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‘Engaging’ smartphone app supports HbA1c reduction in type 2 diabetes
Indian adults with poorly controlled type 2 diabetes assigned to a mobile health intervention for 6 months saw an average 0.7% greater reduction in HbA1c vs. patients assigned to usual care, according to recently published findings.
The intervention, an app designed by Gather Mobile Health, is designed to support diabetes self-management, facilitate patient–provider communication and enable treatment changes between visits via the app and provider web portals.
“In this study, participants assigned to the Gather [Mobile] Health system had greater [HbA1c] reductions than those assigned to usual care,” Nora J. Kleinman, MPH, of Gather Health LLC, and colleagues wrote. “This tool could be an effective way to expand access to quality chronic disease care and improve outcomes across India.”
Kleinman and colleagues analyzed data from 90 adults with poorly controlled type 2 diabetes (HbA1c 7.5%) and an Android smartphone recruited from three sites in India (30% women; mean age, 48 years; mean HbA1c, 9.3%; mean diabetes duration, 10 years). The median length of smartphone ownership was 14 months. Researchers randomly assigned patients to the mobile health intervention or usual care for 6 months; those assigned to the intervention received the app and a mobile phone plan stipend. All participants received free visits, laboratory tests, test strips and lancets.
At 6 months, the 80 returning participants saw an average decrease of 1.5% vs. a decrease of 0.8% in the usual care group (95% CI, 0.1-1.37). Results persisted after adjustments for sex, age and diabetes duration.
When analyzing data from all 90 patients, results for difference in HbA1c were significant (P = .045) using last observation carried forward and “borderline” using imputation from treatment arm means, according to the findings.
The researchers noted that a previous study involving a text message intervention among patients with diabetes in India did not show HbA1c improvements, adding that the “engaging” smartphone format may have facilitated behavior change.
“To our knowledge, there are no studies of smartphone-based [mobile] health interventions for diabetes in India, let alone one of this rigor,” the researchers wrote. “However, as younger and/or wealthier individuals typically use smartphones, these results may not generalize to the wider Indian population.” – by Regina Schaffer
Disclosure: One researcher is a co-founder of Gather Health LLC. Two researchers report serving as advisers to Gather Health LLC.