Impact of a Mobile Application Based Intervention on Improving Glycemic Control

Abstract Purpose Diabetes often remains untreated in low-resource settings due to inadequate healthcare infrastructure and compromised mobility especially, for women. The Glucose Trail (GT) intervention was designed to manage diabetes in patients from a low resource setting via a mobile application and community mobilization. The primary objective of this study was to assess the impact of the intervention on glycemic control parameters. The secondary objective was to examine the change in blood pressure, BMI and waist circumference. Methods A retrospective review was conducted among patients included in the GT intervention conducted between February 2019 to August 2019 at a health-center in Pind Begwal, Pakistan. Patients with HbA1c > 6.5% (48mmol/mol) and FBG >126 mg/dL or random blood glucose >200 mg/dL were included. Patients with end-stage diabetes complications, advanced medical comorbidities requiring frequent hospitalization or lack of ambulation were excluded. Lady health workers, selected from the community, followed patients for 6 months via home visits. During each visit, the patient’s FBG, waist circumference, weight and blood pressure were updated in the GT mobile application. The information was reviewed by a remote physician who titrated treatment. The updated plan was then conveyed to the patient by a lady health worker. Results 44 patients were enrolled in Pind Begwal; 3 lost to follow-up. A decrease in HBA1c (p=0.026)), FBG (p=0.044), systolic blood pressure (p=0.044) and diastolic blood pressure (p=0.002) was recorded. There was an increase in average BMI (p=0.318) and decrease in waist circumference (p=0.511) compared to baseline values. Conclusions The GT application intervention improved glycemic control among patient from a low-resource setting. Further studies with a larger sample size are necessary to solidify this association.