Effectiveness of the Lilly Connected Care Program in Improving Glycemic Management Among Patients With Type 2 Diabetes in China: Retrospective Real-world Study (Preprint)

Abstract

BACKGROUND Type 2 diabetes mellitus (T2DM) has been a worldwide public health concern. Mobile health management platform could be a potential way to achieving effective glycemic control. OBJECTIVE This study aimed to evaluate real-world effectiveness of the Lilly Connected Care Program (LCCP) platform in glycemic control among patients with T2DM in China. METHODS This retrospective study included Chinese patients with T2DM (age ≥18 years) from April 1, 2017 to January 31, 2020 for the LCCP group and from January 1, 2015 to January 31, 2020 for the non-LCCP group. Real-world data was drawn from mobile app and electronic medical records. Propensity score matching (PSM) was used to match the LCCP and non-LCCP groups to reduce confounding, with covariates including age, sex, duration of diabetes, baseline Hemoglobin A1c (HbA1c), and the number of oral antidiabetic medication classes. HbA1c reduction over an average of 4 months, the proportions of patients achieving HbA1c reduction ≥0.5% or ≥1.0%, and the proportions of patients reaching target HbA1c levels ≤6.5% or <7.0% were compared between LCCP and non-LCCP groups using independent t-test and Chi‐square test. Multivariate linear regression was used to assess factors associated with HbA1c reduction. RESULTS A total of 923 patients were included, among whom 303 pairs of patients were well-matched after PSM (Standardized Mean Difference of covariates <15%). HbA1c reduction during the 4-month follow-up was significantly larger in the LCCP group than the non-LCCP group (2.21±2.37% vs. 1.65±2.29%, P=.003). LCCP group had higher proportion of patients with HbA1c reduction ≥1.0% (69.0% vs. 57.4%, P=.003) and ≥0.5% (75.6% vs. 68.0%, P=.038). The proportions of patients reaching target HbA1c level ≤6.5% were significantly different between the LCCP and non-LCCP groups (29.0% vs. 20.1%, P=.011), while difference in the proportions of patients reaching target HbA1c level <7.0% were not statistically significant (LCCP vs. non-LCCP: 42.2% vs. 36.0%, P=.114). LCCP participation and higher baseline HbA1c were associated with larger HbA1c reduction, while older age, longer diabetes duration, and higher baseline dose of premixed insulin analogue were associated with smaller HbA1c reduction. CONCLUSIONS LCCP mobile platform was effective in glycemic control among patients with T2DM in China in the real world.