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关于移动胰岛素滴定应用程序在临床实践中的可行性、可接受性及其对糖尿病结局影响的见解。

Insights into the Feasibility and Acceptability of a Mobile Insulin Titration Application in Clinical Practice and Its Effects on Diabetes Outcomes.

作者信息

Krall Jodi S, Ng Jason M, Mehrotra Neha, Ruppert Kristine, Siminerio Linda M

机构信息

University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

niversity of Pittsburgh, Department of Medicine, Division of Endocrinology and Metabolism, Pittsburgh, PA, USA.

出版信息

touchREV Endocrinol. 2024 Apr;20(1):52-57. doi: 10.17925/EE.2024.20.1.10. Epub 2024 Feb 29.

DOI:10.17925/EE.2024.20.1.10
PMID:38812671
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11132646/
Abstract

: Insulin therapy is most effective if patients learn how to properly adjust insulin to achieve glycaemic targets. There is a need for methods and tools that can assist these processes in clinical practice. The purpose of this feasibility study was to evaluate an approach to support insulin dose adjustment in individual patients using a mobile titration application (app). : A cohort of adults (N=36) with type 2 diabetes with suboptimal glycaemia who were starting basal insulin self-titration were trained by a diabetes care and education specialist to use a mobile titration app to guide adjusting insulin doses. Glycaemia, diabetes distress and patient and provider satisfaction were assessed during the first 3 months after initiating basal insulin titration using the mobile app. : Mean haemoglobin type A1c (HbA1c) was significantly reduced by an average of 2.1 ± 2.2% from baseline to 3 months (p<0.001). Diabetes distress significantly decreased from baseline to follow-up with scores going down (or improving) across all scales. Both patients and providers reported high levels of satisfaction and positive experiences. : The model offers a promising solution to streamline insulin dosage adjustments to achieve specific clinical and self-management goals with high expectations for long-term benefits and warrants further investigation.

摘要

如果患者学会如何正确调整胰岛素以实现血糖目标,胰岛素治疗将最为有效。临床实践中需要能够辅助这些过程的方法和工具。这项可行性研究的目的是评估一种使用移动滴定应用程序(应用)来支持个体患者胰岛素剂量调整的方法。

一组患有血糖控制不佳的2型糖尿病成年人(N = 36)开始基础胰岛素自我滴定,由糖尿病护理和教育专家培训使用移动滴定应用程序来指导调整胰岛素剂量。在使用移动应用程序开始基础胰岛素滴定后的前3个月内,评估血糖、糖尿病困扰以及患者和提供者的满意度。

从基线到3个月,平均糖化血红蛋白(HbA1c)显著降低,平均降低了2.1±2.2%(p<0.001)。从基线到随访,糖尿病困扰显著降低,所有量表的得分均下降(或改善)。患者和提供者均报告了高度的满意度和积极的体验。

该模型为简化胰岛素剂量调整提供了一个有前景的解决方案,有望实现特定的临床和自我管理目标,长期效益可期,值得进一步研究。

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Improving Quality Outcomes: The Value of Diabetes Care and Education Specialists.改善质量成果:糖尿病护理与教育专家的价值
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