Ortiz-Zúñiga Ángel, Simó-Servat Olga, Amigó Judit, Sánchez Mónica, Morer Carla, Franch-Nadal Josep, Mayor Regina, Snel Tim, Simó Rafael, Hernández Cristina
Endocrinology and Nutrition Department, Vall d'Hebron Hospital Campus, 08035 Barcelona, Spain.
Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute, 08035 Barcelona, Spain.
J Clin Med. 2023 Oct 4;12(19):6364. doi: 10.3390/jcm12196364.
To evaluate the efficacy of the self-management of insulin titration based on information received by the Short Message Service (SMS).
A case-control study including 59 subjects in each arm with 16 weeks of follow-up was performed. The inclusion criteria were: (1) Subjects with type 2 diabetes (T2D) under basal insulin treatment; (2) Suboptimal glycemic control: HbA1c ≥ 7.5% and fasting capillary blood glucose (FCBG) > 140 mg/dL (>3 times per week). Subjects were invited to use an insulin titration service based on SMS feedback aimed at optimizing glycemic control depending on fasting blood glucose levels. Psychological aspects were evaluated in the interventional group by means of validated questionnaires (DDS, HADS and SF-12).
The intervention group achieved a lower mean FCBG (126 mg/dL ± 34 vs. 149 mg/dL ± 46, = 0.001) and lower HbA1c (7.5% ± 1.3 vs. 7.9% ± 0.9, = 0.021) than the control group. In addition, the intervention group showed a significant improvement in psychological aspects related to Emotional Burden ( = 0.031), Regimen Distress ( < 0.001), Depression ( = 0.049) and Mental Health ( < 0.01).
The SMS-guided titration was effective in terms of improving glucometric parameters in comparison with the standard of care and improved significant psychological aspects-mainly, the stress associated with insulin treatment.
评估基于短信服务（SMS）所获信息进行胰岛素滴定自我管理的疗效。
进行一项病例对照研究，每组纳入59名受试者，随访16周。纳入标准为：（1）接受基础胰岛素治疗的2型糖尿病（T2D）患者；（2）血糖控制欠佳：糖化血红蛋白（HbA1c）≥7.5%且空腹毛细血管血糖（FCBG）>140 mg/dL（每周超过3次）。邀请受试者使用基于短信反馈的胰岛素滴定服务，旨在根据空腹血糖水平优化血糖控制。通过经过验证的问卷（DDS、HADS和SF-12）对干预组的心理状况进行评估。
与对照组相比，干预组的平均空腹毛细血管血糖更低（126 mg/dL±34 vs. 149 mg/dL±46，P = 0.001），糖化血红蛋白也更低（7.5%±1.3 vs. 7.9%±0.9，P = 0.021）。此外，干预组在与情感负担相关的心理方面（P = 0.031）、治疗方案困扰（P<0.001）、抑郁（P = 0.049）和心理健康（P<0.01）方面有显著改善。
与常规护理相比，短信指导的滴定在改善血糖参数方面是有效的，并且在主要与胰岛素治疗相关的压力等心理方面有显著改善。
