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Smartphone App as Motivational Intervention to Improve Glycemic Control in Adolescents with Type 1 Diabetes

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Abstract

Objectives

Type 1 diabetes (T1D) adolescents often do not achieve good glycemic control. In the context of growing number of technologically savvy adolescents, this study was done to examine the effectiveness of a motivational smartphone app to improve their glycemic control.

Methods

Eleven to eighteen year old adolescents, treated by Pediatric endocrine team of CMC, Vellore, who had T1D ≥ 1 y duration with poor glycemic control (mean HbA1c ≥ 8.5% in preceding 12 mo) were recruited. An app programmed to provide 3 reminders per day regarding insulin, meals and physical exercise was installed on their phone. Diabetes management was continued as per the standard of care. HbA1C was measured after 3 mo.

Results

Thirty seven adolescents were recruited; 3 were excluded as the app became non-functional. Seventeen were boys, mean age was 13.8 y (11–18 y) and mean duration of diabetes was 4.9 y (0.8–16 y). The mean HbA1c levels over preceding 12 mo and at recruitment were 10.75% (1.88) and 10.6% (2.08) respectively. Twenty eight participants returned for repeat HbA1C after 3–4 mo. As compared to baseline there was significant reduction in HbA1c level: 10.6% (2.08) vs. 9.65% (1.6); p = 0.004. Twenty two of twenty eight participants showed reduction in HbA1c after app installation. The magnitude of change in HbA1c levels over a 3 mo period before and after the app use was analyzed. There was significant difference between mean HbA1c levels before and after app use; +0.28 (2.06) vs. −0.914 (1.52); p = 0.019.

Conclusions

Following usage of smartphone app as a motivational intervention in adolescents with Type 1 diabetes, there was significant reduction in HbA1c level after 3 mo. With continued use, this may benefit them to achieve target HbA1c levels. Use of mobile phone apps as motivational interventions is feasible in adolescents with Type 1 diabetes in India.

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Acknowledgements

The authors would like to acknowledge Mr. Matha Venkateswara Sai Vara Prasad, BTech (BPUT), Co-Founder, Director Technical, Epsum Labs Private Ltd. who designed the DMCare app using free license software. They also acknowledge their diabetes nurses Mrs. Marthal, Mrs. Ida and Mrs. Gnanasoundari who helped with the recruitment of study participants.

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Authors and Affiliations

  1. Pediatric Endocrine Division of Pediatrics Unit-1, Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu, India

    Binay Kumar Pramanik, J. Jebashini Angelin, Vineeth John Mathai, Sarah Mathai, Sophy Korula & Anna Simon

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  1. Binay Kumar Pramanik
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  2. J. Jebashini Angelin
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  3. Vineeth John Mathai
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Contributions

BKP, JAJ and VJM proposed the study, contributed to app designing, app installation & follow-up, analysis and manuscript writing. SM, SK and AS contributed to study design, follow-up of participants, critical analysis of results and manuscript editing. SM is the guarantor for this paper. BKP, JAJ and VJM have contributed equally to the study and are joint first authors for the study.

Corresponding author

Correspondence to Sarah Mathai.

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Binay Kumar Pramanik, J. Jebashini Angelin, and Vineeth John Mathai are joint primary authors.

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Pramanik, B.K., Angelin, J.J., Mathai, V.J. et al. Smartphone App as Motivational Intervention to Improve Glycemic Control in Adolescents with Type 1 Diabetes. Indian J Pediatr 86, 1118–1123 (2019). https://doi.org/10.1007/s12098-019-03035-x

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