Backgroud: By reviewing the previous research of telemedicine, we have found out that old diabetic patients have difficulties in using computers, so it is unrealistic for medical teams to communicate with old diabetes patients anytime and anywhere. However, the popularity of smartphones and chatting applications has enabled old people of China to develop skills of chatting on smartphones and become familiar with smartphone operations. Therefore, we have designed an Mobile Health (m-Health) system for diabetics based on smartphones, which greatly streamlined operation interface and functions for maximum automation.In addition, the smartphone-based telemedicine of diabetes has been designed for old people.Objective: To investigate smartphone-based telemedicine applications in the management of older Chinese patients with type 2 diabetes mellitus (T2DM).Variables of interest included efficacy and safety.Methods: A total of 91 older (age>65) patients with T2DM, who presented to our department, were included and randomly assigned to one of two groups.Patients in the intervention group (n=44) were given glucometers capable of data transmission, and received advice pertaining to medications, diet, and exercise via a m-Health telemedicine system. Patients assigned to the control group (n=47) presented to traditional outpatient clinics for their medical care and received no other interventions. We followed up patients in both groups at regular 3-month intervals.Results: After 3 months, patients in the intervention group had significant (P<0.05) improvements in postprandial plasma glucose levels. After 6 months, patients in the intervention group exhibited decreasing trends in postprandial plasma glucose and glycosylated hemoglobin (HbA1C) levels compared with the baseline and those in the control group (P<0.05).
Conclusions:Smartphone-based telemedicine applications are effective for controlling blood glucose and lowering HbA1C in older Chinese patients with T2DM.