Dulce Wireless Tijuana: A Randomized Control Trial Evaluating the Impact of Project Dulce and Short-Term Mobile Technology on Glycemic Control in a Family Medicine Clinic in Northern Mexico.
Dulce Wireless Tijuana: A Randomized Control Trial Evaluating the Impact of Project Dulce and Short-Term Mobile Technology on Glycemic Control in a Family Medicine Clinic in Northern Mexico.
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DOI：
10.1089/dia.2015.0283
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发表时间：
2016-04
影响因子：
5.4
通讯作者：
Philis-Tsimikas A
中科院分区：
文献类型：
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作者：
Anzaldo-Campos MC;Contreras S;Vargas-Ojeda A;Menchaca-Díaz R;Fortmann A;Philis-Tsimikas A
背景：糖尿病的全球流行需要创新的干预措施。本研究评价了Project杜尔塞模型（有和没有无线技术）对墨西哥控制不佳的2型糖尿病患者的血糖控制和其他临床和自我报告结局的有效性。研究对象和方法：从位于梅西科蒂亚戈的墨西哥社会安全研究所（IMSS）第27号家庭医疗单位招募了糖化血红蛋白A1 c（HbA 1 c）水平≥8%的2型糖尿病成人，并随机分配至三组之一：仅Dulce项目（PD）;杜尔塞项目-使用移动的工具增强（PD-TE）;或IMSS标准治疗/对照组（CG）。在基线、第4个月和第10个月评估临床和自我报告结局。分析时间-组间相互作用和组内变化。结果如下：PD-TE（−3.0% [−33 mmol/mol]）和PD（−2.6% [−28.7 mmol/mol]）中HbA 1c自基线至第10个月的降幅显著大于CG（−1.3% [−14.2 mmol/mol]）（分别为P = 0.009和0.001）。与对照组相比，PD-TE和PD组的糖尿病知识水平也有显著提高（均P < 0.05）。在这些指标上，PD和PD-TE之间未检测到统计学显著差异（分别为P = 0.54和0.86）。在其他临床和自我报告指标上观察到几个组内改善，但各组之间没有显著差异。结论：项目杜尔塞有和没有无线技术大大提高血糖控制和糖尿病知识的高风险患者2型糖尿病在墨西哥家庭医疗单位，这表明，整合同伴为主导的教育，护士协调，3G无线技术是一种有效的方法，以改善糖尿病的结果在高风险人群。
Background: The global epidemic of diabetes calls for innovative interventions. This study evaluated the effectiveness of the Project Dulce model, with and without wireless technology, on glycemic control and other clinical and self-reported outcomes in patients with poorly controlled type 2 diabetes in Mexico. Subjects and Methods: Adults with type 2 diabetes and a glycated hemoglobin A1c (HbA1c) level of ≥8% were recruited from Family Medical Unit #27 of the Instituto Mexicano del Seguro Social (IMSS) in Tijuana, México, and randomly assigned to one of three groups: Project Dulce–only (PD); Project Dulce technology-enhanced with mobile tools (PD-TE); or IMSS standard of care/control group (CG). Clinical and self-reported outcomes were assessed at baseline, Month 4, and Month 10. Time-by-group interactions and within-group changes were analyzed. Results: HbA1c reductions from baseline to Month 10 were significantly greater in PD-TE (−3.0% [−33 mmol/mol]) and PD (−2.6% [−28.7 mmol/mol]) compared with CG (−1.3% [−14.2 mmol/mol]) (P = 0.009 and 0.001, respectively). PD-TE and PD also exhibited significant improvement in diabetes knowledge when compared with CG (P < 0.05 for both). No statistically significant differences were detected between PD and PD-TE on these indicators (P = 0.54 and 0.86, respectively). Several within-group improvements were observed on other clinical and self-report indicators but did not vary significantly across groups. Conclusions: Project Dulce with and without wireless technology substantially improved glycemic control and diabetes knowledge in high-risk patients with type 2 diabetes in a Mexican family medical unit, suggesting that integrating peer-led education, nurse coordination, and 3G wireless technology is an effective approach for improving diabetes outcomes in high-risk populations.