Lim, Soo; Kang, Seon Mee; Kim, Kyoung Min; Moon, Jae Hoon; Choi, Sung Hee; Hwang, Hee; Jung, Hye Seung; Park, Kyong Soo; Ryu, Jun Oh; Jang, Hak Chul
Acta diabetologica
2016Apr ; 53 ( 2 ) :189-98.
PMID : 25936739
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Lim, Soo -
Kang, Seon Mee -
Kim, Kyoung Min -
Moon, Jae Hoon -
Choi, Sung Hee -
Hwang, Hee -
Jung, Hye Seung -
Park, Kyong Soo -
Ryu, Jun Oh -
Jang, Hak Chul -
ABSTRACT
AIMS: In 2011, we demonstrated that an individualized health management system employing advanced medical information technology, designated ubiquitous (u)-healthcare, was helpful in achieving glycemic control without hypoglycemia in patients with diabetes. Following this, we generated a new multidisciplinary u-healthcare system by upgrading our clinical decision support system (CDSS) rule engine and integrating a physical activity-monitoring device and dietary feedback into a comprehensive package.
METHODS: In a randomized, controlled clinical trial, patients with type 2 diabetes aged over 60?years were assigned randomly to a self-monitored blood glucose (SMBG) group (N?=?50) or u-healthcare group (N?=?50) for 6?months. The primary endpoint was the proportion of patients achieving glycated hemoglobin (HbA1c) <7?% without hypoglycemia. Changes in body composition and lipid profiles were also investigated. The u-healthcare group was educated to use a specially designed glucometer and an activity monitor that automatically transferred test results to a hospital-based server. An automated CDSS rule engine generated and sent patient-specific messages about glucose, diet, and physical activity to their mobile phones and a Web site.
RESULTS: After 6?months of follow-up, the HbA1c level was significantly decreased in the u-healthcare group [8.0?±?0.7?% (64.2?±?8.8?mmol/mol) to 7.3?±?0.9?% (56.7?±?9.9?mmol/mol)] compared with the SMBG group [8.1?±?0.8?% (64.9?±?9.1?mmol/mol) to 7.9?±?1.2?% (63.2?±?12.3?mmol/mol)] (P?
keyword
Clinical decision support system; Telemedicine; Ubiquitous healthcare
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