Effectiveness of DialBetesPlus, a self-management support system for diabetic kidney disease: Randomized controlled trial.
Journal
NPJ digital medicine
ISSN: 2398-6352
Titre abrégé: NPJ Digit Med
Pays: England
ID NLM: 101731738
Informations de publication
Date de publication:
27 Apr 2024
27 Apr 2024
Historique:
received:
23
07
2023
accepted:
15
04
2024
medline:
28
4
2024
pubmed:
28
4
2024
entrez:
27
4
2024
Statut:
epublish
Résumé
We evaluated the effectiveness of a mobile health (mHealth) intervention for diabetic kidney disease patients by conducting a 12-month randomized controlled trial among 126 type 2 diabetes mellitus patients with moderately increased albuminuria (urinary albumin-to-creatinine ratio (UACR): 30-299 mg/g creatinine) recruited from eight clinical sites in Japan. Using a Theory of Planned Behavior (TPB) behavior change theory framework, the intervention provides patients detailed information in order to improve patient control over exercise and dietary behaviors. In addition to standard care, the intervention group received DialBetesPlus, a self-management support system allowing patients to monitor exercise, blood glucose, diet, blood pressure, and body weight via a smartphone application. The primary outcome, change in UACR after 12 months (used as a surrogate measure of renal function), was 28.8% better than the control group's change (P = 0.029). Secondary outcomes also improved in the intervention group, including a 0.32-point better change in HbA1c percentage (P = 0.041). These improvements persisted when models were adjusted to account for the impacts of coadministration of drugs targeting albuminuria (GLP-1 receptor agonists, SGLT-2 inhibitors, ACE inhibitors, and ARBs) (UACR: -32.3% [95% CI: -49.2%, -9.8%] between-group difference in change, P = 0.008). Exploratory multivariate regression analysis suggests that the improvements were primarily due to levels of exercise. This is the first trial to show that a lifestyle intervention via mHealth achieved a clinically-significant improvement in moderately increased albuminuria.
Identifiants
pubmed: 38678094
doi: 10.1038/s41746-024-01114-8
pii: 10.1038/s41746-024-01114-8
doi:
Types de publication
Journal Article
Langues
eng
Pagination
104Subventions
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Organisme : Japan Agency for Medical Research and Development (AMED)
ID : JP19ek0210095
Informations de copyright
© 2024. The Author(s).
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