T2D remains a global epidemic and has become a major public health concern in Brazil, with almost 17M people living with T2D. Poor glycemic control leads to severe loss in life expectancy, quality of life and increased healthcare expenses. The main challenges to support patients with T2D in developing countries are geographical dispersion and limited budgets.
The primary objective of this study is to determine whether the use of a low-cost, 100% virtual patient monitoring program, can improve disease control in patients with T2D in Brazil, using remote diabetes support through Appia’s digital platform connected to a smart BGM, coupled with remote coaches.
Methods: Thirty-one participants aged 36-69 years old previously diagnosed with T2D that measure their BG levels at least 2 times per week, were recruited online and enrolled in the program. Most of them were just receiving oral medication treatment. HbA1c was measured at the beginning and at the end of the program. During the 12-week lifestyle modification program, the patients were given an intelligent BGM connected to a mobile app that stores BG measurements in the cloud. Additionally, patients were given access to a remote diabetes coach for personalized content, weekly goals setting and support. Patients did not receive medical intervention outside of their PCP.
Results: The mean HbA1c was significantly reduced by 1.11% (95% CI: -1.5754 - -0.7446, p<0.0001) from a starting mean of 8.5% to 7.39% at the end of the program. Total average BG levels dropped from 169 mg/dL to 138 mg/dL with n=2439 readings. Also, the severe hyperglycemic events (>300 mg/dL) were reduced by 51.55%, without increasing level 2 (<54 mg/dL) and 3 hypoglycemic events. Finally, the total number of BG measurements during the program increased by 8.43% in 90 days (from 0.8/day to 0.9/day per patient).
Conclusion: The combination of remote diabetes coaching with a smart BGM connected to an app was effective for improving glycemic control in patients with T2D in Brazil.
M. Carrica: Stock/Shareholder; Self; Appia. F. Valente: Consultant; Spouse/Partner; Sanofi Genzyme. Speaker’s Bureau; Self; AstraZeneca, Novo Nordisk Inc. L. Migliano: Employee; Self; Appia. Y. Lorda Dumont: None. J.E. Salles: Board Member; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk Inc.