Qatar Diabetes Mobile Application Trial

Hamad Medical Corporation180 enrolled

Overview

Diabetes mobile technology is an emerging and rapidly expanding field that seeks to combine cutting edge behavioral insights with best practice in diabetes self management education to improve patient empowerment and deliver better patient outcomes.The question that arises is whether or not, diabetes mobile applications are effective in improving glycemic control, clinical outcomes, quality of life and overall patient satisfaction, in diabetic patients in Qatar. To answer this, we plan to enroll 90 diabetic patients into a custom-made diabetes app for Qatar (Droobi) (as intervention group) in comparison with 90 diabetic patients followed in the current standard care, matched in characteristics (as control group). We have the hypothesis that with utilization of the mobile application, patients will have improved glycemic control, improved self management and patient empowerment; together with improved patient-educator/doctor interaction.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

180

Conditions

Type2 Diabetes Mellitus

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * • Adults with T2DM (more than 18 yrs of age and younger than 60) who are able to provide consent * Arabic speaking and non-arabic speaking T2DM patients, who can communicate in Arabic and or English language. * Uncontrolled diabetes with HbA1c more than or equal to 8.5% * T2DM on insulin with or without any other oral medication * Subject must have a smart phone (must be an iOS (Apple) phone user) and must be interested in using a smart phone app. * Subject must have no visual impairment. * Minimal level of literacy (able to read and write in english or arabic). * To be able to communicate via chat with the mobile app team through the app as evidenced by at least weekly use of any of the social media such as WhatsApp, Viber, Facebook Messenger etc * Subject must be willing to utilize a mobile application for diabetes control Exclusion Criteria: * • Recent history (3 months) of stroke or Myocardial infarction. * Patients with proliferating retinopathy * Patients with an acute illness during the past 2 weeks. * Patients who plan to be away for more than 3 months. * Patients with CKD requiring dialysis. * Hypoglycemia unawareness. * More than one episode of severe hypoglycemia in the previous 6 months. * Female patients who are planning for pregnancy in the coming 6 months.

Outcomes

Primary Outcomes

Difference in mean HbA1c

Difference in mean HbA1C between the intervention arm and the standard care

Time frame: 6 months

Difference in mean HbA1c

Difference in mean HbA1C between the intervention arm and the standard care

Time frame: 3 months

Secondary Outcomes

Subject perceptions of diabetes self management

Within subject changes in perceptions of diabetes self-management as assessed by diabetes self-management questionnaire (DSMQ) scores subsection glucose management and overall rating. DSM-Q is a 16 item questionnaire to assess self-care activities associated with glycemic control. Four subscales, 'Glucose Management' (GM), 'Dietary Control' (DC), 'Physical Activity' (PA), and 'Health-Care Use' (HU), as well as a 'Sum Scale' (SS) as a global measure of self-care. Scale scores are calculated as sums of item scores and then transformed to a scale ranging from 0 to 10 (raw score / theoretical maximum score \* 10. A transformed score of ten thus represents the highest self-rating of the assessed behavior

Time frame: 6 months

Change in subjects attitudes towards disease

Within subject changes in attitudes towards disease assessed the proportion of subjects with diabetes distress scales (DDS) scores consistent with moderate or high distress.The DDS yields a total distress score plus 4 subscale (emotional burden,physical distress, regimen distress and interpersonal distress) scores each addressing a different kind of distress. A mean item score 2.0-2.9 is considered moderate distress and a mean score of more than or equal to 3 is considered high stress.

Time frame: 6 months

Changes in insulin doses

Difference in number of recommended insulin dose adjustments per subject between intervention and usual care arm

Time frame: 6 months

Changes in reported hypoglycemia

Difference in the number of reported hypoglycemic events per subject between the intervention and usual care arm.

Time frame: 6 months

Time to achieve normoglycemia

Reduction in the time required to reach normoglycemia (in-range blood glucose readings) between the intervention and control groups.

Time frame: 6 months

Number of clinical interactions

• Differences in the number of clinical interactions per subjects with healthcare providers through the mobile app and through usual means in the standard care

Time frame: 6 months

Missed clinical appointments

Percent of missed clinical appointments in each arm.

Time frame: 6 months

Weight

Changes in weight from baseline at 6 months

Time frame: 6 months

Blood Pressure

Changes in blood pressure from baseline at 6 months

Time frame: 6 months

Lipids

Changes in lipids from baseline at 6 months

Time frame: 6 months

Qatar Diabetes Mobile Application Trial

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts