Advertisement

Welltang – A smart phone-based diabetes management application – Improves blood glucose control in Chinese people with diabetes

  • Weibin Zhou
    Affiliations
    Department of Endocrinology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79, Qingchun Road, Hangzhou, Zhejiang 310003, PR China
    Search for articles by this author
  • Min Chen
    Correspondence
    Corresponding author. Tel.: +86 571 87236866; fax: +86 571 87236874.
    Affiliations
    Department of Endocrinology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79, Qingchun Road, Hangzhou, Zhejiang 310003, PR China
    Search for articles by this author
  • Jingyun Yuan
    Affiliations
    Department of Endocrinology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79, Qingchun Road, Hangzhou, Zhejiang 310003, PR China
    Search for articles by this author
  • Yan Sun
    Affiliations
    Department of Endocrinology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79, Qingchun Road, Hangzhou, Zhejiang 310003, PR China
    Search for articles by this author

      Abstract

      Aims

      The primary objective was to evaluate the impact of the smart phone-based diabetes management application, Welltang, on glycated hemoglobin (HbA1c). The second objective was to measure whether Welltang improves blood glucose, low-density lipoprotein cholesterol, weight, blood pressure, hypoglycemic events, satisfaction of patients to use Welltang, diabetes knowledge of patients, and self-care behaviors.

      Methods

      One hundred evenly randomized subjects with diabetes, aged 18–74 years, were recruited from the outpatient Department of Endocrinology for a 3-month study. The Welltang intervention group received training for the use of Welltang, while the control group received their usual standard of care. HbA1c, blood glucose, low-density lipoprotein cholesterol, weight, blood pressure, hypoglycemic events, satisfaction of patients to use Welltang, diabetes knowledge of patients, and self-care behaviors were measured. Patient data were analyzed using independent t test and paired sample test using SPSS version 12.

      Results

      The average decrease in HbA1c was 1.95% (21 mmol/mol) in the intervention group and 0.79% (8 mmol/mol) in the control group (P < 0.001). Measures of self-monitored blood glucose, diabetes knowledge, and self-care behaviors improved in patients in the intervention group. Eighty four percent of patients in the intervention group were satisfied with the use of Welltang. Differences in hypoglycemic events, low-density lipoprotein cholesterol, weight, and blood pressure were not statistically significant.

