Summary: In adults with type 2 diabetes and baseline HbA1c of 7.5 to 9.5 percent, a physician-led digital education and remote-monitoring platform was tested against conventional outpatient education in a single-centre pilot randomised trial (n=56 analysed). At three months HbA1c fell by 0.5 percent to 7.8 percent in the intervention arm (within-group P=.01) and by 0.2 percent to 7.8 percent in the control arm; both arms reached an identical 7.8 percent, and the early gain reversed once remote monitoring stopped.
PICO Summary
| Element | Detail |
|---|---|
| Population | Adults aged 19 years or older with type 2 diabetes and HbA1c between 7.5 and 9.5 percent; 66 enrolled and 56 analysed after 10 dropouts; single diabetes centre, Republic of Korea; pilot randomised controlled trial. |
| Intervention | Physician-delivered face-to-face education using a digital platform (Doctorvice, iKooB Inc.) at enrolment and at the 3- and 6-month visits, plus remote glucose monitoring during the first 3 months only (n=26). |
| Comparison | Conventional outpatient education without the digital platform or remote monitoring (n=30). |
| Outcome | Primary endpoint: change in HbA1c. At 3 months HbA1c fell by 0.5 percent to 7.8 percent (SD 0.9) in the intervention arm (within-group P=.01) and by 0.2 percent to 7.8 percent (SD 0.7) in the control arm; both arms reached 7.8 percent and no significant between-group difference was reported. HbA1c rose again between 3 and 6 months once remote monitoring ended. Treatment satisfaction improved in the intervention arm (mean change +3.6 points; P=.006). Medication adherence improved in both arms with no significant difference at 6 months (P=.59). No 95 percent confidence intervals, ARR, or NNT were reported. |
Digital physician feedback for HbA1c in type 2 diabetes
Pilot RCT · type 2 diabetes · 3 months
Both arms reached an identical 7.8 percent HbA1c at 3 months with no significant between-group difference, and the early intervention gain reversed once remote monitoring stopped. A feasibility signal, not proof the platform beats usual care.
Expert Commentary
This pilot randomised trial is best read as a feasibility signal, not as evidence that the digital platform lowers HbA1c better than usual care. The headline often attached to this study, that physician feedback improves glycaemic control, is overstated. The reported P value of .01 reflects a within-group fall in the intervention arm, and the comparison that matters is undermined by the fact that both arms reached an identical 7.8 percent at three months, with no significant between-group difference reported. The gain was also transient: HbA1c drifted upward once remote monitoring was withdrawn after month three, which suggests the active ingredient may be continuous monitoring rather than the education itself. Several limitations temper enthusiasm, but the most important is that this small single-centre study of 56 analysed participants was neither designed nor powered to demonstrate superiority, so it cannot support causal efficacy claims. The platform is manufactured by a commercial vendor (iKooB Inc.), and the open-label design with subjective secondary endpoints such as satisfaction invites bias. Can I use this with my patients? Not yet; the data do not justify recommending this specific platform over standard education for routine glycaemic control. The honest takeaway is that remote monitoring appears to help while it is active, and an adequately powered trial with a durable monitoring component and blinded outcome adjudication is needed before adoption.
References
Yu J, Lee J, Yang Y, Lee EY, Lee SH, Cho JH. Clinical impact of personalized physician’s education and remote feedback via a digital platform on glycemic control: pilot randomized controlled trial. JMIR Mhealth Uhealth. 2025;13:e67151. doi:10.2196/67151