Kumbara Abhimanyu B, Iyer Anand K, Green Courtney R, Jepson Lauren H, Leone Keri, Layne Jennifer E, Shomali Mansur
Welldoc, Inc, Columbia, MD, United States.
Dexcom, Inc, San Diego, CA, United States.
JMIR Diabetes. 2023 Sep 11;8:e47638. doi: 10.2196/47638.
The BlueStar (Welldoc) digital health solution for people with diabetes incorporates data from multiple devices and generates coaching messages using artificial intelligence. The BlueStar app syncs glucose data from the G6 (Dexcom) real-time continuous glucose monitoring (RT-CGM) system, which provides a glucose measurement every 5 minutes.
The objective of this real-world study of people with type 2 diabetes (T2D) using the digital health solution and RT-CGM was to evaluate change in glycemic control and engagement with the program over 3 months.
Participants were current or former enrollees in an employer-sponsored health plan, were aged 18 years or older, had a T2D diagnosis, and were not using prandial insulin. Outcomes included CGM-based glycemic metrics and engagement with the BlueStar app, including logging medications taken, exercise, food details, blood pressure, weight, and hours of sleep.
Participants in the program that met our analysis criteria (n=52) were aged a mean of 53 (SD 9) years; 37% (19/52) were female and approximately 50% (25/52) were taking diabetes medications. The RT-CGM system was worn 90% (SD 8%) of the time over 3 months. Among individuals with suboptimal glycemic control at baseline, defined as mean glucose >180 mg/dL, clinically meaningful improvements in glycemic control were observed, including reductions in a glucose management indicator (-0.8 percentage points), time above range 181-250 mg/dL (-4.4 percentage points) and time above range >250 mg/dL (-14 percentage points; all P<.05). Time in range 70-180 mg/dL also increased by 15 percentage points (P=.016) in this population, which corresponds to an increase of approximately 3.5 hours per day in the target range. Over the 3-month study, 29% (15/52) of participants completed at least one engagement activity per week. Medication logging was completed most often by participants (23/52, 44%) at a rate of 12.1 (SD 0.8) events/week, and this was closely followed by exercise and food logging.
The combination of an artificial intelligence-powered digital health solution and RT-CGM helped people with T2D improve their glycemic outcomes and diabetes self-management behaviors.
BlueStar（Welldoc）糖尿病患者数字健康解决方案整合了来自多个设备的数据，并使用人工智能生成指导信息。BlueStar应用程序可同步来自G6（德康）实时连续血糖监测（RT-CGM）系统的血糖数据，该系统每5分钟提供一次血糖测量值。
这项针对使用数字健康解决方案和RT-CGM的2型糖尿病（T2D）患者的真实世界研究的目的是评估3个月内血糖控制的变化以及对该项目的参与度。
参与者为当前或以前参加雇主赞助的健康计划的人员，年龄在18岁及以上，患有T2D诊断，且未使用餐时胰岛素。结果包括基于CGM的血糖指标以及与BlueStar应用程序的参与度，包括记录所服用的药物、运动、食物细节、血压、体重和睡眠时间。
符合我们分析标准的项目参与者（n = 52）的平均年龄为53（标准差9）岁；37%（19/52）为女性，约50%（25/52）正在服用糖尿病药物。RT-CGM系统在3个月内佩戴时间为90%（标准差8%）。在基线血糖控制不佳（定义为平均血糖>180 mg/dL）的个体中，观察到血糖控制有临床意义的改善，包括血糖管理指标降低（-0.8个百分点）、血糖高于181 - 250 mg/dL的时间减少（-4.4个百分点）以及血糖高于250 mg/dL的时间减少（-14个百分点；所有P<.05）。该人群中血糖在70 - 180 mg/dL范围内的时间也增加了15个百分点（P = 0.016），这相当于每天在目标范围内的时间增加约3.5小时。在为期3个月的研究中，29%（15/52）的参与者每周至少完成一项参与活动。参与者完成药物记录的频率最高（23/52，44%），为每周12.1（标准差0.8）次，其次是运动和食物记录。
人工智能驱动的数字健康解决方案与RT-CGM相结合，有助于T2D患者改善血糖结果和糖尿病自我管理行为。
