Globally, more than 400 million adults live with diabetes, affecting both diabetics and their relatives. This number is increasing and diabetes is an important public health problem estimated to cost the world more than US$ 827 billion annually (1). Diabetes is a chronic disease that requires a complex treatment regimen and self-management skills, to optimize glycemic control and health outcomes. Diabetes management tasks require the individual to make daily decisions about food, activity and medications to achieve their goals, which can be quite challenging. EHealth technologies have a demonstrated potential for assisting individuals with diabetes self-management behaviors (2, 3).
Hedia is a mobile diabetes assistant (application) developed for people with type 1 diabetes (T1D) and type 2 diabetes (T2D) and is thus targeting one of four priority noncommunicable diseases, contributing to reduce the impact of diabetes. Hedia is free for all to use and is improving management of diabetes by ensuring equitable access to essential technologies for management of diabetes and improving the lives of those living with the disease.
Hedia facilitates the dosing of insulin and makes is safer. Hedia gathers information about blood glucose, carbohydrate intake, level of activity and insulin intake. Hedia will offer a complete picture of the diabetic and use it in algorithms for further personalized recommendations. Hedia can contribute with significant ‘real time’ knowledge for the user and other interested parties.
Hedia is effective in improving glycemic control
We hypothesized that the adoption of a mobile diabetes application, like Hedia, could help people with diabetes achieve better glycemic control.
Using real-time data available from Hedia we had a total of 644 users. 42 of these individuals had more than 25 typing’s. We selected 4 individuals with up to 500 typing’s. These four individuals were chosen because they had been using Hedia for 14 weeks, which means that they had been using Hedia since the beginning.
It seems, that when using Hedia the amount of blood glucose typing’s are increasing with time. When using Hedia, these four individuals improved their frequency of blood glucose monitoring by 11 measurements over the time period of 14 weeks. The first week of using Hedia they used it 10.75 times in average, compared to week 14 where they used Hedia 21.75 times in average (p-value = 0.033, 95% CI).
Hedia has shown statistically significant positive effect on the blood glucose of a person with T1D. A linear regression analysis established that with every typing our users have registered in Hedia, they are improving their blood glucose by 0,0046 mmol/l compared to their target blood glucose (p-value 0,000).
This indicates, that by using Hedia people with diabetes are improving their frequency of blood glucose measurements and thus optimizing their glycemic control.
Mobile health care has been continuously developed in recent decades and has recently been applied to manage chronic diseases, such as diabetes (4). According to the first WHO diabetes report, new technologies such as mobile phone technologies, especially mobile applications, present a unique opportunity to help patients improve adherence to the complex self-management tasks. When properly designed, mobile diabetes support has generated a statistically significant improvement in areas such as patient glycemic control in the short-term and long-term, and medication adherence (1).
Several studies show strong evidence that mobile app-based interventions are associated with statistically significant improvements in glycemic control and self-management in diabetes care, especially for people with T2D. It is thus suggested that glycemic control of adult outpatients with diabetes can benefit from apps. It seems that the complexity of the management of T1D may explain why people with T1D experience less HbA1c reduction than people with T2D (5).
References
1. WHO. Global Report on Diabetes. France; 2016. Contract No.: 978924156525.
2. Hood M. WR, Corsica J., Bradley L., Chriniros D., Vivo A. What do we know about mobile applications for diabetes self-management? A review of reviews. . J Behav Med. 2016;39((6)):981-94.
3. Megan E Rollo AJE, Rebecca L Williams, Wynne Katie, Kriss Michelle, Callister Robin, Collins E Clare eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2016;9:381-90.
4. In-Young J, Seung-Hyon y., Da Young L., Cheol-Young P., Eun Mi K., . Diabetes Management via a Mobile Application: a Case Report. Case Report. Department of Dietitics, Kangbuk Samsung; 2017 21 january
5. Wu Y. YX, Vespasiani G., Nicolucci A., Dong Y., . Mobile App-based Interventions to support Diabetes Self-Management: A systematic Review of Randomized Control Trials to Identify Functions Associated with Glycemic Efficacy. JMIR Mhealth Uhealth. 2017;5(3):18.
