Factorial Design Study Of Type 2 Diabetes Patients Using Diabetes APP For Self-Management

Research purpose:1.To explore the influence of diabetes APP on metabolic indexes of patients with type 2 diabetes.2.To explore the influence of diabetes APP on diabetes knowledge,health belief and self-management behavior of type 2 diabetes patients.3.To compare the effects of diabetes APP and telephone follow-up on the compliance rate of self-glucose monitoring in patients with type 2 diabetes.4.To understand the satisfaction of type 2 diabetes patients with diabetes APP.Materials and Methods:The factorial design method was used to study patients treated in endocrinology department of two tertiary grade A hospitals in Chengdu with diabetes APP.A total of273 patients were randomly divided into 4 groups:G1 received routine care,G2received weekly telephone follow-up,G3 received diabetes management by diabetes APP,and G4 received weekly telephone follow-up on the basis of diabetes APP.After 6months of follow-up,Hb A_1c,height,weight,blood pressure and frequency of self-glucose monitoring were collected,and the general data questionnaire,the Diabetes Knowledge Scale（DKN）,the Health Belief Scale（HBS）,the Type 2 Diabetes Self-care Scale（2-DSCS）and the diabetes APP satisfaction questionnaire were used to evaluate the intervention effect.Result:1.273 patients with type 2 diabetes were included in the study,and there was no significant difference in baseline data among the four groups（P>0.05）.226（82.8%）were followed up at 3 months and 220（80.6%）at 6 months.2.After intervention,Hb A_1creached the standard increased in the four groups（P<0.05）.The Hb A_1creached the standard in groups G3 and G4（44.0%,45.5%）was higher than that in groups G1 and G2（34.7%,33.3%）,but there was no difference between groups（P>0.05）.Systolic blood pressure in the four groups decreased significantly from baseline,and there were differences among the groups at 3 months after intervention（P<0.05）.The systolic blood pressure in groups G3 and G4（123.62±14.75,124.78±18.71）was lower than that in group G1（131.94±18.84）,and that in group G3 was lower than that in group G2（130.61±14.58）.Factorial analysis showed no interaction between phone follow-up and APP,and diabetes APP reduced systolic blood pressure（P<0.05）,while diastolic blood pressure was not different among the four groups（P>0.05）.There was no difference in BMI among the four groups after intervention（P>0.05）.3.After intervention,the knowledge score of G3 and G4 groups（52.86±20.71,51.60±19.83）were higher than those of G1 group（38.95±22.96）,and the knowledge score of G3 group was higher than that of G2 group（40.69±23.43）.The results of factorial analysis showed no interaction between phone follow-up and APP.Diabetes APP increased knowledge score（P<0.05）.The health belief scores of G3 and G4（82.92±8.55,85.73±7.88）were higher than those of G1（78.82±6.24）,and the health belief scores of G4 were higher than those of G2（80.72±8.15）.The results of factorial analysis showed no interaction between phone follow-up and APP.Diabetes APP increased the health belief level（P<0.05）.Diabetes self-management behavior score and good rate were improved in all four groups compared with baseline,with no difference between groups（P>0.05）.4.The proportion of patients in G2 and G4 groups（77.2%and 72.7%）who reached the standard of self-glucose monitoring was higher than that in G1 and G3groups（69.4%and 58.0%）,but there was no statistical difference in the rate of self-glucose monitoring reaching the standard among the four groups（P>0.05）.5.In the satisfaction evaluation of diabetes APP,the score of each item is above4.50 points.Conclusion:1.Diabetes APP has a tendency to improve the Hb A_1cstandard rate of patients with type 2 diabetes.Diabetes APP can help reduce the blood pressure of patients with type 2diabetes.2.Diabetes APP can improve diabetes knowledge and health belief of patients with type 2 diabetes.3.There was no difference in the compliance rate of self-glucose monitoring in type 2 diabetes patients between diabetes APP and telephone follow-up.4.Patients with type diabetes have a high degree of satisfaction with diabetes APP.