Effect of Voluntary Participation on Mobile Health Care in Diabetes Management: Randomized Controlled Open-Label Trial.

BACKGROUND: The role of mobile health care (mHealth) in glycemic control has been investigated, but its impact on self-management skills and its psychological aspects have not been studied. OBJECTIVE: We evaluated the efficacy of mHealth-based diabetes self-management education and the effect of voluntary participation on its effects. METHODS: This study was a randomized controlled open-label trial conducted for 6 months at Kangbuk Samsung Hospital. Participants in the control group (n=31) maintained their previous diabetes management strategies. Participants in the intervention group (n=41) additionally received mHealth-based diabetes self-management education through a mobile app and regular individualized feedback from health care professionals. The primary outcome was change in glycated hemoglobin (HbA1c) level over 6 months between the 2 groups (intervention versus control) and within each group (at 6 months versus baseline). The secondary outcomes were changes in body mass index, blood pressure, lipid profile, and questionnaire scores (the Korean version of the Summary of Diabetes Self-Care Activities Questionnaire, an Audit of Diabetes Dependent Quality of Life, the Appraisal of Diabetes Scale, and Problem Areas in Diabetes) over 6 months between groups and within each group. RESULTS: A total of 66 participants completed this study. HbA1c (P=.04), total cholesterol level (P=.04), and Problem Areas in Diabetes scores (P=.02) significantly decreased; total diet (P=.03) and self-monitoring of blood glucose level scores (P=.01), based on the Summary of Diabetes Self-Care Activities Questionnaire, markedly increased within the intervention group. These significant changes were observed in self-motivated participants who were recruited voluntarily via advertisements. CONCLUSIONS: mHealth-based diabetes self-management education was effective at improving glycemic control and diabetes self-management skills and lowering diabetes-related distress in voluntary participants. TRIAL REGISTRATION: ClinicalTrials.gov NCT03468283; http://clinicaltrials.gov/ct2/show/NCT03468283.

Eating alone and metabolic syndrome: A population-based Korean National Health and Nutrition Examination Survey 2013-2014.

Eating alone has been an emerging social concern in modern life. However, there is little research on the association between eating alone and Metabolic syndrome (MetS). We aimed to assess the association between eating alone and the MetS and to identify whether sociodemographic factors modify this association. This study included 7725 adults (≥19 years) who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) 2013-2014. Multivariable logistic regression analysis was used for assessing the association of eating alone (none, 1 time/day, and ≥2 times/day) with MetS. The percentages of subjects with MetS were 30.4% in men and 24.2% in women. 20.8% of men and 29.2% of women ate alone ≥2 times/day. Individuals who ate alone 2 or more times per day showed higher frequency of living alone, having no spouse, skip meals, and less eating out (p<0.05). Women with eating alone ≥2 times/day had a crude OR of 1.29 (95% CI:1.08-1.53, p-trend=0.001) for MetS compared with women without eating alone. However, this association was no longer significant after adjustments for confounding factors. Eating alone ≥2 times/day was significantly associated with increase abdominal obesity (OR, 95% CI:1.45, 1.10-1.91, p-trend=0.039) and MetS (1.64, 1.28-2.10, p-trend=0.004) in men. Eating alone was associated with a higher likelihood of having a MetS in men without spouse as compared with those with spouse (OR for men without spouse 3.02, 95% CI:1.50-6.11 and OR for men with spouse 1.48, 95% CI:1.22-1.7, p-interaction=0.027). Our results indicate that eating alone may be a potential risk factor for MetS.