(Objectives) We investigated whether using a smartphone personal health record (PHR) application would improve HbA1c levels and body weight in patients with type 2 diabetes. (Methods) This multicenter cohort study was conducted in 20 medical clinics. We analyzed 118 patients (97 men and 21 women) with type 2 diabetes who were able to use the Welby Mykarte PHR application. We measured HbA1c levels and body weight when the patients started using the PHR application and then every 3 months for 24 months. Patients were stratified according to the frequency at which they used the application (<15 or ≥15 times per month). (Results) HbA1c values improved significantly from 7.2 % at baseline to 6.8 % at 24 months in all patients. The frequent user group demonstrated a greater improvement (from 7.1 % to 6.4 %) in comparison to the infrequent user group. Body weight also decreased. (Conclusion) These data suggest that better compliance with lifestyle modifications through 24 months of use of a PHR application may bring about therapeutic effects, including improved HbA1c.
We present the case of a 69-year-old man with type 2 diabetes mellitus. He had a medical history of hereditary hemorrhagic telangiectasia. Four months after being aware of the carbohydrate restriction, he was admitted to our hospital because of hyperglycemia and impaired consciousness. After admission, the patient was diagnosed with hyperammonemia and a portacaval shunt. BCAA treatment was initiated to prevent loss of muscle mass. Laxatives and metformin were administered, and the poor absorption of antibiotics, kanamycin, hyperammonemia, and consciousness disturbance improved. The quantity and quality of protein intake and defecation control are common issues in both hepatic encephalopathy and diabetes. To improve the patient's prognosis, as in this case, it is useful to consider treatment from multiple perspectives.