Potter Eden, Burstein Frada, Flynn Daphne, Hwang In Dae, Dinh Tina, Goh Tian Yu, Mohammad Ebrahim Mina, Gilfillan Christopher
Design Health Collab, Monash Art, Design and Architecture, Monash University, Melbourne, Australia.
Faculty of Information Technology, Monash University, Melbourne, Australia.
JMIR Form Res. 2022 May 10;6(5):e31736. doi: 10.2196/31736.
Type 2 diabetes (T2D) is increasingly prevalent in society, in part because of behavioral issues, with sedentary behavior, reduced exercise, and the consumption of foods with a high glycemic index being major contributors. There is evidence for the efficacy of mobile apps in promoting behavior change and lifestyle improvements in people with T2D. Many mobile phone apps help to monitor the condition of people with T2D and inform them about their health. Some of these digital interventions involve patients using apps on their own or in conjunction with health care professionals.
This study aimed to test the acceptability of receiving app-based, daily physician feedback for patients with T2D that is informed by the continuous monitoring of their activity, food choices, and glucose profiles, with the aim of encouraging healthier behavior. The GLOOK! app was designed and developed by an academic research team and pilot-tested at an Australian public hospital.
A total of 15 patients diagnosed with T2D wore a glucose monitor and an Apple Watch for 12 days. The uploaded data were integrated into the GLOOK! app on the patients' smartphones, which also enabled the recording of activity and consumed food. A physician provided daily feedback to each individual through the app based on their data from each of the 12 days. At the beginning and end of the study, data were collected on vital signs, anthropometry, hemoglobin A level, fructosamine level, and fasting lipids level. Participants were also interviewed at the beginning and end of the study to assess the acceptability of the intervention and its potential impact on promoting positive behavior change.
Over the 12 days of the study, there was a significant reduction of 0.22% (P=.004) in hemoglobin A level. There were favorable changes in fructosamine and lipid fractions; however, none reached significance. There was also a fall of 0.65 kg in body weight and falls in blood pressure and pulse rate that did not reach significance. Patient feedback on the GLOOK! system was positive. Of the 15 participants, 13 (87%) were enthusiastic about continuing to use the app system if some usability and reliability aspects were improved. All participants regarded the personalized physician feedback as supportive and helpful in understanding their own health behavior. Of the 15 participants, 4 (27%) felt that using the system encouraged long-term behavior changes.
A mobile app system that provides people with T2D daily, physician-generated, personalized feedback can produce favorable changes in glycemic and cardiovascular risk parameters-even in the short term-and encourage better self-management of their condition. Study participants found the experience of using the mobile app system acceptable and were motivated to establish longer-term lifestyle improvements through behavior changes.
2型糖尿病（T2D）在社会中日益普遍，部分原因是行为问题，久坐不动、运动量减少以及高血糖指数食物的摄入是主要因素。有证据表明移动应用程序在促进T2D患者的行为改变和生活方式改善方面具有功效。许多手机应用程序有助于监测T2D患者的病情并告知他们自身健康状况。其中一些数字干预措施涉及患者自行使用应用程序或与医疗保健专业人员联合使用。
本研究旨在测试T2D患者接受基于应用程序的每日医生反馈的可接受性，该反馈基于对他们的活动、食物选择和血糖状况的持续监测，以鼓励更健康的行为。GLOOK!应用程序由一个学术研究团队设计和开发，并在一家澳大利亚公立医院进行了试点测试。
共有15名被诊断为T2D的患者佩戴血糖监测仪和苹果手表12天。上传的数据被整合到患者智能手机上的GLOOK!应用程序中，该应用程序还能记录活动和摄入的食物。医生根据每位患者12天的数据，通过应用程序为其提供每日反馈。在研究开始和结束时，收集生命体征、人体测量数据、糖化血红蛋白水平、果糖胺水平和空腹血脂水平的数据。在研究开始和结束时还对参与者进行了访谈，以评估干预措施的可接受性及其对促进积极行为改变的潜在影响。
在研究的12天里，糖化血红蛋白水平显著降低了0.22%（P = 0.004）。果糖胺和血脂部分有有利变化；然而，均未达到显著水平。体重下降了0.65千克，血压和脉搏率下降，但未达到显著水平。患者对GLOOK!系统的反馈是积极的。15名参与者中，有13名（87%）表示，如果在一些可用性和可靠性方面得到改善，他们热衷于继续使用该应用程序系统。所有参与者都认为个性化的医生反馈在理解自身健康行为方面具有支持性和帮助性。15名参与者中，有4名（27%）觉得使用该系统鼓励了长期行为改变。
一个为T2D患者提供每日医生生成的个性化反馈的移动应用程序系统，即使在短期内也能在血糖和心血管风险参数方面产生有利变化，并鼓励更好地自我管理病情。研究参与者发现使用移动应用程序系统的体验是可以接受的，并愿意通过行为改变来实现更长期的生活方式改善。
