Philippe Klee1,2, Catherine Bussien3, Montserrat Castellsague4, Christophe Combescure5, Mirjam Dirlewanger1,2, Celine Girardin1,2, Jean-Luc Mando6, Luz Perrenoud4, Carole Salomon7, Franck Schneider8, Valerie M Schwitzgebel1,2. 1. 1 Pediatric Endocrine and Diabetes Unit, Department of Pediatrics, University Hospitals of Geneva , Geneva, Switzerland . 2. 2 Diabetes Center of the Faculty of Medicine, University of Geneva , Geneva, Switzerland . 3. 3 Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva , Geneva, Switzerland . 4. 4 Care Directorate, University Hospitals of Geneva , Geneva, Switzerland . 5. 5 Division of Clinical Epidemiology, Department of Health and Community Medicine, University Hospitals of Geneva , Geneva, Switzerland . 6. 6 KM Koncept, Veyrier, Switzerland . 7. 7 Pediatric Research Platform, Department of Pediatrics, University Hospitals of Geneva , Geneva, Switzerland . 8. 8 Division of Digital Communication, University Hospitals of Geneva , Geneva, Switzerland .
Abstract
BACKGROUND: Prevention of type 1 diabetes mellitus (T1DM)-related complications is dependent on metabolic control. The recommended glycated hemoglobin (HbA1c) values <7.5% (58.5 mmol/mol) are met only by a minority of diabetic children and especially adolescents. The aim of this study was to evaluate the impact of an intervention comprising the use of Webdia, a patient-designed app for smartphones, on metabolic control of T1DM in children. METHODS:Fifty-five patients with T1DM, 10-18 years of age, were included in this single-center, randomized double-crossover study. We tested an intervention consisting of using Webdia for 3 months with monthly feedback and adaptation of the treatment. Main outcome was modification of HbA1c. Secondary outcomes were the prevalence of hypoglycemia and quality of life (QoL). RESULTS:Of the 55 included patients, 33 completed the study, 9 dropped out, and 13 were excluded due to insufficient use of the app. The app was well accepted by the users who completed the study (46.4% rated the program as good and 39.3% as excellent). The intervention led to a reduction of HbA1c by 0.33%, compared to the control group in which HbA1c rose by 0.21% (P = 0.048) in patients with HbA1c values >8.0% (63.9 mmol/mol) at inclusion, without increasing the prevalence of hypoglycemia (8.52 ± 9.45 hypoglycemic events during last 2 weeks of intervention vs. 7.62 ± 6.37 observation, P = 0.680). QoL scores were not modified. CONCLUSIONS: The intervention resulted in a significant decrease in HbA1c, without increasing the prevalence of hypoglycemia in patients with initial HbA1c >8.0% (63.9 mmol/mol).
RCT Entities:
BACKGROUND: Prevention of type 1 diabetes mellitus (T1DM)-related complications is dependent on metabolic control. The recommended glycated hemoglobin (HbA1c) values <7.5% (58.5 mmol/mol) are met only by a minority of diabeticchildren and especially adolescents. The aim of this study was to evaluate the impact of an intervention comprising the use of Webdia, a patient-designed app for smartphones, on metabolic control of T1DM in children. METHODS: Fifty-five patients with T1DM, 10-18 years of age, were included in this single-center, randomized double-crossover study. We tested an intervention consisting of using Webdia for 3 months with monthly feedback and adaptation of the treatment. Main outcome was modification of HbA1c. Secondary outcomes were the prevalence of hypoglycemia and quality of life (QoL). RESULTS: Of the 55 included patients, 33 completed the study, 9 dropped out, and 13 were excluded due to insufficient use of the app. The app was well accepted by the users who completed the study (46.4% rated the program as good and 39.3% as excellent). The intervention led to a reduction of HbA1c by 0.33%, compared to the control group in which HbA1c rose by 0.21% (P = 0.048) in patients with HbA1c values >8.0% (63.9 mmol/mol) at inclusion, without increasing the prevalence of hypoglycemia (8.52 ± 9.45 hypoglycemic events during last 2 weeks of intervention vs. 7.62 ± 6.37 observation, P = 0.680). QoL scores were not modified. CONCLUSIONS: The intervention resulted in a significant decrease in HbA1c, without increasing the prevalence of hypoglycemia in patients with initial HbA1c >8.0% (63.9 mmol/mol).
Authors: Maria Reinius; Pamela Mazzocato; Sara Riggare; Ami Bylund; Hanna Jansson; John Øvretveit; Carl Savage; Carolina Wannheden; Henna Hasson Journal: BMJ Open Date: 2022-01-24 Impact factor: 2.692
Authors: Amanda S Newton; Sonja March; Nicole D Gehring; Arlen K Rowe; Ashley D Radomski Journal: J Med Internet Res Date: 2021-12-02 Impact factor: 5.428
Authors: María Begoña Martos-Cabrera; Almudena Velando-Soriano; Laura Pradas-Hernández; Nora Suleiman-Martos; Guillermo A Cañadas-De la Fuente; Luis Albendín-García; José L Gómez-Urquiza Journal: J Clin Med Date: 2020-03-04 Impact factor: 4.241