THE EFFECT OF SMARTPHONE APPS AND TECHNOLOGY COMPATIBILITY ON DIABETES CONTROL IN DIABETIC PATIENTS USING INSULIN

Öz

Objective: This study was done to determine the need for technological systems in diabetes patients using insulin in Turkey, and to investigate the relationship between diabetes control and their smartphone apps. Material and Methods: This descriptive cross-sectional type of study was carried out with 506 diabetic patients using insulin who were followed up at the Diabetes Outpatient Clinics within the Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, between March and September 2017. The data were obtained with a face-to-face interview of the physician using the data collection form. Results: The mean age of the participants was 54.23±15.23 (18-89) years. The investigation of distribution in accordance with age showed that 71 patients (14%) were in the 18-34 age group, 302 (59.7%) in the 35-64 age group, and 133 (26.3%) were aged 65 years and above. The rate of those with Type 1 diabetes was 22.9% (n=116) and the rate of those with Type 2 diabetes was 77.1% (n=390). Four-hundred and sixty-four (92.5%) of the patients stated that a patient follow-up system specific to our country would be useful in increasing the quality of life for diabetic patients. Three-hundred and twenty-one (63.4%) of the patients stated they have been using applications on - technological and telecommunication devices, and 185 patients (36.6%) stated they did not use the applications. In the model that examined the factors affecting the use of smartphone applications (Nagelkerke R2=44.6%, sensitivity=82.9% specificity=69.2%), it showed that higher education students’ rate of using smartphone applications was 14.7 times higher than those with lower education; and those with an income level between 2 and 4 times above minimum wage were found to be 2.5 times higher than those with an income level of or below minimum wage. Conclusion: It is anticipated that a system specific to our country will be needed for diabetic patients using insulin and that educated young patients with middle income will be highly interested in this system.

Anahtar Kelimeler

• Insulin-dependent diabetes mellitus
• technological innovations
• applications

İNSÜLİN KULLANAN DİYABET HASTALARINDA AKILLI TELEFON UYGULAMALARI VE TEKNOLOJİYE UYUMUN DİYABET KONTROLÜ ÜZERİNE ETKİSİ

Öz

Amaç: Türkiye’de insulin kullanan diyabet hastalarında teknolojik sistemlere duyulan ihtiyacın belirlenmesi ve akıllı telefon uygulamalarının diyabet kontrolü ile ilişkisinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Tanımlayıcı kesitsel tipte tasarlanan çalışma Mart ve Eylül 2017 tarihleri arasında Istanbul Üniversitesi, İstanbul Tıp Fakültesi, İç Hastalıkları Bölümü bünyesindeki Diyabet Polikliniklerinde takip edilen ve insulin kullanmakta olan 506 diyabet hastası ile gerçekleştirildi. Veriler, hazırlanan veri toplama formu yardımı ile görevli doktor tarafından yüz yüze görüşme yöntemi kullanılarak elde edildi. Bulgular: Katılımcıların yaş ortalaması 54,23±15,23 (18 ile 89) yıl idi. Yaş kategorilerine göre dağılım incelendiğinde; 71’i (%14) 18-34, 302’si (%59,7) 35-64 yaş aralığında, 133’ü (%26,3) ise 65 yaş ve üstü grupta bulunmaktaydı. Tip 1 diyabet olanların oranı %22,9 (n=116), tip 2 diyabet olanlar ise %77,1 (n=390) idi. Hastaların 468’i (%92,5) diyabet hastalarının yaşam kalitesini artıracak ülkemize özgü bir hasta takip sisteminin faydalı olacağını belirtti. Hastaların 321’i (%63,4) teknolojik iletişim ve haberleşme cihazlarındaki uygulamaları kullandığını, 185’i (%36,6) ise kullanmadığını belirtti. Akıllı telefon uygulaması kullanımını etkileyen faktörlerin incelendiği modelde (Nagelkerke R2=%44,6, duyarlılık=%82,9 özgüllük=%69,2) yüksek eğitim görenlerin akıllı telefon uygulaması kullanma oranı, eğitimi olmayanlara göre 14,7 kat; gelir seviyesi asgari ücretin 2 ile 4 katı arasında olanlar da ise gelir seviyesi asgari ücret ve altında olanlara göre 2,5 kat daha yüksek bulundu. Sonuç: İnsülin kullanan diyabet hastaları için ülkemize özgü bir sisteme ihtiyaç olduğu ve bu sisteme genç eğitimli ve gelir seviyesi orta yüksek olan hastaların ilgilerinin yüksek olacağı öngörülmektedir.

