PMID- 30843865
OWN - NLM
STAT- MEDLINE
DCOM- 20200129
LR  - 20200309
IS  - 2291-5222 (Print)
IS  - 2291-5222 (Electronic)
IS  - 2291-5222 (Linking)
VI  - 7
IP  - 3
DP  - 2019 Mar 7
TI  - Impact of Use Frequency of a Mobile Diabetes Management App on Blood Glucose 
      Control: Evaluation Study.
PG  - e11933
LID - 10.2196/11933 [doi]
LID - e11933
AB  - BACKGROUND: Technology has long been used to carry out self-management as well as 
      to improve adherence to treatment in people with diabetes. However, most 
      technology-based apps do not meet the basic requirements for engaging patients. 
      OBJECTIVE: This study aimed to evaluate the effect of use frequency of a diabetes 
      management app on glycemic control. METHODS: Overall, 2 analyses were performed. 
      The first consisted of an examination of the reduction of blood glucose (BG) 
      mean, using a randomly selected group of 211 users of the SocialDiabetes app 
      (SDA). BG levels at baseline, month 3, and month 6 were calculated using the 
      intercept of a regression model based on data from months 1, 4, and 7, 
      respectively. In the second analysis, the impact of low and high BG risk was 
      examined. A total of 2692 users logging SDA >/=5 days/month for >/=6 months were 
      analyzed. The highest quartile regarding low blood glucose index (LBGI) and high 
      blood glucose index (HBGI) at baseline (t1) was selected (n=74 for group A; n=440 
      for group B). Changes in HBGI and LBGI at month 6 (t2) were analyzed. RESULTS: 
      For analysis 1, baseline BG results for type 1 diabetes mellitus (T1DM) groups A 
      and B were 213.61 (SD 31.57) mg/dL and 206.43 (SD 18.65) mg/dL, respectively, 
      which decreased at month 6 to 175.15 (SD 37.88) mg/dL and 180.6 (SD 40.47) mg/dL, 
      respectively. For type 2 diabetes mellitus (T2DM), baseline BG was 218.77 (SD 
      40.18) mg/dL and 232.55 (SD 46.78) mg/dL, respectively, which decreased at month 
      6 to 160.51 (SD 39.32) mg/dL and 173.14 (SD 52.81) mg/dL for groups A and B, 
      respectively. This represents a reduction of estimated A(1c) (eA(1c)) of 
      approximately 1.3% (P<.001) and 0.9% (P=.001) for T1DM groups A and B, 
      respectively, and 2% (P<.001) for both A and B T2DM groups, respectively. For 
      analysis 2, T1DM baseline LBGI values for groups A and B were 5.2 (SD 3.9) and 
      4.4 (SD 2.3), respectively, which decreased at t2 to 3.4 (SD 3.3) and 3.4 (SD 
      1.9), respectively; this was a reduction of 34.6% (P=.005) and 22.7% (P=.02), 
      respectively. Baseline HBGI values for groups A and B were 12.6 (SD 4.3) and 10.6 
      (SD 4.03), respectively, which decreased at t2 to 9.0 (SD 6.5) and 8.6 (SD 4.7), 
      respectively; this was a reduction of 30% (P=.001) and 22% (P=.003), 
      respectively. CONCLUSIONS: A significant reduction in BG was found in all groups, 
      independent of the use frequency of the app. Better outcomes were found for T2DM 
      patients. A significant reduction in LBGI and HBGI was found in all groups, 
      regardless of the use frequency of the app. LBGI and HBGI indices of both groups 
      tend to have similar values after 6 months of app use.
CI  - (c)Josep Vehi, Jordi Regincos Isern, Adria Parcerisas, Remei Calm, Ivan Contreras. 
      Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 
      07.03.2019.
FAU - Vehi, Josep
AU  - Vehi J
AUID- ORCID: 0000-0001-6884-9789
AD  - Institut d'Informatica i Aplicacions, Universitat de Girona, Girona, Spain.
AD  - Centro de Investigacion Biomedica en Red de Diabetes y Enfermedades Metabolicas 
      Asociadas, Girona, Spain.
FAU - Regincos Isern, Jordi
AU  - Regincos Isern J
AUID- ORCID: 0000-0001-8451-0638
AD  - Institut d'Informatica i Aplicacions, Universitat de Girona, Girona, Spain.
FAU - Parcerisas, Adria
AU  - Parcerisas A
AUID- ORCID: 0000-0003-4364-1601
AD  - Institut d'Informatica i Aplicacions, Universitat de Girona, Girona, Spain.
FAU - Calm, Remei
AU  - Calm R
AUID- ORCID: 0000-0002-2756-9315
AD  - Institut d'Informatica i Aplicacions, Universitat de Girona, Girona, Spain.
FAU - Contreras, Ivan
AU  - Contreras I
AUID- ORCID: 0000-0001-6896-818X
AD  - Institut d'Informatica i Aplicacions, Universitat de Girona, Girona, Spain.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190307
PL  - Canada
TA  - JMIR Mhealth Uhealth
JT  - JMIR mHealth and uHealth
JID - 101624439
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Adult
MH  - Blood Glucose/analysis
MH  - Blood Glucose Self-Monitoring/*instrumentation/methods/psychology
MH  - Diabetes Mellitus/psychology/*therapy
MH  - Evaluation Studies as Topic
MH  - Female
MH  - Humans
MH  - Hyperglycemia/blood/diagnosis
MH  - Hypoglycemia/blood/diagnosis
MH  - Male
MH  - Middle Aged
MH  - Mobile Applications/*standards/statistics & numerical data
MH  - Self-Management/methods/psychology
PMC - PMC6427097
OTO - NOTNLM
OT  - blood glucose self-monitoring
OT  - diabetes mellitus
OT  - evaluation studies
OT  - mHealth
OT  - self-management
COIS- Conflicts of Interest: JV has worked in SocialDiabetes as the Chief Researcher 
      Officer and also received research support. The terms of this arrangement have 
      been reviewed and approved by the University of Girona in accordance with its 
      policy on objectivity in research.
EDAT- 2019/03/08 06:00
MHDA- 2019/03/08 06:01
PMCR- 2019/03/07
CRDT- 2019/03/08 06:00
PHST- 2018/08/14 00:00 [received]
PHST- 2019/02/17 00:00 [accepted]
PHST- 2018/11/16 00:00 [revised]
PHST- 2019/03/08 06:00 [entrez]
PHST- 2019/03/08 06:00 [pubmed]
PHST- 2019/03/08 06:01 [medline]
PHST- 2019/03/07 00:00 [pmc-release]
AID - v7i3e11933 [pii]
AID - 10.2196/11933 [doi]
PST - epublish
SO  - JMIR Mhealth Uhealth. 2019 Mar 7;7(3):e11933. doi: 10.2196/11933.