Insulin Dose Titration System Using a Short Messaging Service (SMS) Automatically Produced by a Knowledge Matrix
Condition: Diabetes Mellitus, Type 2
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2
Study type: Interventional

Summary: 
      The investigators designed the system in type 2 diabetic patients treated with long acting
      insulin to produce an automatic adjustment of insulin dose based on real time glucose level
      data and to provide to the patients the needed insulin dose by using a short message service
      (SMS) and apply to the clinical practice.
    

Detailed description: 
      Most patients with type 2 diabetes will, in time, need insulin therapy. Starting insulin
      poses considerable challenges. Also, improving glycemic control with insulin therapy often
      requires periodic dose adjustments based on glycemic response. Therefore, how to adjust their
      insulin doses are very important for improvement of glycemic control. Long acting insulin
      offers the benefit of a more consistent pharmacological dynamic with less hypoglycemia.
      Therefore, long acting insulin dose adjustments are widely used by patients based on
      simplified insulin dosing algorithms.

      In the management of diabetes, it is important to maintain an intimate and continuous
      doctor-patient relationship. To achieve an optimal glucose level and to prevent diabetic
      complications, frequent contact with a medical doctor is recommended, but this causes an
      increased amount of medical expense. In recent years, web and phone delivery of
      self-management programs have emerged as popular approaches to the management of diabetes.
      The major focus of the system was support for blood glucose monitoring with substantive
      feedback from expert to help interpret results of glucose-level values. Moreover, with this
      system the patients could be advised to determine the amount of insulin required. However,
      despite of using these programs, it can take a significant amount of effort and time for
      physicians to look over each patient's data, formulate an appropriate message, and send it to
      the patients. Accordingly, computerized, knowledge-based medical treatment advice systems
      will provide more abundant medical advices, also can be more economic than the previous
      systems, in which medical personnel were required for the same process.

      Recently we designed an Internet-based diabetic patient management using short message
      service (SMS) that was automatically produced by a knowledge matrix. Moreover, we reported
      this unique system has shown the great efficacy in glucose control. In this study, we
      designed the system in patients treated with long acting insulin to produce an automatic
      adjustment of insulin dose based on real time glucose level data and to provide to the
      patients the needed insulin dose by using a SMS and apply to the clinical practice with
      diabetic patients.
    

Intervention name(s): Insulin dose titration system using a SMS
Intervention type(s): Other
Intervention description(s): We applied 'Insulin dose titration system in diabetic patients using a short messaging service automatically produced by a knowledge matrix' for 12 weeks in the intervention group. In the control group, a conventional insulin titration schedule was used. The insulin used in this study was Lantus (insulin glargine).
Other intervention name(s): insulin used in this study = Lantus (insulin glargine)
Intervention MeSH terms: Insulin; Insulin, Globin Zinc; Insulin Glargine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Diabetes Mellitus, Type 2; Insulin dose titration system