Sabharwal Mudit, Misra Anoop, Ghosh Amerta, Chopra Gautam
BeatO, Health Arx Technologies Pvt. Ltd., New Delhi, India.
Fortis C-DOC Hospital, Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, New Delhi, India.
Diabetes Metab Syndr Obes. 2022 Jan 5;15:23-33. doi: 10.2147/DMSO.S345785. eCollection 2022.
Poor glycemic control is prevalent in patients with type 2 diabetes mellitus (T2DM) in India. This study aims to understand the effectiveness of a smartphone-connected glucometer, real-time feedback, and contextualized counseling on glycemic control and hypoglycemic episodes in T2DM patients.
This retrospective, multicenter study reviewed the medical records of T2DM patients belonging to several cities of north India, who were digitally engaged with a smartphone-connected glucometer and who had received at least one counseling session between September 2019 and July 2020. Intervention included self-monitoring of blood glucose (SMBG) using a smartphone-connected glucometer enabled with real-time transmission of information to certified diabetes educators (CDE) and their corresponding counseling based on SMBG findings.
Of 7111 adult T2DM patients included in this study, majority (75%) of the patients received a single session of counseling, and the remaining patients received 2 (16.7%), 3 (5%), 4 (2%), or ≥5 (1.3%) sessions. The mean age of the patients was 51.6 years, and the majority (77.9%) were males. Digital monitoring of BG and counseling with CDE significantly reduced the mean fasting (by 9.6%), pre-prandial (by 9.9%), and post-prandial (by 9.2%) BG values in 53%, 52%, and 54% of patients, respectively. The majority (81.4%) of patients showed no hypoglycemic episode (≤70 mg/dL) post-counseling. The hypoglycemia episodes observed with FBG, pre-prandial, and post-prandial BG values were reduced significantly by 58.5%, 48.1%, and 61.8%, respectively, post-counseling.
Digitally supported and real-time SMBG-driven counselling was effective in glycemic control and reduction of hypoglycemic episodes in T2DM patients in India. Moreover, reduction in hypoglycemia may be due to back end real-time support of CDE intervention.
在印度，2型糖尿病（T2DM）患者血糖控制不佳的情况普遍存在。本研究旨在了解一款与智能手机相连的血糖仪、实时反馈以及情境化咨询对T2DM患者血糖控制和低血糖发作的有效性。
这项回顾性多中心研究回顾了印度北部几个城市的T2DM患者的病历，这些患者使用了与智能手机相连的血糖仪，并在2019年9月至2020年7月期间至少接受了一次咨询。干预措施包括使用与智能手机相连的血糖仪进行血糖自我监测（SMBG），该血糖仪能够将信息实时传输给认证糖尿病教育者（CDE），并根据SMBG结果进行相应咨询。
本研究纳入的7111例成年T2DM患者中，大多数（75%）患者接受了一次咨询，其余患者接受了2次（16.7%）、3次（5%）、4次（2%）或≥5次（1.3%）咨询。患者的平均年龄为51.6岁，大多数（77.9%）为男性。对血糖的数字监测以及与CDE的咨询分别使53%、52%和54%的患者的平均空腹血糖（降低9.6%）、餐前血糖（降低9.9%）和餐后血糖（降低9.2%）值显著降低。大多数（81.4%）患者在咨询后未出现低血糖发作（≤70mg/dL）。咨询后，空腹血糖、餐前血糖和餐后血糖值出现的低血糖发作分别显著减少了58.5%、48.1%和61.8%。
在印度，数字支持且由实时SMBG驱动的咨询对T2DM患者的血糖控制和减少低血糖发作有效。此外，低血糖的减少可能归因于CDE干预的后端实时支持。
