Ding Y, Yue T, Wu W M, Zhou Y W, Luo S H, Zheng X Y, Weng J P, Chen Z F
Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China.
Department of Endocrinology, Changshu Hospital of Traditional Chinese Medicine, Changshu 215516, China.
Zhonghua Yi Xue Za Zhi. 2022 Apr 26;102(16):1196-1201. doi: 10.3760/cma.j.cn112137-20211010-02240.
To analyze the changes in glucose after using a decision support system (DSS) of a smartphone mobile application (APP) in adults with type 1 diabetes mellitus (T1DM). In the intervention study, the data (including general information at the time of registration) of adult T1DM patients enrolled in the Chinese T1DM Registration Management Project and registered with TangTangQuan® APP were collected. Within 1 year after registration, fasting blood glucose, pre-prandial and postprandial blood glucose at the three meals, blood glucose before bedtime and in nocturnal time were collected every 3 months. Frequencies of total recorded glucose values and proportion of different ranges of glycemia were also collected and analyzed, including the range between 3.9-7.8 mmol/L (Euglycemia), ranged below 3.9 mmol/L (Hypoglycemia) and range above 13.9 mmol/L (hyperglycemia). The patients were divided into 3 groups according to the daily use frequency of DSS (Low/Moderate/High frequency groups). The changes in point blood glucose, the proportion of hyperglycemia and hypoglycemia over time were compared among different groups, as well as the baseline characteristics and glucose characteristics of patients. A total of 629 eligible T1DM patients were included, including 216 (34.3%) males and 413 (65.7%) females, aged (31.5±10.8) years, and disease duration [(, )] of 1.2 (0.1, 7.4) years. There were 239, 189 and 201 patients in the low, moderate and high frequency groups, respectively. Significant differences were observed among the three groups in all timepoints of self-monitoring blood glucose except for the glucose before bedtime from 10 to 12 months after registration (all values<0.05), and the glucose level at each point in the high frequency group was lower than that in the other two groups. In the first three months after registration, there was no difference in the proportion of hypoglycemia among the three groups (>0.05). However, from 10 to 12 months after registration, the proportion [(, )] of hypoglycemia [3.34% (0.85%, 7.40%), 3.00% (0.78%, 6.17%), 1.81% (0.37%, 4.69%)] (=0.022) between groups (from low to high frequency groups) and hyperglycemia [4.04% (0, 12.16%), 1.88% (0, 7.80%), 0.81% (0, 3.87%)] (=0.001) were significantly different. The DSS function of mobile APP is helpful to the glucose management of adult patients with T1DM within 1 year after registration. The average blood glucose in adults with T1DM decreased, and the proportions of hyperglycemia and hypoglycemia were also reduced.
分析1型糖尿病（T1DM）成年患者使用智能手机移动应用程序（APP）的决策支持系统（DSS）后血糖的变化情况。在干预性研究中，收集了参加中国T1DM注册管理项目并使用糖糖圈®APP注册的成年T1DM患者的数据（包括注册时的一般信息）。注册后1年内，每3个月收集一次空腹血糖、三餐前及餐后血糖、睡前及夜间血糖。还收集并分析了总记录血糖值的频率以及不同血糖范围的比例，包括3.9 - 7.8 mmol/L（正常血糖）、低于3.9 mmol/L（低血糖）和高于13.9 mmol/L（高血糖）范围。根据DSS的每日使用频率将患者分为3组（低频/中频/高频组）。比较不同组间即时血糖、高血糖和低血糖比例随时间的变化情况，以及患者的基线特征和血糖特征。共纳入629例符合条件的T1DM患者，其中男性216例（34.3%），女性413例（65.7%），年龄（31.5±10.8）岁，病程[（，）]为1.2（0.1，7.4）年。低频组、中频组和高频组分别有239例、189例和201例患者。除注册后10至12个月的睡前血糖外，三组在自我监测血糖的所有时间点均观察到显著差异（所有P值<0.05），高频组各时间点的血糖水平均低于其他两组。注册后的前三个月，三组间低血糖比例无差异（P>0.05）。然而，注册后10至12个月，组间（从低频组到高频组）低血糖比例[3.34%（0.85%，7.40%），3.00%（0.78%，6.17%），1.81%（0.37%，4.69%）]（P = 0.022）和高血糖比例[4.04%（0，12.16%），1.88%（0，7.80%），0.81%（0，3.87%）]（P = 0.001）存在显著差异。移动APP的DSS功能有助于T1DM成年患者注册后1年内的血糖管理。T1DM成年患者的平均血糖下降，高血糖和低血糖比例也降低。
