糖尿病病的自我管理支持系统DialBetesPlus的有效性:随机对照试验
Kayo Waki1,2,3, Mitsuhiko Nara4,5, Syunpei Enomoto6
1Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. kwaki-tky@m.u-tokyo.ac.jp.
NPJ digital medicine
|April 27, 2024
概括
移动健康 (mHealth) 干预改善了糖尿病病患者的功能. 这种使用智能手机技术的生活方式干预导致白蛋白尿显著减少,并改善了血糖控制.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 数字健康数字健康
背景情况:
- 糖尿病病 (DKD) 是2型糖尿病 (T2DM) 的一个主要并发症.
- 适度增加的白蛋白尿症表明早期的DKD和进展的风险.
- 改变生活方式对于管理DKD至关重要,但坚持可能是具有挑战性的.
研究的目的:
- 为了评估移动健康 (mHealth) 干预对T2DM患者中适度增加的白色素尿的功能的有效性.
- 评估干预对血糖控制和其他次要结果的影响.
- 确定导致观察到的改善的因素.
主要方法:
- 一个为期12个月的随机对照试验,涉及126名T2DM患者,UACR为30-299 mg/g.
- 干预组接受了标准护理以及DialBetesPlus mHealth系统进行自我监测 (运动,葡萄糖,饮食,血压,体重).
- 对照组接受了标准的护理. 主要结局:尿动白蛋白与肌素比率 (UACR) 的变化.
主要成果:
- 与对照组相比,mHealth干预组在UACR中表现出28.8%的更大改善 (P=0.029).
- 在HbA1c (0.32点更好的变化,P=0.041) 中也观察到显著改善.
- 在调整为针对白尿的药物后,结果仍然显著,在UACR变化中,组间差异为-32.3% (P=0.008).
结论:
- 基于计划行为的mHealth生活方式干预理论可以显著改善T2DM患者中适度增加的白蛋白尿症.
- 干预对功能和血糖控制的好处在临床上具有意义.
- 增加运动水平似乎是干预成功的主要驱动因素.
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