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- Title
Improving HbA<sub>1c</sub> with Glucose Self-Monitoring in Diabetic Patients with EpxDiabetes, a Phone Call and Text Message-Based Telemedicine Platform: A Randomized Controlled Trial.
- Authors
Xu, Ran; Xing, Maggie; Javaherian, Kavon; Peters, Robert; Ross, Will; Bernal-Mizrachi, Carlos
- Abstract
Background:We conducted a randomized controlled trial of EpxDiabetes, a novel digital health intervention as an adjunct therapy to reduce HbA1c and fasting blood glucose (FBG) among patients with type 2 diabetes mellitus (T2DM). In addition, we examined the effect of social determinants of health on our system. Methods:Sixty-five (n = 65) patients were randomized at a primary care clinic. Self-reported FBG data were collected by EpxDiabetes automated phone calls or text messages. Only intervention group responses were shared with providers, facilitating follow-up and bidirectional communication. ΔHbA1c and ΔFBG were analyzed after 6 months. Results:There was an absolute HbA1c reduction of 0.69% in the intervention group (95% confidence interval [CI], −1.41 to 0.02) and an absolute reduction of 0.03% in the control group (95% CI, −0.88 to 0.82). For those with baseline HbA1c >8%, HbA1c decreased significantly by 1.17% in the intervention group (95% CI, −1.90 to −0.44), and decreased by 0.02% in the control group (95% CI, −0.99 to 0.94). FBG decreased in the intervention group by 21.6 mg/dL (95% CI, −37.56 to −5.639), and increased 13.0 mg/dL in the control group (95% CI, −47.67 to 73.69). Engagement (proportion responding to ≥25% of texts or calls over 4 weeks) was 58% for the intervention group (95% CI, 0.373–0.627) and 48% for the control group (95% CI, 0.296–0.621). Smoking, number of comorbidities, and response rate were significant predictors of ΔHbA1c. Conclusions:EpxDiabetes helps to reduce HbA1c in patients with uncontrolled T2DM and fosters patient–provider communication; it has definite merit as an adjunct therapy in diabetes management. Future work will focus on improving the acceptability of the system and implementation on a larger scale trial.
- Subjects
GLYCOSYLATED hemoglobin; BLOOD sugar monitors; PEOPLE with diabetes; PATIENT self-monitoring; RANDOMIZED controlled trials; TELEPHONE calls; TYPE 2 diabetes
- Publication
Telemedicine & e-Health, 2020, Vol 26, Issue 6, p784
- ISSN
1530-5627
- Publication type
Article
- DOI
10.1089/tmj.2019.0035