The Effect of a Smartphone-Based, Patient-Centered Diabetes Care System in Patients With Type 2 Diabetes: A Randomized, Controlled Trial for 24 Weeks
Abstract
OBJECTIVE: This study evaluated the efficacy of a smartphone-based, patient-centered diabetes care system (mDiabetes) for type 2 diabetes that contains comprehensive modules for glucose monitoring, diet, physical activity, and a clinical decision support system. RESEARCH DESIGN AND METHODS: We conducted a 24-week, multicenter, randomized controlled trial with adult patients with inadequately controlled type 2 diabetes. The patients were randomly assigned to the mDiabetes group or the paper logbook (pLogbook) group. The primary end point was the difference of the change in HbA1c from baseline between the two groups. RESULTS: HbA1c reduction from baseline was greater in the mDiabetes group (−0.40 ± 0.09%, n = 90) than in the pLogbook group (−0.06 ± 0.10%, n = 82). The difference of adjusted mean changes was 0.35% (95% CI 0.14–0.55, P = 0.001). The proportion of patients whose HbA1c fell below 7.0% (53 mmol/mol) was 41.1% for the mDiabetes group and 20.7% for the pLogbook group (odds ratio [OR] 2.01, 95% CI 1.24–3.25, P = 0.003). The percentage of patients who attained HbA1c levels below 7.0% (53 mmol/mol) without hypoglycemia was 31.1% in the mDiabetes group and 17.1% in the pLogbook group (OR 1.82, 95% CI 1.03–3.21, P = 0.024). There was no difference in the event numbers of severe hyperglycemia and hypoglycemia between the two groups. CONCLUSIONS: The implementation of the mDiabetes for patients with inadequately controlled type 2 diabetes resulted in a significant reduction in HbA1c levels, with tolerable safety profiles.
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The majority of previous eHealth interventions focused on mental health in individuals with obesity focused on diet, physical activity, weight loss or the combination of these.
“The majority of previous eHealth interventions focused on the mental health in individuals with obesity focused on diet, physical activity, weight loss or the combination of these (55–57).”
From Efficacy of eHealth interventions to reduce depression symptoms in individuals with obesity: a systematic review of randomized controlled trials (2024) · cites this paper as [55]
Of the 27 papers, 12 focused on T2DM, with 743 patients in the intervention groups and 645 in the control groups.
“12 were focused on T2DM (743 patients in the intervention groups and 645 patients in the control groups) [50-61]”
From Effectiveness of Disease-Specific mHealth Apps in Patients With Diabetes Mellitus: Scoping Review (2021) · cites this paper as [55]
In T2DM, eleven studies reported a decrease of HbA1c within the app intervention groups, yielding a mean difference of -0.42%.
“Eleven of the studies reported a decrease of HbA1c within the app intervention groups, yielding a mean difference of –0.42% [50-52,54-61], but only 1 study reported a significant change of –1.1% (P<.001) [56].”
From Effectiveness of Disease-Specific mHealth Apps in Patients With Diabetes Mellitus: Scoping Review (2021) · cites this paper as [55]
Of 11 T2DM studies that included control groups, 7 reported significant differences (mean difference: -0.78%, -1.51 to -0.35) in favor of the app intervention groups.
“Of 11 studies that included control groups in their study design, 7 studies reported significant differences (mean difference: –0.78%, –1.51 to –0.35) in favor of the app intervention groups [51,53-58]”
From Effectiveness of Disease-Specific mHealth Apps in Patients With Diabetes Mellitus: Scoping Review (2021) · cites this paper as [55]
None of the 7 T2DM studies that reported on blood pressure found significant differences either within or between groups.
“None of the 7 studies that reported on blood pressure found significant differences either within or between groups [51-53,55,57,58,61].”
From Effectiveness of Disease-Specific mHealth Apps in Patients With Diabetes Mellitus: Scoping Review (2021) · cites this paper as [55]
Kim et al did not report significant differences between intervention and control groups for body weight (P=.531).
“Meanwhile, Kim et al [55] did not report significant differences between the intervention and control groups (P=.531).”
From Effectiveness of Disease-Specific mHealth Apps in Patients With Diabetes Mellitus: Scoping Review (2021) · cites this paper as [55]
Cholesterol levels were reported in 7 T2DM studies (407 intervention, 348 control).
“Cholesterol levels were reported in 7 studies (407 patients in the intervention groups and 348 patients in the control groups).”
From Effectiveness of Disease-Specific mHealth Apps in Patients With Diabetes Mellitus: Scoping Review (2021) · cites this paper as [55]
HDL and LDL cholesterol were both included in 7 T2DM studies.
“High-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol were both included in 7 studies [52,53,55-58,61].”
From Effectiveness of Disease-Specific mHealth Apps in Patients With Diabetes Mellitus: Scoping Review (2021) · cites this paper as [55]
Three T2DM studies observed body weights of 215 intervention and 156 control patients.
“Three studies [52,55,59] observed the body weights of 215 patients in intervention groups and 156 patients in control groups.”
From Effectiveness of Disease-Specific mHealth Apps in Patients With Diabetes Mellitus: Scoping Review (2021) · cites this paper as [55]
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- Authors
- Kim, E. K., Kwak, S. H., Jung, H. S., Koo, B. K., Moon, M. K., Lim, S., Jang, H. C., Park, K. S., & Cho, Y. M.
- Affiliations
- Seoul National University (KR)
- Corresponding author
- Cho, Young Min
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2018-10-30
- Volume
- 42
- Issue
- 1
- Pages
- 3-9
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2898904656
- Cited by
- 61
- References
- 20
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 13 · 2023: 4 · 2022: 7 · 2021: 9 · 2020: 11 · 2019: 9
- FWCI
- 11.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, patient-centered care, glycemic control, HbA1c reduction, glucose monitoring, clinical decision support, diet and physical activity, hypoglycemia, hyperglycemia, glycemic variability
- MeSH terms
- Smartphone, Adult, Aged, Aged, 80 and over, Blood Glucose, Cholesterol, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Hyperglycemia, Hypoglycemia, Hypoglycemic Agents, Insulin, Male, Middle Aged, Pilot Projects, Triglycerides, Blood Glucose Self-Monitoring, Body Mass Index, Patient-Centered Care, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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