基于移动APP的互动式同伴支持对1型糖尿病血糖管理效果评价

The effect of mobile application based interactive peer support on glycemic control in patients with type 1 diabetes mellitus

目的评价基于移动APP互动式同伴支持对1型糖尿病(T1DM)血糖管理效果。方法以我国目前最大的T1DM患者网络社区移动APP平台“糖糖圈”作为目标APPo根据注册APP后1年的月互动指数(由点赞、评论、发帖和收藏4个指标构成)将使用APP满1年且资料完整的T1DM患者分为高互动组和低互动组。比较两组使用APP后1年的自我血糖监测(SMBG)频率、糖化血红蛋白(HbAlc)、高血糖发生率和低血糖发生率等糖尿病管理水平指标。结果238例T1DM患者中,77.3%为女性(184/238),年龄(27±8)岁。基线SMBG频率为(1.77±1.15)次/d,HbAlc为(6.74±1.01)%。APP使用1年后,高互动组SMBG频率增加显著高于低互动组[SMBC变化(ΔSMBG)(0.59+2.06)次/d比(0.08+1.69)次/d,4=4.280,P=0.04],且其HbA1c改善更明显[HbAlc变化(ΔHbAlc)(-0.40±1.10)%比(-0.06+1.13)%,P=0.018],高血糖发生率明显低于低互动组[13.19(6.22,23.19)%比17.69(10.56,30.49)%,Z=2.850,P=0.005],两组间的低血糖发生率差异无统计学意义[(4.62(2.14,8.03)%比4.83(2.06,8.87)%,Z=1.276,P=0.204]。相关性分析显示,互动指数与HbAlc和高血糖发生率改善的相关性均有统计学意义。结论T1DM患者通过移动APP参与互动式同伴教育或有助于血糖管理。

Objective To evaluate the effect of mobile application(APP)based interactive peer support on glycemic control in patients with type 1 diabetes mellitus(T1DM).Methods The data of the present study were from the largest mobile APP platform for patients with T1DM in China,Tangtangquan.Patients with T1DM who has registered in the APP for at least 1 year and had completed data entiy were recruited.According to the monthly interaction index during the first year of APP registration(including four indicators:praise,comment,posting and collection),the eligible patients were divided into the high-interaction group and the low-interaction group.The changes from baseline of self-blood glucose monitoring frequency(SMBG),glycosylated hemoglobin(HbAlc),incidence of hyperglycemia and incidence of hypoglycemia were compared between the two groups after one year of using the APP.Results A total of 238 patients with T1DM with an age of(27±8)years were included.Among them,77.3%(184/238)were female.The baseline SMBG[the low-interaction group(1.71±1.14)times/day vs.the high-interaction group(1.82±1.15)times/day]and HbAlc[the low-interaction group(6.72±0.99)%vs.the high-interaction group(6.76±1.04)%]were comparable between the two groups.After one year use of the APP,the frequency of SMBG in the high-interaction group was significantly higher than that in the low-interaction group[ΔSMBG(0.59+2.06)times/d vs.(0.08+1.69)times/d,Z=4.280,P=0.04),and the reduction of HbAlc was more obvious in the high-interaction group[ΔHbAlc(-0.40+1.10)%vs.(—0.06+1.13)%,t=5.651,P=0.018]than in the lower-interaction group.The incidence of hyperglycemia in the high-interaction group was significantly lower than that in the low-interaction group[13.19(6.22,23.19)%vs.17.69(10.56,30.49)%,Z=2.850,P=0.005].There was no significant difference in the incidence of hypoglycemia between the two groups[4.62(2.14,8.03)%vs.4.83(2.06,8.87)%,Z=1.276,P=0.204].The correlation analysis showed that interaction index was significantly associated with the reduction of HbAlc and incidence of hyperglycemia.Conclusion Participation in interactive peer education via mobile APP may be beneficent for glycemic control in patients with T1DM.