Self-Management of Type-2 Diabetes Using a Mobile Application
Condition: Diabetes Mellitus
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2
Study type: Interventional

Summary: 
      Diabetes Mellitus (DM) is a global health emergency, since its prevalence has become alarming
      in many countries in the previous years. Because of the increasing healthcare requirement, it
      has also progressively become an economic burden for every country. From the International
      Diabetes Federation (IDF) Atlas (International Diabetes Federation, 2015), 415 million people
      worldwide were estimated to have DM in 2015 and this figure is expected to rise to 642
      million in 2040. DM contributed to 5 million adult deaths globally in 2015. Mauritius has one
      of the highest DM prevalence in the world (24.3% prevalence for ages 20 - 79) for 2015
      (International Diabetes Federation, 2015). 2,932 adult died due to Diabetes, and the average
      cost of DM related problems amount to 2 billion rupees per year. The Mauritius Non
      Communicable Diseases Survey (Ministry of Health and Quality of Life, 2015) reports an
      estimated 257,442 people between the ages of 25 and 74 with Diabetes in Mauritius. A high
      prevalence of pre-diabetes is also noted, which may subsequently result in diabetes and heart
      disease, if not appropriately managed. The DM epidemic has a significant impact locally and
      globally, calling for urgent remedial strategies to curb the spread.

      Studies have shown that patient's self-care including monitoring of blood glucose improve
      glycemic control (Allemann et al, 2009; Skeie et al, 2009; Istepanian et al, 2009). Patients
      are currently empowered through face to face counselling, websites, social media and other
      state of the art technologies. The use of smart phones for self-monitoring of blood glucose
      has shown to have substantial beneficial effects (Liang et al, 2011; Pal et al 2014). This
      project aims at using mobile technologies to instil behavioural changes in people living with
      DM and pre-diabetes in an attempt to alleviate the long term problems associated with DM.
      More precisely, it will constitute the development of an autonomous system for
      self-management of type 2 diabetes mellitus (T2DM) patients in Mauritius. The prototype will
      be tested for feasibility among patients with T2DM and pre-diabetes. It is expected that the
      proposed system will help to reduce the financial burden on the healthcare system in
      Mauritius through patient empowerment and improved self-care in the long run.
    

Detailed description: 
      he global burden of diabetes mellitus is an issue of increasing concern globally. The social
      and economic burden is soaring, pushing scientist to discover alternative options to reduce
      the burden. It is estimated that the burden is worse in countries with limited resources such
      as Mauritius.

      Mauritius has one of the highest DM prevalence in the world (24.3% prevalence for ages 20 -
      79) for 2015 (International Diabetes Federation, 2015). 2,932 adult died due to diabetes, and
      the average cost of DM related problems amount to 2 billion rupees per year. The Mauritius
      Non Communicable Diseases Survey (Ministry of Health and Quality of Life, 2015) reports an
      estimated 257,442 people between the ages of 25 and 74 with Diabetes in Mauritius. A high
      prevalence of pre-diabetes is also noted, which may subsequently result in diabetes and heart
      disease, if not appropriately managed. The DM epidemic has a significant impact locally and
      globally, calling for urgent remedial strategies to curb the spread.

      Studies have shown that patient's self-care including monitoring of blood glucose improve
      glycemic control (Allemann et al, 2009; Skeie et al, 2009; Istepanian et al, 2009). Patients
      are currently empowered through face to face counselling, websites, social media and other
      state of the art technologies. The use of smart phones for self-monitoring of blood glucose
      has shown to have substantial beneficial effects (Liang et al, 2011; Pal et al 2014).

      Aims and objectives:

      The aim of the study is to evaluate the effect on glycaemic levels among patients living with
      type 2 diabetes who are using a newly designed mobile application.

      The objectives are to:

      Measure the change in HbA1c after 3 months of using the application Compare secondary
      outcomes such as weight and BMI following the use of the application Assess the perception of
      patients using the digital tool and relate behavioural changes with the use of the
      application

      Methodology:

      A single arm prospective non randomised study is proposed. Participants will be recruited
      using adverts in the local newspapers and social media. Interested participants will be
      screened for eligibility and given the mobile application to use. They will be advised to
      record their daily fasting and post-prandial blood glucose as well as their levels of
      physical activity.

      The following clinical and biomarkers will be checked before and after the use of the
      intervention: HbA1c, FBS, weight, BMI and blood pressure. The duration of follow up will be
      3-6 months. An investigator designed questionnaire will be used to evaluate the use of the
      mobile app.
    

Intervention name(s): DiaMon - Mobile Application for Type 2 Diabetes mellitus and pre-diabetes
Intervention type(s): Other
Intervention description(s): Each participant will be provided with a mobile application aimed at monitoring their clinical markers such as FBG and HbA1c. The mobile application consists of medical details and demographics as well as a section dedicated to daily glucose levels and record of physical activity.
Intervention model: Single Group Assignment
Intervention model description: Single group assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Type 2 Diabetes Mellitus, E health, glycaemic control, physical activity