Ongoing research has established that mobile health applications (apps) are feasible tools for improving self-management of diabetes and to maintain glycemic control. This single-arm, multi-center, observational study evaluated the effectiveness of an app-based diabetes education program in improving HbA1c among patients with type 2 diabetes mellitus (T2DM) treated with premixed insulin for 12 weeks. A total of 9426 patients were included. Primary endpoint was the change in HbA1c from baseline to week 12. Secondary endpoints included the association of HbA1c reduction with number of diabetes education courses completed and learning mode, and the association of SMBG frequency with diabetes education courses. According to the number of diabetes education courses completed, the patients were divided into 3 groups: 0-4 courses, 5-29 courses, and ≥30 courses. After 12 weeks of engagement in app, there was a decrease in HbA1c levels (9.84 ± 1.47 % vs. 7.36 ± 1.15 %) with 36% of patients achieving HbA1c target at week 12. The HbA1c control rate was the highest among patients completing ≥30 courses (49%; mean change: -2.9%) , followed by those who completed 5-29 courses (38%; -2.7%) and 0-4 courses (35%; -2.4%) (P<0.0001) . Besides, the frequency of SMBG testing increased with the ascending number of courses completed (≥30 courses: 7.4 times/week; 5-29 courses: 3.5 times/week; 0-4 courses: 1.2 times/week; P<0.0001) . HbA1c reduction (-2.7% vs. -2.4%; P<0.0001) and the proportion of patients with HbA1c <7% (42% vs. 35%; P<0.0001) were significantly lower in patients who preferred audio-visual learning over visual learning for diabetes course engagement. To summarize, participants who completed more diabetes education courses had better HbA1c reduction over 12 weeks and better self-management of blood glucose with the app.


C.Si: None. J.Lu: None. Y.Bao: None. J.Zhou: n/a. W.Jia: None.

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