Digital Assistance May Optimize Treatment in Type 2 Diabetes With Hypertension

A digital health offering may help optimize treatment in patients with uncontrolled hypertension and type 2 diabetes, according to data from a new study.

Researchers conducted a study with 96 participants in which they compared usual care with a digital health offering (Proteus Discover). They found that those who used the digital health offering achieved greater reductions in blood pressure and LDL cholesterol levels and were also more likely to achieve their blood pressure goal compared with those who received usual care.

“These results are impressive since many interventions to improve adherence to medications and control of blood pressure and cholesterol have not been successful,” said study investigator Lars Osterberg, MD, MPH, associate professor of medicine at Stanford University School of Medicine in California.

The results from this study were presented at the American College of Cardiology’s (ACC) 65th Scientific Sessions.

The Proteus Discover consists of sensor-enabled medicines, a wearable sensor, patient app, and a provider portal. It can directly measure medication-taking, activity, and rest patterns to support patient self-management and facilitate provider therapy optimization.

Despite available treatments, only about 50% of patients with type 2 diabetes and hypertension achieve their treatment goals, said Dr Osterberg.

“The literature suggests that lack of patient engagement, such as nonadherence to medications and poor health behaviors, combined with the lack of therapy optimization, can be significant factors in poor control of diabetes, hypertension, and hyperlipidemia,” Dr Osterberg told Endocrinology Advisor

“In fact, the World Health Organization (WHO) reported that around half of patients with chronic diseases do not take their medicines as prescribed. Interventions to help improve medication adherence and other patient behaviors may be able to improve patient outcomes.”

Dr Osterberg and colleagues analyzed data on 96 patients with uncontrolled hypertension (systolic blood pressure ≥140 mm Hg) and type 2 diabetes (HbA1c ≥7%) treated with at least 2 antihypertensives plus metformin and/or a sulfonylurea. Mean age was 58.2 years and 50% were women. 

All participants received the digital health offering with sensor-enabled medications for 4 or 12 weeks or usual care.  

For this investigation, the primary outcome was change in systolic blood pressure at week 4, and secondary outcomes included change in diastolic blood pressure, HbA1c measured at week 12, and the proportion of subjects at blood pressure target, defined as lower than 140/90 mm Hg.