Project

Following the presentation of the M Diabètes protocol at FAMX Paris (see below) by the Pr Maïmouna Ndour Mbaye, the Foundation of the French Academy of Medicine (FAM) would like to apply it with the help of the IPC (social security) in France. This would be a pilot study on a Muslim population to see if the application developed in Africa could work in France.

As a reminder, M Diabète, thanks to a mobile phone application, provides dietary advice to patients with type 2 diabetes and precarious pre-diabetic conditions (including during Ramadan).

Why do this project?

Type 2 diabetes is in constant expansion with a higher prevalence in precarious populations where it is poorly managed. Insufficient compliance (50%) characterizes the follow-up of type 2 patients and prediabetics, explaining the poor glycemic control which is the source of multiple complications and an increasing incidence of the disease.

Therapeutic education, whose effectiveness has been demonstrated, does not receive sufficient funding and is very difficult to implement in precarious or immigrant populations. Hence the project to implement a simple method of monitoring by smartphone that has proven its efficiency in Senegal.

Objectives of the study

Organize via periodic contacts by smartphone the follow-up of precarious diabetic or pre-diabetic patients to improve therapeutic compliance and prevent the apparition of diabetes in hyperglycemic subjects who are not yet diabetic. It is therefore a question of improving the currently unfavourable situation of precarious diabetics and pre-diabetics by a simple and inexpensive method.

Methodology of the study

Population

Precarious or immigrant subjects:

-Diabetics type 2

-Prediabetics identified on clinical and biological criteria (fasting hyperglycemia)

Materials and methods

1-Review patients with smartphones who will be part of the study

2-Convene them in consultation for :

->Get their commitment

->Explain the principle of the study to them

->Inform yourself of the existence of a treating physician

->Assess their clinical, biological, complications, socio-professional, family, psychological and pregnancy status, current treatment (with the agreement of the attending physician).

The number of subjects to be monitored will be determined by the importance of having homogeneous groups to allow statistical comparisons.

3-Create a telephone reception platform to receive calls, SMS and periodically contact the subjects included in the study to renew dietary and therapeutic advice (via SMS contacts or telephone for illiterate people).

A coordinating doctor and trained paramedical staff should be provided.

4-Evaluation of the effectiveness of the method

It will be carried out after a study time to be defined (months-years), SMS reception rate, SMS reading rate.

The other criteria will be discussed:

->Weight evolution, PA

->Prevalence of hyperglycemia

->Blood glucose, HbA1c

->Evolution of complications, retinopathies, cardio-vascular, condition of the feet, nephropathies

->Quality of life, level of satisfaction

Difficulties

-Planning a large number of study outings

-Homogeneous groups

-Relations with the attending physician

-Constitution and operation of the platform

-Financing

Participants

FAM, IRD, Avicenne Hospital Diabetology Department, French Diabetic Association.

Pr Maïmouna Ndour Mbaye, who developed the application in Senegal

Pr Claude JAFFIOL, member of the French Academy of Medicine

Docteur Yves Juillet, member of the FAM strategic committee