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一款数字应用程序对糖尿病患者糖化血红蛋白水平的影响:一项随机对照试验。

Impact of a digital application on HbA1c levels in people with diabetes: a randomized controlled trial.

作者信息

Roth Lena, Steckhan Nico, Schwarz Peter E H

机构信息

Department for Prevention and Care of Diabetes, Department of Medicine III, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.

出版信息

Front Digit Health. 2025 Jun 30;7:1544668. doi: 10.3389/fdgth.2025.1544668. eCollection 2025.

Abstract

AIMS

Digital applications have the potential to enhance diabetes management, particularly in patients treated with insulin. This study aims to evaluate the impact of a digital application on self-management (ESYSTA, Germany), expressed in a change in HbA1c levels, in people with diabetes treated with insulin.

MATERIALS AND METHODS

A randomized controlled, multicentric trial was conducted in 204 people with diabetes (60% type 2 diabetes) treated with insulin to assess the efficacy of ESYSTA. Participants were randomly assigned to either the intervention group (IG) using ESYSTA in addition to the German standard of Care (SoC) according to the German disease management programs (DMP) for 6 months or a control group (CG) receiving SoC only. The primary endpoint was the change in HbA1c levels. Secondary endpoints included well-being and diabetes-related distress.

RESULTS

A clinically relevant reduction in HbA1c levels of on average -0.48% points (-0.66; -0.29) was observed in the IG after 6 months. Compared to the CG, this reduction was more pronounced, especially in the per-protocol sample [mean difference, -0.28% points; 95% CI (-0.54; -0.02)]. Improvements in the IG in further secondary endpoints, such as well-being or diabetes-related distress, indicate enhanced overall glycemic control and patient satisfaction in the IG.

CONCLUSIONS

The use of ESYSTA improved HbA1c levels and other secondary outcomes in people with diabetes who are treated with insulin in comparison with German SoC in the context of DMP. These findings support the integration of digital tools in routine diabetes care to optimize patient outcomes.

CLINICAL TRIAL REGISTRATION

https://drks.de/search/de/trial/DRKS00025996, identifier DRKS00025996.

摘要

目的

数字应用有潜力改善糖尿病管理,尤其是在接受胰岛素治疗的患者中。本研究旨在评估一款数字应用(德国的ESYSTA)对接受胰岛素治疗的糖尿病患者自我管理的影响,以糖化血红蛋白(HbA1c)水平的变化来表示。

材料与方法

对204例接受胰岛素治疗的糖尿病患者(60%为2型糖尿病)进行了一项随机对照、多中心试验,以评估ESYSTA的疗效。参与者被随机分配到干预组(IG),除了按照德国疾病管理计划(DMP)的德国标准护理(SoC)外,还使用ESYSTA 6个月,或仅接受SoC的对照组(CG)。主要终点是HbA1c水平的变化。次要终点包括幸福感和糖尿病相关困扰。

结果

6个月后,干预组的HbA1c水平平均临床相关降低了-0.48个百分点(-0.66;-0.29)。与对照组相比,这种降低更为明显,尤其是在符合方案样本中[平均差异,-0.28个百分点;95%置信区间(-0.54;-0.02)]。干预组在其他次要终点方面的改善,如幸福感或糖尿病相关困扰,表明干预组的整体血糖控制和患者满意度有所提高。

结论

与德国疾病管理计划背景下的德国标准护理相比,使用ESYSTA改善了接受胰岛素治疗的糖尿病患者的HbA1c水平和其他次要结局。这些发现支持将数字工具整合到常规糖尿病护理中,以优化患者结局。

临床试验注册

https://drks.de/search/de/trial/DRKS00025996,标识符DRKS00025996。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7178/12257309/baa101897225/fdgth-07-1544668-g001.jpg

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