      Conclusion

      Diabetes patients using the Welltang application achieved statistically significant improvements in HbA1c, blood glucose, satisfaction of patients to use of Welltang, diabetes knowledge, and self-care behaviors.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Diabetes Research and Clinical Practice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Xu Y.
        • Wang L.
        • He J.
        • et al.
        Prevalence and control of diabetes in Chinese adults.
        JAMA. 2013; 310: 948-958
        • American Diabetes Association
        American diabetes association position statement: standards of medical care in diabetes.
        Diabetes Care. 2014; 37: S14-S80
        • Marrero D.G.
        • Ard J.
        • Delamater A.M.
        • et al.
        Twenty-first century behavioral medicine: a context for empowering clinicians and patients with diabetes.
        Diabetes Care. 2013; 36: 463-470
        • Haapala I.
        • Barengo N.C.
        • Biggs S.
        • et al.
        Weight loss by mobile phone: a 1-year effectiveness study.
        Public Health Nutr. 2009; 12: 2382-2391
        • Fjeldsoe B.S.
        • Miller Y.D.
        • Marshall A.L.
        MobileMums: a randomized controlled trial of an SMS-based physical activity intervention.
        Ann Behav Med. 2010; 39: 101-111
        • Quinn C.C.
        • Clough S.S.
        • Minor J.M.
        • et al.
        WellDoc mobile diabetes management randomized controlled trial: change in clinical and behavioral outcomes and patient and physician satisfaction.
        Diabetes Technol Ther. 2008; 10: 160-168
        • Rami B.
        • Popow C.
        • Horn W.
        • et al.
        Telemedical support to improve glycemic control in adolescents with type 1 diabetes mellitus.
        Eur J Pediatr. 2006; 165: 701-705
        • Turner J.
        • Larsen M.
        • Tarassenko L.
        • et al.
        Implementation of telehealth support for patients with type 2 diabetes using insulin treatment: an exploratory study.
        Inform Prim Care. 2009; 17: 47-53
        • Quinn C.C.
        • Shardell M.D.
        • Terrin M.L.
        • et al.
        Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control.
        Diabetes Care. 2011; 34: 1934-1942
        • Deborah J.S.E.
        • Russell E.
        The summary of diabetes self- care activities measure.
        Diabetes Care. 2000; 23: 943-950
        • Fitzgerald J.T.
        • Anderson R.M.
        • Funnell M.M.
        • et al.
        The reliability and validity of a brief diabetes knowledge test.
        Diabetes Care. 1998; 21: 706-710
        • Haas L.
        • Maryniuk M.
        • Beck J.
        • et al.
        2012 standards revision task force. National standards for diabetes self-management education and support.
        Diabetes Care. 2014; 37: s144-s153
        • Norris S.L.
        • Engelgau M.M.
        • Narayan K.M.
        Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials.
        Diabetes Care. 2001; 24: 561-587
        • McGowan P.
        • McGowan P.
        The challenge of integrating self-management support into clinical settings.
        Can J Diabetes. 2013; 37: 45-50
        • Brown J.B.
        • Nichols G.A.
        • Perru A.
        The burden of treatment failure in type 2 diabetes.
        Diabetes Care. 2004; 27: 1535-1540
        • Peyrot M.
        • Rubin R.R.
        • Lauritzen T.
        • et al.
        The international DAWN advisory panel: resistance to insulin therapy among patients and providers: results of the cross-national diabetes attitudes, wishes, and needs (DAWN) study.
        Diabetes Care. 2005; 28: 2673-2679
        • Saydah S.H.
        • Fadkin J.
        • Cowie C.C.
        Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes.
        JAMA. 2004; 291: 335-342
        • Bott D.M.
        • Kapp M.C.
        • Johnson L.B.
        • et al.
        Disease management for chronically ill beneficiaries in traditional medicare.
        Health Aff (Millwood). 2009; 28: 86-98
        • Eakin E.
        • Reeves M.
        • Lawler S.
        • et al.
        Telephone counseling for physical activity and diet in primary care patients.
        Am J Prev Med. 2009; 36: 142-149
        • Riley W.T.
        • Rivera D.E.
        • Atienza A.A.
        • et al.
        Health behavior models in the age of mobile interventions: are our theories up to the task?.
        Transl Behav Med. 2011; 1: 53-71
        • Tang T.S.
        • Gillard M.L.
        • Funnell M.M.
        • et al.
        Developing a new generation of ongoing diabetes self-management support interventions: a preliminary report.
        Diabetes Educ. 2005; 31: 91-97
        • Heisler M.
        • Vijan S.
        • Anderson R.M.
        • et al.
        When do patients and their physicians agree on diabetes treatment goals and strategies, and what difference does it make?.
        J Gen Intern Med. 2003; 18: 893-902
        • Zoffmann V.
        • Lauritzen T.
        Guided self determination improves life skills with type 1 diabetes and A1C in randomized controlled trial.
        Patient Educ Couns. 2006; 64: 78-86
        • Garg S.K.
        • Bookout T.R.
        • McFann K.K.
        • et al.
        Improved glycaemic control in intensively treated adult subjects with type 1 diabetes using insulin guidance software.
        Diabetes Technol Ther. 2008; 10: 369-375
        • Peeples M.M.
        • Iyer A.K.
        • Cohen J.L.
        Integration of a mobile-integrated therapy with electronic health records: lessons learned.
        J Diabetes Sci Technol. 2013; 7: 602-611