Feasibility of a mobile phone-based data service for functional insulin treatment of type 1 diabetes mellitus patients
Feasibility of a mobile phone-based data service for functional insulin treatment of type 1 diabetes mellitus patients
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DOI：
10.2196/jmir.9.5.e36
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发表时间：
2007-01-01
影响因子：
7.4
通讯作者：
Ludvik, Bernhard
中科院分区：
文献类型：
--
作者：
Kollmann, Alexander;Riedl, Michaela;Ludvik, Bernhard
背景资料：1型糖尿病（DM 1）患者必须积极参与治疗，因为他们不可避免地要负责自己的日常护理。移动的互联网接入的可用性正在迅速发展，并且移动的电话现在以低成本广泛可用。因此，移动的电话有可能帮助日常糖尿病管理，并使患者和卫生保健专业人员之间的远程医疗互动。目的：本研究的目的是评估基于移动的电话的数据服务的可行性和用户接受度，以帮助DM 1患者进行强化胰岛素治疗。方法：开发了一个名为Diab-Memory（基于Java 2移动的版）的软件应用程序，以支持患者输入糖尿病相关数据，并与监测中心的远程数据库同步。然后对数据进行处理，以生成统计数据和趋势，并通过门户网站向患者及其医疗保健专业人员提供。该系统已在临床试验前后的过程中进行了评估。结果测量集中于患者对治疗的依从性、监测系统的可用性以及对代谢状态的影响。一般用户接受的系统进行了评估，使用questionnaire.Results：10例患者（4名女性）DM 1参加了试验。平均年龄为36.6岁（+/- 11.0岁），研究前糖化血红蛋白（HbA（1c））为7.9%（+/- 1.1%）。在研究的3个月期间，共登记了3850次登录。接收到的数据集总数为13003，相当于每名患者每天平均传输14个参数。该服务被患者很好地接受（无脱落），并且在96.5%的病例中，通过移动的电话的数据传输在第一次尝试时就成功了。研究完成后，观察到代谢控制的统计学显著改善（HbA（1c）：研究前7.9% +/- 1.1% vs研究后7.5% +/- 0.9%; P= 0.02）。虽然平均血糖水平略有下降（研究前141.8 mg/dL +/- 22.5 mg/dL vs研究后141.2 mg/dL +/- 23.1 mg/dL; P= 0.69），但差异无统计学意义。结论：临床试验的结果表明，该糖尿病管理系统被患者广泛接受，并可用于日常使用。因此，使用移动的电话作为患者终端似乎提供了一个无处不在的，易于使用的，并具有成本效益的解决方案，以患者为中心的数据采集管理DM 1。为了证实试点试验的有希望的结果，必须进行进一步的研究，以研究对血糖控制和成本效益的长期影响。
Background: Patients with type 1 diabetes mellitus (DM1) have to be active participants in their treatment because they are inevitably responsible for their own day-to-day-care. Availability of mobile Internet access is advancing rapidly and mobile phones are now widely available at low cost. Thus, mobile phones have the potential to assist in daily diabetes management and to enable a telemedical interaction between patients and health care professionals.Objective: The aim of the study was to evaluate the feasibility and user acceptance of a mobile phone-based data service to assist DM1 patients on intensive insulin treatment.Methods: A software application called Diab-Memory (based on Java 2 Mobile Edition) has been developed to support patients when entering diabetes-related data with synchronization to the remote database at the monitoring center. The data were then processed to generate statistics and trends, which were provided for the patient and his/her health care professional via a Web portal. The system has been evaluated in the course of a clinical before-after pilot trial. Outcome measures focused on patients' adherence to the therapy, availability of the monitoring system, and the effects on metabolic status. General user acceptance of the system was evaluated using a questionnaire.Results: Ten patients (four female) with DM1 participated in the trial. Mean age was 36.6 years (+/- 11.0 years) and prestudy glycated hemoglobin (HbA(1c) was 7.9% (+/- 1.1%). A total of 3850 log-ins were registered during the 3 months of the study. The total number of received datasets was 13003, which equates to an average of 14 transmitted parameters per patient per day. The service was well accepted by the patients (no dropouts), and data transmission via mobile phone was successful on the first attempt in 96.5% of cases. Upon completion of the study, a statistically significant improvement in metabolic control was observed (HbA(1c) : prestudy 7.9% +/- 1.1% versus poststudy 7.5% +/- 0.9%; P=.02). While there was a slight decrease in average blood glucose level (prestudy 141.8 mg/dL +/- 22.5 mg/dL vs poststudy 141.2 mg/dL +/- 23.1 mg/dL; P=.69), the difference was not statistically significant.Conclusion: The results of the clinical pilot trial indicate that this proposed diabetes management system was well accepted by the patients and practical for daily usage. Thus, using the mobile phone as patient terminal seems to provide a ubiquitous, easy-to-use, and cost efficient solution for patient-centered data acquisition in the management of DM1. To confirm the promising results of the pilot trial further research has to be done to study long-term effects on glycemic control and cost-effectiveness.