰岛素治疗（主要是预混胰岛素）的T2DM患者。为患者提供了能够将数据同步传输给医疗保健提供者和家庭成员的血糖仪。主要目标是根据空腹血糖（FBG）和餐后血糖（PPG）水平从基线到12周的变化评估LCCP的益处。配对t检验用于评估从基线到第12周血糖（BG）的变化。

结果

总共招募了14,085例T2DM患者。与基线相比，第12周时FBG和PPG显著降低（FBG：-0.39 mmol/L；PPG：-0.79 mmol/L；均P<0.001）。此外，在第12周时，FBG<7.0 mmol/L和PPG<10.0 mmol/L的目标血糖水平患者比例分别为25.37%和59.68%，与基线时相比有统计学显著增加（分别为6.74%和45.59%，均P<0.001）。与偶尔监测的患者相比，频繁监测的患者FBG（28.1%对24.2%）和PPG（64.4%对55.1%）的目标达成率更高。此外，低血糖发生率逐渐降低，且显著低于基线水平。