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

Figures & data

Figure 1 Connected diabetes care program for patients with type 2 diabetes.

Table 1 Characteristics of Patients Engaged with Digital Diabetes Engagement Platform

Parameters	Values
Total number of type 2 diabetes patients (N)	7111
Gender distribution, n (%)
Male	5541 (77.9%)
Female	1570 (22.1%)
Mean age (years)	51.6
Age distribution
18–40 years, n (%)	1477 (20.8%)
41–60 years, n (%)	3619 (50.9%)
>60 years, n (%)	2015 (28.3%)
Mean BMI (kg/m^2) (n = 6082)	27.1
Mean duration of diabetes (years) (n = 6607)	9.2
Mean HbA1c level (%) (n = 992)	8.4
Total number of counseling sessions conducted	9932
Patients attending 1 counseling session n (%)	5335 (75%)
Patients attending 2 counseling sessions n (%)	1184 (16.7%)
Patients attending 3 counseling sessions n (%)	357 (5.0%)
Patients attending 4 counseling sessions n (%)	143 (2.0%)
Patients attending 5 or more counseling sessions n (%)	92 (1.3%)

Figure 2 Improvement in mean BG values.

Table 2 Effect of SMBG-Driven Counseling on Mean Blood Glucose Levels

Categories	Mean Values Pre- Counseling Mean (SD)	Mean Values Post-Counseling Mean (SD)	Absolute Difference in Mean	Percentage Change (%)	p values
Overall effect of counseling
Fasting (n = 3512)	185.4 (67.3)	167.5 (56.2)	17.9	9.6%	<0.05
Pre-prandial (n = 1574)	214.5 (85.5)	193.3 (73.6)	21.2	9.9%	<0.05
Post-prandial (n = 2296)	225.9 (81.5)	205.0 (68.6)	20.9	9.2%	<0.05
Age-wise effect of counseling
Fasting blood glucose values (n = 3512)
18–40 years	203.3 (68.3)	178.4 (59.4)	24.9	12.2%	<0.05
41–60 years	188.6 (64.8)	170.5 (55.2)	18.1	9.6%	<0.05
>60 years	168.8 (67.1)	155.5 (53.6)	13.3	7.9%	<0.05
Pre-prandial blood glucose values (n = 1574)
18–40 years	221.8 (83.6)	196.9 (71.3)	24.9	11.2%	<0.05
41–60 years	217.1 (84.8)	192.7 (75.4)	24.4	11.2%	<0.05
>60 years	206.1 (87.2)	192.1 (71.9)	14.0	6.8%	<0.05
Post-prandial blood glucose values (n = 2296)
18–40 years	227.4 (81.2)	208.1 (74.8)	19.3	8.5%	<0.05
41–60 years	230.5 (81.8)	206.5 (67.7)	24.0	10.4%	<0.05
>60 years	216.7 (80.3)	200.1 (65.7)	16.6	7.7%	<0.05
Effect of counseling with respect to number of counseling sessions
Fasting blood glucose values (n = 3512)
1 session	183.5 (65.6)	165.7 (53.6)	17.8	9.7%	<0.05
2 sessions	190.5 (69.8)	171.2 (58.3)	19.3	10.1%	<0.05
3 sessions	194.1 (73.2)	172.1 (70.6)	22.0	11.3%	<0.05
4 sessions	190.8 (75.7)	174.9 (61.8)	15.9	8.3%	<0.05
Pre-prandial blood glucose values (n = 1574)
1 session	211.9 (84.8)	191.8 (74.8)	20.1	9.5%	<0.05
2 sessions	219.5 (89.0)	198.2 (73.6)	21.3	9.7%	<0.05
3 sessions	229.3 (88.7)	189.9 (63.4)	39.4	17.2%	<0.05
4 sessions	214.5 (81.7)	209.6 (77.3)	4.9	2.3%	0.7
Post-prandial blood glucose values (n = 2296)
1 session	224.8 (80.9)	203.6 (68.3)	21.2	9.4%	<0.05
2 sessions	230.9 (81.6)	208.6 (70.8)	22.3	9.7%	<0.05
3 sessions	220.6 (85.2)	203.3 (64.4)	17.3	7.8%	<0.05
4 sessions	239.1 (88.2)	217.6 (71.4)	21.5	9.0%	0.08

Notes: “n” signifies number of patients taking different types of SMBG readings. Percentage change was calculated depicting relative change of mean blood glucose values (pre-counseling % − post-counseling % / pre-counseling %).

Abbreviations: SD, standard deviation; SMBG, self-monitoring of blood glucose.

Figure 3 Effect of SMBG-driven counseling on mean BG values.

Table 3 Effect of SMBG-Driven Counseling on Hypoglycemia Episode

Blood Glucose Values, mg/dL	Pre-Counseling Hypoglycemia Episodes		Post-Counseling Hypoglycemia Episodes		Percentage Change in Hypoglycemic Episodes	p values
	No. of Blood Glucose Values	No. of Values <70 mg/dL	No. of Blood Glucose Values	No. of Values <70 mg/dL
Fasting (n = 3512)	18,003	734 (4.1%)	18,721	316 (1.7%)	58.5%	<0.001
Pre-prandial (n = 1574)	5794	302 (5.2%)	6070	166 (2.7%)	48.1%	<0.001
Post-prandial (n = 2296)	9813	331 (3.4%)	10,269	139 (1.3%)	61.8%	<0.001

Notes: “n” signifies number of patients taking different types of SMBG readings. Percentage change was calculated depicting relative % change of hypoglycemic episodes (pre-counseling % episodes − post-counseling % episodes / pre-counseling % episodes).

Figure 4 Impact of SMBG-driven counseling on occurrence of hypoglycemia episodes.

Table 4 Age Profiling of Patients Showing Hypoglycemia Episode Post-SMBG-Driven Counselling

Age Group	Total (n = 959 Patients)	Improved (No BG Reading ≤70 mg/dL Post-Counseling)	Unimproved (At Least 1 BG Reading ≤70 mg/dL Post-Counseling)
≤40 years	138	114 (82.6%)	24 (17.4%)
41–50 years	173	153 (88.4%)	20 (11.6%)
51–60 years	300	245 (81.7%)	55 (18.3%)
>60 years	348	269 (77.3%)	79 (22.7%)