Efficacy of Digitally Supported and Real-Time Self-Monitoring of Blood Glucose-Driven Counseling in Patients with Type 2 Diabetes Mellitus: A Real-World, Retrospective Study in North India

Abstract

Purpose

Poor glycemic control is prevalent in patients with type 2 diabetes mellitus (T2DM) in India. This study aims to understand the effectiveness of a smartphone-connected glucometer, real-time feedback, and contextualized counseling on glycemic control and hypoglycemic episodes in T2DM patients.

Methods

This retrospective, multicenter study reviewed the medical records of T2DM patients belonging to several cities of north India, who were digitally engaged with a smartphone-connected glucometer and who had received at least one counseling session between September 2019 and July 2020. Intervention included self-monitoring of blood glucose (SMBG) using a smartphone-connected glucometer enabled with real-time transmission of information to certified diabetes educators (CDE) and their corresponding counseling based on SMBG findings.

Results

Of 7111 adult T2DM patients included in this study, majority (75%) of the patients received a single session of counseling, and the remaining patients received 2 (16.7%), 3 (5%), 4 (2%), or ≥5 (1.3%) sessions. The mean age of the patients was 51.6 years, and the majority (77.9%) were males. Digital monitoring of BG and counseling with CDE significantly reduced the mean fasting (by 9.6%), pre-prandial (by 9.9%), and post-prandial (by 9.2%) BG values in 53%, 52%, and 54% of patients, respectively. The majority (81.4%) of patients showed no hypoglycemic episode (≤70 mg/dL) post-counseling. The hypoglycemia episodes observed with FBG, pre-prandial, and post-prandial BG values were reduced significantly by 58.5%, 48.1%, and 61.8%, respectively, post-counseling.

Conclusion

Digitally supported and real-time SMBG-driven counselling was effective in glycemic control and reduction of hypoglycemic episodes in T2DM patients in India. Moreover, reduction in hypoglycemia may be due to back end real-time support of CDE intervention.

Keywords:

• type 2 diabetes mellitus
• glucometer
• glycemic control
• self-monitoring of blood glucose
• counseling

Abbreviations

AI, artificial intelligence; BG, blood glucose; BMI, body mass index; CDE, certified diabetes educators; FBG, fasting blood glucose; HbA1c, glycated hemoglobin; SMBG, self-monitoring of blood glucose; T2DM, type 2 diabetes mellitus.

Data Sharing Statement

Data will be available from the corresponding author upon request.

Consent for Publication

All authors provided written consent to publish this study.

Acknowledgments

The authors would like to thank Rupali Jangid (Senior Medical Writer) for providing assistance in writing the original manuscript, Dr. Vamsi Krishna Kolukula (Medical Director, Medical Affairs), and Dr. Venugopal Madhusudhana (Vice President, Medical Affairs) for additional editorial assistance in the development of this manuscript. All the above belong to THB c/o Sekhmet Technologies Pvt Ltd., Gurugram, Haryana, India. The authors would also like to thank Ajrendra Gaurav (VP Products, Health Arx Technologies Pvt. Ltd., New Delhi, India) for assisting in data collation and data analysis.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agreed to be accountable for all aspects of the work.

Disclosure

Gautam Chopra and Mudit Sabharwal declare that they serve as Chief Executive Officer and Head of Medical Affairs, respectively, at Health Arx Technologies Pvt. Ltd., New Delhi, India (manufacturer of BeatO smartphone-connected glucometer). The authors report no other conflicts of interest in this work.

Additional information

Funding

The study was funded by Health Arx Technologies Pvt. Ltd.