Anahtar Kelimeler

• İnsülin bağımlı diyabet
• teknolojik yenilikler
• uygulamalar

Kaynakça

1. 1. TEMD Diyabet Çalışma Grubu. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu-2019, retrieved December 19, 2020, from http://temd.org.tr/ admin/uploads/tbl_kilavuz/20190819095854-2019tbl_ kilavuzb48da47363.pdf
2. 2. World Health Organization. Diabetes, retrieved August 19, 2020, from https://www.who.int/health-topics/diabetes
3. 3. International Diabetes Federation. Diabetes Atlas Ninth Edition 2019. IDF Publ. Brusselles, 2019: pp: 10-41, retrieved November 20, 2020, from https://diabetesatlas.org/upload/ resources/material/20200302_133351_IDFATLAS9e-finalweb. pdf
4. 4. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28(2):169-80. [CrossRef]
5. 5. TUİK. Adrese Dayalı Nüfus Kayıt Sistemi 2018 verileri, retrieved November 22, 2020, from https://tuikweb.tuik. gov.tr/PreTablo.do?alt_id=1059
6. 6. Suhrcke M, Nugent RA, Stuckler D, Rocco L. Chronic disease: an economic perspective. London: Oxford Health Alliance. November 2006, retrieved November 22, 2020, from https://www.who.int/management/programme/ncd/ Chronic-disease-an-economic-perspective.pdf
7. 7. Bommer C, Sagalova V, Heesemann E, Manne-Goehler J, Atun R, Barnighausen T, et al. Global economic burden of diabetes in adults: projections from 2015 to 2030. Diabetes care, 2018;41(5):963-70. [CrossRef]
8. 8. Brzan PP, Rotman E, Pajnkihar M, Klanjek P. Mobile applications for control and self management of diabetes: a systematic review. J Med Syst 2016;40(9):210. [CrossRef]

9. 9. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes care 2004;27(5):1047-53. [CrossRef]
10. 10. Bullard KM, Cowie CC, Lessem SE, Saydah SH, Menke A, Geiss SS, et al. Prevalence of diagnosed diabetes in adults by diabetes type—United States, 2016. MMWR Morb Mortal Wkly Rep 2018;67(12):359. [CrossRef]
11. 11. Faridi Z, Liberti L, Shuval K, Northrup V, Ali A, Katz DL. Evaluating the impact of mobile telephone technology on type 2 diabetic patients’ self-management: the NICHE pilot study. J Eval Clin Pract 2008;14(3):465-9. [CrossRef]
12. 12. Arsand E, Tatara N, Ostengen G, Hartvigsen G. Mobile phone-based self-management tools for type 2 diabetes: the few touch application. J Diabetes Sci Technol 2010;4(2):328-36. [CrossRef]
13. 13. Carroll AE, DG Marrero and SM Downs. The HealthPia GlucoPack™ diabetes phone: a usability study. Diabetes Technol Ther 2007;9(2):158-64. [CrossRef]
14. 14. Liang X, Wang Q, Yang X, Cao J, Chen J, Mo X, et al. Effect of mobile phone intervention for diabetes on glycaemic control: a meta-analysis. Diabet Med 2011;28(4):455-63. [CrossRef]
15. 15. Whitehead L, Seaton P. The effectiveness of selfmanagement mobile phone and tablet apps in long-term condition management: a systematic review. J Med Internet Res 2016;18(5):e97. [CrossRef]
16. 16. Holt RI, Cockram C, Flyvbjerg A, Goldstein BJ. Textbook of diabetes. Fifth Edition. John Wiley and Sons. 2017. [CrossRef]
17. 17. Hou C, Carter B, Hewitt J, Francisa T, Mayor S. Do mobile phone applications improve glycemic control (HbA1c) in the self-management of diabetes? A systematic review, metaanalysis, and GRADE of 14 randomized trials. Diabetes care, 2016;39(11):2089-95. [CrossRef]
18. 18. Franklin V. Influences on technology use and efficacy in type 1 diabetes. J Diabetes Sci Technol 2016;10(3):647-55. [CrossRef]
19. 19. Nanayakkara N, Ranasinha S, Gadowski A, Heritier S, Flack JR, Wischer N, et al. Age, age at diagnosis and diabetes duration are all associated with vascular complications in type 2 diabetes. J Diabetes Complications 2018;32(3):279- 90. [CrossRef]
20. 20. Tönnies T, Stahl-Pehe A, Baechle C, Castillo K, Kuss O, Yossa R, et al. Risk of microvascular complications and macrovascular risk factors in early-onset type 1 diabetes after at least 10 years duration: an analysis of three populationbased cross-sectional surveys in Germany between 2009 and 2016. Int J Endocrinol 2018;2018:7806980. [CrossRef]
21. 21. Guneş G. Colaklar H. Innovative technologies in the management of electronic medical records: e-pulse. European Association for Health Information and Libraries Congress. 6-11 June, Sevilla, Spain. 2016.
22. 22. Kahraman M, Karan MA, Nalcaci M. Rational drug use habits of patients with chronic diseases: A cross-sectional examination focusing on the use of technological devices. Int J Clin Pract 2021:e14222. [CrossRef]
23. 23. Gallagher R, Roach K, Sadler L, Glinatsis H, Belshaw J, Kirkness A, et al. Mobile technology use across age groups in patients eligible for cardiac rehabilitation: survey study. JMIR Mhealth Uhealth 2017;5(10):e161. [CrossRef]