Intervention Study Of Wearable Monitoring Device Combined With Internet Management Platform On Type 2 Diabetes Patients

Objective:In recent years,web-based medicine has been widely used to prevent and manage chronic non-communicable diseases.However,the comprehensive effects of wearable monitoring devices on blood glucose,blood lipids and uric acid in patients with type 2 diabetes mellitus(T2DM)were seldom studied.The purpose of this study was to investigate the effect of wearable monitoring device combined with an Internet management platform on the comprehensive management of T2 DM patients.Methods:A total of 120 patients with T2 DM were enrolled from August 2021 to August2022 and divided into the control group and the intervention group according to the random allocation sequence.All participants were followed 6 months.In addition to routine diabetes care,participants in the intervention group were provided with a wearable monitoring device that could monitor blood glucose,total cholesterol,and serum uric acid.The wearable device could connect to the Internet management platform to upload self-monitoring data.The control group was only given routine diabetes care.The changes of Hb A1 c,FPG,2h PG,Tyg index,blood lipids,serum uric acid,serum creatinine,e GFR,UACR and patient satisfaction were compared after intervention.Results:1.Comparison of general information: a total of 120 participants were enrolled,including 61 in the intervention group and 59 in the control group.There were no significant differences in other baseline parameters between the two groups except for the high 2-hour postprandial C-peptide in the intervention group(P < 0.05).2.At 6 months,Hb A1 c,FPG and 2h PG of participants in the intervention group were slightly lower than those at 3 months,but the difference was not significant(P >0.05).By contrast,Hb A1 c,FPG and 2h PG in the intervention group decreased significantly(P < 0.05).After adjusting for confounding factors,the reduction of Hb A1 c,FPG and 2h PG in the intervention group was statistically significant,compared with the control group after 6 months.3.Compared with the baseline,Hb A1 c,FPG,2h PG,Tyg index in the intervention group decreased significantly after 3 months(P < 0.05).By comparison,Hb A1 c decreased by 0.30%(P = 0.036),FPG decreased by 0.56mmol/L(P = 0.002),2h PG decreased by 0.79mmol/L(P = 0.028),Tyg index decreased by 0.26(P < 0.001)in the intervention group.After adjusting for confounding factors,the results were consistent with those before.4.After 3 months,compared with baseline,TG,TC,and LDL-C in the intervention group decreased significantly(P < 0.05),while there was little change in control group.There were no significant differences in TC,LDL-C,HDL-C,serum uric acid,serum creatinine,e GFR and UACR between the two groups(P > 0.05).In contrast,the reduction in TG levels was significantly greater in the intervention group than in the control group.However,after adjusting for confounding factors,the change of TG was not significant.5.After 3 months,participants in both groups had improved DTSQ scores compared to baseline.However,the intervention group had a greater improvement in the DTSQ score(P < 0.05).EQ-5D and GSES scores were similar among the two groups,with little difference between groups(P > 0.05).6.After 6months,a subgroup analysis of changes in Hb A1 c was performed based on age,sex,education,BMI,diabetes duration,and baseline Hb A1 c level.T he improvement of Hb A1 c was more in women,participants younger than 60 years of age,and participants with baseline Hb A1 c levels of 8% or greater(P < 0.05).7.After 3 months,compared with the control group,Hb A1 c,FPG and 2h PG decreased in both the good adherence group and the poor adherence group,but only the good adherence group had a greater reduction(P < 0.05).Compared with the participants with poor compliance,the participants with good compliance had a significant reduction in Hb A1 c,FPG and 2h PG(P < 0.05).After 6 months,compared with 3 months,Hb A1 c,FPG and 2h PG decreased in each group,but there was no significant difference(P > 0.05).8.After 3 months,the compliance rate of blood glucose and comprehensive compliance rate in the intervention group was more ideal than that in the control group(P < 0.05),while the compliance rate of blood lipid and uric acid was not significantly different between the two groups.Conclusion:The intervention of wearable monitoring device combined with the Internet management platform significantly improve blood glucose control in T2 DM patients,as well as the overall standard attainment rate and patient satisfaction with treatment.Wearable monitoring devices are an effective tool for the comprehensive management of T2 DM patients,but further prospective studies with longer duration and larger scale are needed.