1934-LB: Patient Adherence to Self-Monitoring Practices and Glycemic Control—Findings from a Multiyear Digital Coaching Program

• Published in: Diabetes (New York, N.Y.) Vol. 74; no. Supplement_1; p. 1
• Main Authors: HUANG, YONG, NAGESH, NITISH, SUBRAMANIAN, AJAN, LIU, ZHIYU, STAFFORD, RANDALL S., RAHMANI, AMIR, HOU, WEIYI, WANG, LI
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 20.06.2025
• Subjects: Chronic illnesses; Diabetes mellitus; Glucose; Patients; Primary care
• DOI: 10.2337/db25-1934-LB
• ISSN: 0012-1797

Introduction and Objective: Chronic disease management relies on patient adherence to interventions. We analyzed glucose measurements from 3803 diabetic patients during their first 6 months in a coaching program. We observed decreasing glucose readings, validated by HbA1c reductions. Subjects who monitored more frequently demonstrated greater decreases in HbA1c levels. Methods: Primary care physicians enrolled patients with diabetes into the iHealth Unified Care program during 2019-2023. Patients received Bluetooth-connected devices and a mobile app to monitor blood glucose and other vital signs. Participants underwent laboratory tests measuring markers such as HbA1c. We categorized participants into three adherence groups based on monitoring patterns: low adherence (2.43 average measurements per week), medium (5.62), and high (12.78). Initial analysis revealed a downward trend in HbA1c values over time, with higher adherence correlating with better outcomes. A linear mixed effects model was used to account for individual differences and assess program effectiveness. Results: Our model demonstrated that HbA1c decreased by 0.003% per week (p = 0.039). Using the low adherence group as reference, higher adherence was associated with greater reductions in HbA1c. Patients in the highest adherence group showed an additional decrease of 0.1724% (p = 0.093), while medium adherence showed an additional decrease of 0.1577% (p = 0.005). Compared to obese patients, healthy BMI was associated with lower HbA1c (-0.143%, p=0.050). Current smoking was associated with higher HbA1c (+0.500%, p<0.001). Conclusion: Our analysis demonstrated that higher adherence to monitoring practices significantly improved glycemic control. Patients with greater adherence experienced more substantial improvements in glucose readings. These findings highlight the critical role of consistent monitoring in effectively managing chronic diseases, emphasizing the need for patient engagement for optimal health outcomes.