Diabetes & Metabolism Journal

Brief Report

Metabolic Risk/Epidemiology
Short-Term Effects of the Internet-Based Korea Diabetes Prevention Study: 6-Month Results of a Community-Based Randomized Controlled Trial: Jin-Hee Lee, Sun-Young Lim, Seon-Ah Cha, Chan-Jung Han, Ah Reum Jung, Kook-Rye Kim, Kun-Ho Yoon, Seung-Hyun Ko; Diabetes Metab J. 2021;45(6):960-965. Published online March 17, 2021; DOI: https://doi.org/10.4093/dmj.2020.0225

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Graphical Abstract Abstract PDF PubReader ePub

The aims of this study were to determine the short-term effectiveness of an internet-based lifestyle modification (LSM) program in preventing the onset of type 2 diabetes mellitus (T2DM) in prediabetes patients in community settings. A total of 415 subjects who were diagnosed with prediabetes were randomly assigned to the LSM and standard management (SM) groups. After the 6-month intervention, the LSM group had a statistically significant reduction in body weight, body mass index compared to the SM group participants. In the LSM group, blood glucose levels were significantly decreased after intervention and the clinical improvement effect was evident in the group that achieved the target weight loss of 5% or more of the initial weight for 6 months. Internet-based 6-month-intensive LSM programs conducted by public health center personnel are an effective way to provide lifestyle intervention programs and encourage maintenance of healthy behaviors in subjects with a high risk of T2DM in community settings.

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Original Article

A Randomized Controlled Trial of an Internet-Based Mentoring Program for Type 1 Diabetes Patients with Inadequate Glycemic Control: Sunghwan Suh, Cheol Jean, Mihyun Koo, Sun Young Lee, Min Ja Cho, Kang-Hee Sim, Sang-Man Jin, Ji Cheol Bae, Jae Hyeon Kim; Diabetes Metab J. 2014;38(2):134-142. Published online April 18, 2014; DOI: https://doi.org/10.4093/dmj.2014.38.2.134

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Abstract PDF PubReader

Background

To determine whether an internet-based mentoring program can improve glycemic control in subjects with type 1 diabetes mellitus (T1DM).

Methods

Subjects with T1DM on intensive insulin therapy and with hemoglobin A1c (HbA1c) ≥8.0% were randomized to mentored (glucometer transmission with feedback from mentors) or control (glucometer transmission without feedback) groups and were examined for 12 weeks. Five mentors were interviewed and selected, of which two were T1DM patients themselves and three were parents with at least one child diagnosed with T1DM since more than 5 years ago.

Results

A total of 57 T1DM adult subjects with a mean duration after being diagnosed with diabetes of 7.4 years were recruited from Samsung Medical Center. Unfortunately, the mentored group failed to show significant improvements in HbA1c levels or other outcomes, including the quality of life, after completion of the study. However, the mentored group monitored their blood glucose (1.41 vs. 0.30) and logged into our website (http://ubisens.co.kr/) more frequently (20.59 times vs. 5.07 times) than the control group.

Conclusion

A 12-week internet-based mentoring program for T1DM patients with inadequate glycemic control did not prove to be superior to the usual follow-up. However, the noted increase in the subjects' frequency of blood glucose monitoring may lead to clinical benefits.

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Review

Ubiquitous Diabetes Management System via Interactive Communication Based on Information Technologies: Clinical Effects and Perspectives: Jae-Hyoung Cho, Hun-Sung Kim, Jae-Hoon Han, Jin-Hee Lee, Jeong-Ah Oh, Yoon-Hee Choi, Kun-Ho Yoon; Korean Diabetes J. 2010;34(5):267-273. Published online October 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.5.267

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Abstract PDF PubReader

New diabetes management systems based on interactive communication have been introduced recently, accompanying rapid advances in information technology; these systems are referred to as "ubiquitous diabetes management systems." In such ubiquitous systems, patients and medical teams can communicate via Internet or telecommunications, with patients uploading their glucose data and personal information, and medical teams sending optimal feedback. Clinical evidence from both long-term and short-term trials has been reported by some researchers. Such systems appear to be effective not only in reducing the levels of HbA1c but also in stabilizing glucose control. However, most notably, evidence for the cost-effectiveness of such a system should be demonstrated before it can be propagated out to the general population in actual clinical practice. To establish a cost-effective model, various types of clinical decision supporting software designed to reduce the labor time of physicians must first be developed. A number of sensors and devices for monitoring patients' data are expected to be available in the near future; thus, methods for automatic interconnections between devices and web charts were also developed. Further investigations to demonstrate the clinical outcomes of such a system should be conducted, hopefully leading to a new paradigm of diabetes management.

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Clinical Trial

Perspectives of "Ubiquitous Health Care System" for Diabetes Management.: Jae Hyoung Cho, Hyuk Sang Kwon, Kun Ho Yoon; Korean Diabetes J. 2006;30(2):87-95. Published online March 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.2.87

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Abstract PDF

Although clear evidences of the beneficial effects of tight glycemic control on diabetic patients had been already made, the past decade has not seen any noticeable improvement in terms of glycemic control. "Ubiquitous health care system", which is one of the developing fusion technologies of IT, BT and NT, could give us new solutions in future. We established the Internet based glucose monitoring system (IBGMS) and conducted prospective, randomized short-term and long-term clinical trials using the system which can guide the patients with diabetes by mobile technology anytime and anywhere. The mean HbA1c and HbA1c fluctuation index (SD of mean HbA1c) during the whole study period was significantly lowered by the intervention, suggesting more improved state in both HbA1c level and glucose stability. Appropriate physician's advises to the patients' questions and problems at the right time through the IBGMS were the major interventions. Although many unsolved problems still exist, the Internet-based bidirectional communication system developed by the advanced information technology can contribute to the foundations to tomorrow's or ubiquitous medicine

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Randomized Controlled Trial

Establishment of Blood Glucose Monitoring System using Internet.: Hee Soo Kim, Jae Hyoung Cho, Hyuk Sang Kwon, Jin Hee Lee, Bok Re Song, Jung A Oh, Kun Ho Yoon, Ho Young Son; Korean Diabetes J. 2003;27(3):280-287. Published online June 1, 2003

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Abstract PDF: BACKGROUND
The internet has been used world wide as a communication tool. To improve the quality of glucose control, the effectiveness of an Internet-based Blood Glucose Monitoring System (IBGMS), on changes in HbA1c levels, was investigated. RESEARCH DESIGN AND METHODS: A randomized clinical trial, involving 110 patients who had visited outpatient's clinic at the Kangnam St. Mary's Hospital diabetes center for 3 months, was conducted. The study subjects were treated with IBGMS for 12 weeks, with a control group receiving the usual outpatient management for the same period. HbA1C and other laboratory tests were performed at the baseline and at the end of the study. RESULTS: There were no significant differences found between the two groups at the baseline measurements, with respect to age, sex, diabetes duration, body mass index, blood pressure, HbA1C and other laboratory data. In the follow up tests, the study group showed a significant reduction in the HbA1C level, by 7.1% (0.54% absolute, p=0.001), while the control group showed an increased HbA1C level (p=0.054). Moreover, there was an 11.1% reduction (0.92% absolute, p<0.001) in the HbA1C level in the patients with HbA1C levels > or =7.0% at baseline in the study group, but those with HbA1C levels <7.0% maintained good HbA1c levels, 6.32%, by the end of the study. CONCLUSIONS: This new IBGMS resulted in a significant reduction in the HbA1C levels during the study period. We propose this IBGMS as a new method for glycemic control.

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