Telemedicine-assisted structured self-monitoring of blood glucose in management of T2DM results of a randomized clinical trial

Abstract

Background This prospective study aimed to compare telemedicine-assisted structured self-monitoring of blood glucose(SMBG) with a traditional blood glucose meter (BGM) in adults of type 2 diabetes mellitus (T2DM). Methods Adult participants with T2DM were assigned to an intervention group or a control group. The patients in the intervention group received a connected BGM with real-time data submission as well as individual needs-based tele-coaching to address and improve motivation and daily diabetes self-management. The patients in the control group received a traditional BGM. Changes in glycated hemoglobin(HbA1c), low blood glucose index(LBGI), and diabetes self-management behaviors were analyzed. Results The study demonstrated the superiority of the telemedicine-assisted structured SMBG versus the traditional BGM for improving HbA1c. Additionally, the telemedicine-assisted SMBG reduced the risk of hypoglycemia and enhanced diabetes self-management behaviors, as differences in the LBGI and the Diabetes Self-Management Questionnaire(DSMQ) results between the groups after 6 months were found to be significant. Conclusions Telemedicine-assisted structured SMBG helps physicians and patients to achieve a specific level of glycemic control and reduce hypoglycemia. The use of coaching applications and telemedicine-assisted SMBG indicated beneficial effects for T2DM self-management, which may help limit disease progression. Trial registration Chinese Clinical Trail Registry No: ChiCTR2300072356 on 12/06/2023. Retrospectively registered.

Effectiveness of Digital Health Intervention Strategies on Type 2 Diabetes Management：A Systematic Review and Network Meta-Analysis (Preprint)

“…Finally, the combination DHI-GIK (guide, management, monitor) that only include a few strategies was relatively weak. This may be due to a lack of communication and patient engagement, reflecting insufficient communication between healthcare professionals and patients in real clinical practice, and a lack of enthusiasm and participation from patients in treatment [78,106]. In addition, relying solely on guidance and management, while ignoring the psychological and lifestyle factors of patients, can also easily lead to poor treatment outcomes.…”

“…A total of 27 RCTs [14,50,[53][54][55]57,59,60,66,68,70,72,74,77,78,80,82,84,85,87,88,93,94,[96][97][98]100] assessed the effects of 12 different DHI strategy combinations on HbA1c levels in patients with type 2 diabetes. These 12 strategy combinations encompassed: (1) ABCDEFGHIJKLMNOQR (action planning, communication, cues, engagement, feedback, goal setting, guide, identity, management, model/demonstrate, monitor, prompt, restructure, reward, shape, support, tailor), ( 2) ABDEFGIKLOPQ (action planning, communication, engagement, feedback, goal setting, guide, management, monitor, prompt, shape, stimulate, support), ( 3) FGIKQ (goal setting, guide, management, monitor, support), ( 4)BGKR (communication, guide, monitor, tailor), ( 5) EGIKPR (feedback, guide, management, monitor, stimulate, tailor), ( 6) EKP (feedback, monitor, stimulate), ( 7) DGIKPQR (engagement, guide, management, monitor, stimulate, support, tailor), ( 8) BDFIQ (communication, engagement, goal setting, management, support), (9) BDGI (communication, engagement, guide, management), ( 10) BDGKNOP (communication, engagement, guide, monitor, reward, shape, stimulate), (11) DFGKP (engagement, goal setting, guide, monitor, stimulate), ( 12) GIK (guide, management, monitor).…”

“…The network evidence plot was shown in Figure 3. The SUCRA probability ranking for the reducing effect of HbA1c of different DHI strategy combinations was shown in (2) The effects of strategy combinations on FBG A total of 7 RCTs [74,78,84,85,87,97,98] assessed the effects of 6 different digital health intervention strategy combinations on FBG levels in patients with type 2 diabetes. These 6 strategy combinations encompassed: (1) DGIKPQR (engagement, guide, management, monitor, stimulate, support, tailor), ( 2) BDGI (communication, engagement, guide, management), (3) DFGKP (engagement, goal setting, guide, monitor, stimulate), ( 4) BGKR (communication, guide, monitor, tailor), ( 5) GIK (guide, management, monitor), ( 6) BDFIQ (communication, engagement, goal setting, management, support).…”

“…(3) The effects of strategy combinations on BMI A total of 11 randomized controlled trials (RCTs) [60,66,70,[72][73][74]78,84,85,97,98] assessed the effects of 9 different DHI strategy combinations on BMI levels in patients with type 2 diabetes. These 9 strategy combinations encompassed: (1) FGIKQ (goal setting, guide, management, monitor, support), ( 2) BGKR (communication, guide, monitor, tailor), ( 3) EKP (feedback, monitor, stimulate), ( 4) BDFGIKLOPQ (communication, engagement, goal setting, guide, management, monitor, prompt, shape, stimulate, support), ( 5) DGIKPQR (engagement, guide, management, monitor, stimulate, support, tailor), ( 6) BDGI (communication, engagement, guide, management), ( 7) DFGKP (engagement, goal setting, guide, monitor, stimulate), ( 8) GIK (guide, management, monitor), ( 9) BDFIQ (communication, engagement, goal setting, management, support).…”

The Impact of the COVID-19 Pandemic on Diabetes Self-Management in Saudi Arabia

“…The DSMQ has been utilized extensively in various settings, contexts, and countries such as Egypt, Ethiopia, Hungary, India, Indonesia, Iran, Kuwait, Nigeria, Philippines, Qatar, Romania, Spain, Thailand, and the United States of America [ 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. Some of the highest scores have been published in the German (7.8) and Chinese (7.79) populations, and lower scores have been reported in the United Kingdom (4.14) and Pakistan (3.96) [ 8 , 34 , 35 , 36 ]. Permission to use the questionnaire was obtained through Mapi Research Trust ( (accessed on 9 March 2021)).…”