Johari Sa'ida Munira, Razalli Nurul Huda, Chua Kai Jia, Shahar Suzana
Alpro Pharmacy SDN. BHD., Seremban, Malaysia.
Dietetic Program, Centre for Healthy Aging and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
Diabetol Metab Syndr. 2024 Jun 21;16(1):135. doi: 10.1186/s13098-024-01379-9.
The aim of this study was to determine the effect of a Self-Monitoring Blood Glucose (SMBG) intervention package through a subscription model in improving HbA1c and health parameters among type-2 diabetes mellitus (T2DM) individuals in Malaysia.
This is a quasi-experimental study involving a total number of 111 individuals with T2DM (mean age 57.0 ± 11.7 years, 61% men) who were assigned to intervention (n = 51) and control (n = 60) groups. The intervention group participants were the subscribers of SugO365 program which provided a personalized care service based on self-recorded blood glucose values. Subscribers received a Contour Plus One glucometer which can connect to Health2Sync mobile app to capture all blood glucose readings as well as physical and virtual follow up with dietitians, nutritionists, and pharmacists for 6 months. Outcome measures were body weight, body mass index (BMI), random blood glucose (RBG), glycated haemoglobin (HbA1c) and health-related quality of life (HRQoL, assessed by SF-36 questionnaire). Data were measured at baseline, third and sixth months.
Repeated-measure analysis of covariance showed significant improvement in HbA1c level (ƞp = 0.045, p = 0.008) in the intervention (baseline mean 7.7% ± 1.1%; end mean 7.3% ± 1.3%) as compared to control (baseline mean 7.7% ± 0.9%; end mean 8.1% ± 1.6%) group. Similar trend was observed for Role Emotional domain of the quality of life (ƞp = 0.047, p = 0.023) in the intervention (baseline mean 62.8 ± 35.1, end mean 86.3 ± 21.3) compared to control (baseline mean group 70.5 ± 33.8; end mean 78.4 ± 27.3) group. Negative association was found in HbA1c changes using Z-score and Physical Function domain (r = - 0.217, p = 0.022).
A 6 months SMBG intervention package through a subscription model improved blood glucose control as measured by HbA1c and health-related quality of life, particularly the Role Emotional domain. Elevated HbA1c levels are correlated with decreased physical function.There is a need to further examine the efficacy of SMBG intervention package using a larger sample and a longer period of intervention and to determine its cost efficacy.
本研究旨在通过订阅模式确定自我血糖监测（SMBG）干预方案对改善马来西亚2型糖尿病（T2DM）患者糖化血红蛋白（HbA1c）及健康参数的效果。
这是一项准实验研究，共纳入111例T2DM患者（平均年龄57.0±11.7岁，61%为男性），分为干预组（n = 51）和对照组（n = 60）。干预组参与者为SugO365项目的订阅者，该项目根据自我记录的血糖值提供个性化护理服务。订阅者获得一台Contour Plus One血糖仪，可连接至Health2Sync移动应用程序以记录所有血糖读数，并与营养师、营养学家和药剂师进行为期6个月的线下及线上随访。观察指标包括体重、体重指数（BMI）、随机血糖（RBG）、糖化血红蛋白（HbA1c）以及健康相关生活质量（HRQoL，采用SF - 36问卷评估）。在基线、第3个月和第6个月测量数据。
重复测量协方差分析显示，与对照组（基线均值7.7%±0.9%；最终均值8.1%±1.6%）相比，干预组（基线均值7.7%±1.1%；最终均值7.3%±1.3%）的HbA1c水平有显著改善（ƞp = 0.045，p = 0.008）。干预组（基线均值62.8±35.1，最终均值86.3±21.3）与对照组（基线均值70.5±33.8；最终均值78.4±27.3）相比，生活质量的角色情感领域也呈现类似趋势（ƞp = 0.047，p = 0.023）。使用Z分数和身体功能领域发现HbA1c变化呈负相关（r = - 0.217，p = 0.022）。
通过订阅模式进行为期6个月的SMBG干预方案可改善血糖控制，表现为HbA1c及健康相关生活质量的提高，尤其是角色情感领域。HbA1c水平升高与身体功能下降相关。有必要使用更大样本和更长干预时间进一步研究SMBG干预方案的疗效，并确定其成本效益。
