Clinical efficacy and plausibility of a smartphone-based integrated online real-time diabetes care system via glucose and diet data management: a pilot study

Background Smartphones have become novel healthcare tools for patients with diabetes. However, it is uncertain whether the smartphone application support system helps in glycaemic control in patients with type 2 diabetes. Aims To evaluate the efficacy and plausibility of smartphone-based integrated online real-time diabetes care. Methods Forty patients with type 2 diabetes were randomly assigned to the smartphone-based care (SC) (n = 20) and conventional care (CC) (n = 20) groups for 12 weeks. The SC group was instructed to use smartphone application (Noom Coach) and a glucose meter, and was provided medical supervision based on blood glucose level and food intake information sent to the central database server. The efficacy was evaluated by glycated haemoglobin (A1C <= 6.5%). The Summary of Diabetes Self-Care Activities (SDSCA) questionnaire was collected at baseline and at week 12. Results Seventeen and 18 patients of the SC and CC groups completed the study respectively. In the SC group, more patients achieved target A1C compared with the CC group (47.1% vs 11.1%, P = 0.019). In both group, SDSCA scores excluding the exercise item showed overall improvement (general diet, 1.4 +/- 2.0 -> 2.6 +/- 2.3 vs 0.4 +/- 1.1 -> 1.8 +/- 2.2; specific diet, 4.2 +/- 1.7 -> 5.4 +/- 1.2 vs 3.8 +/- 1.6 -> 5.1 +/- 1.1; blood glucose test, 3.3 +/- 2.8 -> 4.9 +/- 2.3 vs 1.0 +/- 2.2 -> 4.7 +/- 2.3; foot care, 1.5 +/- 1.6 -> 3.6 +/- 2.8 vs 1.4 +/- 1.9 -> 6.1 +/- 1.4; all P < 0.05). There was no difference between both groups other than the aspect of foot care (P = 0.008). Conclusions The smartphone-based integrated online real-time diabetes care system through glucose and diet data management showed clinical plausibility in glucose control in real clinical practice.