Web-Based TangPlan and WeChat Combination to Support Self-management for Patients With Type 2 Diabetes: Randomized Controlled Trial

Abstract

Background China has the largest number of patients with type 2 diabetes mellitus (T2DM) in the world. However, owing to insufficient knowledge of self-management in patients with diabetes, blood glucose (BG) control is poor. Most diabetes-related self-management applications fail to bring significant benefits to patients with T2DM because of the low use rate and difficult operation. Objective This study aims to examine the effectiveness of the combination of the self-designed web-based T2DM management software TangPlan and WeChat on fasting BG (FBG), glycated hemoglobin (HbA1c), body weight, blood pressure (BP), and lipid profiles in patients with T2DM over a 6-month period. Methods Participants were recruited and randomized into the TangPlan and WeChat or control groups. Participants in the control group received usual care, whereas the TangPlan and WeChat participants received self-management guidance with the help of TangPlan and WeChat from health care professionals, including BG self-monitoring; healthy eating; active physical exercise; increasing medication compliance; and health education during follow-ups, lectures, or web-based communication. They were also asked to record and send self-management data to the health care professionals via WeChat to obtain timely and effective guidance on diabetes self-management. Results In this study, 76.9% (120/156) of participants completed the 6-month follow-up visit. After the intervention, FBG (mean 6.51, SD 1.66 mmol/L; P=.048), HbA1c (mean 6.87%, SD 1.11%; P<.001), body weight (mean 66.50, SD 9.51 kg; P=.006), systolic BP (mean 127.03, SD 8.00 mm Hg; P=.005), diastolic BP (mean 75.25, SD 5.88 mm Hg; P=.03), serum low-density lipoprotein cholesterol (mean 2.50, SD 0.61 mmol/L; P=.006), and total cholesterol (mean 4.01, SD 0.83 mmol/L; P=.02) in the TangPlan and WeChat group were all significantly lower, whereas serum high-density lipoprotein cholesterol (mean 1.20, SD 0.25 mmol/L; P=.01) was remarkably higher than in those in the control group. Compared with the baseline data, significance was found in the mean change in FBG (95% CI −0.83 to −0.20; P=.002), HbA1c (95% CI −1.92 to −1.28; P<.001), body weight (95% CI −3.13 to −1.68; P<.001), BMI (95% CI −1.10 to −0.60; P<.001), systolic BP (95% CI −7.37 to −3.94; P<.001), diastolic BP (95% CI −4.52 to −2.33; P<.001), triglycerides (95% CI −0.16 to −0.03; P=.004), serum low-density lipoprotein cholesterol (95% CI −0.54 to −0.30; P<.001), and total cholesterol (95% CI −0.60 to −0.34; P<.001) in the TangPlan and WeChat group but not in the control group (P=.08-.88). Conclusions Compared with usual care for patients with T2DM, the combination of TangPlan and WeChat was effective in improving glycemic control (decrease in HbA1c and BG levels) and serum lipid profiles as well as reducing body weight in patients with T2DM after 6 months. Trial Registration Chinese Clinical Trial Registry ChiCTR2000028843; https://tinyurl.com/559kuve6

Analyzing the Effectiveness of mHealth to Manage Diabetes Mellitus Among Adults Over 50: A Systematic Literature Review

“…This theme appeared in 15/107 (14%) of the occurrences. 29 , 32 , 37–39 , 41 , 43 , 45 , 47 , 48 , 50 , 51 , 54 , 56 , 58 The theme “improved exercise” appeared in 10/107 (9%) of the occurrences. The themes “improved diet” 36–39 , 47 , 48 and “improved weight loss” 34 , 39 , 41 , 42 , 58 each appeared in 6/107 (6%) of the occurrences.…”

“… 29 , 32 , 37–39 , 41 , 43 , 45 , 47 , 48 , 50 , 51 , 54 , 56 , 58 The theme “improved exercise” appeared in 10/107 (9%) of the occurrences. The themes “improved diet” 36–39 , 47 , 48 and “improved weight loss” 34 , 39 , 41 , 42 , 58 each appeared in 6/107 (6%) of the occurrences. The theme “increased disease awareness” appeared in 4/107 (4%) of the occurrences.…”

“…Improved BMI appeared in 3/107 (3%) occurrences. The themes “increased communication”, 43 , 45 “improved blood pressure”, 56 , 58 “improved cholesterol”, 56 , 58 “improved treatment adherence”, 36 , 39 and “app identified patients at risk”, 31 , 44 each occurred in 2/107 (2%) occurrences. The following observations could not be categorized into themes: “increased access to support”, “improved cardiopulmonary endurance”, and “improved foot care.” 33 , 48 , 53 …”

“… 29 , 32–35 , 39 , 42 , 43 , 45 , 47 , 49 , 51 , 54 , 55 , 57 The theme “improved blood glucose/HbA1C” appeared 15/100 (15%) of the occurrences. 29 , 32 , 37–39 , 41 , 43 , 45 , 47 , 48 , 50 , 51 , 54 , 56 , 58 The theme “improved physical functioning” occurred 9/100 (9%) occurrences. 32 , 36–39 , 42 , 47 , 48 , 50 Improved diet 36–39 , 47 , 48 and increased disease awareness 31 , 32 , 36 , 42 , 46 , 47 each appeared 6/100 (9%) occurrences.…”

Effectiveness of smart health-based rehabilitation on patients with poststroke dysphagia: A brief research report

“…To date, WeChat-based rehabilitation programs have been widely used in several chronic diseases, including for diabetes patients ( 25 ), postoperative women with breast cancer ( 26 ), and patients with chronic obstructive pulmonary disease ( 27 ). However, very few WeChat-based rehabilitation programs have been developed to support PSD patients.…”