Thai diabetes app shows little extra HbA1c benefit over standard education
Key takeaway:
In a 6-month randomized trial of 129 adults with uncontrolled type 2 diabetes, a Thai-language self-management app did not lower HbA1c more than standard education alone, although fasting plasma glucose improved in participants younger than 65 years.
Study at a glance
What was studied
A Thai-language diabetes self-management app added to standard outpatient education.
Study type
Randomized Controlled Trials (RCTs)
duration
Medium-Term (3–12 mo)
Intervention
Rama App
Outcomes
HbA1c, Fasting Plasma Glucose, Self-management behaviors
Funding
Non-industry sponsored
Main effects
HbA1c ↓ in both groups, with no clear added benefit from the app
Fasting plasma glucose ↓ in participants younger than 65 years using the app
DSMES score ↑ during follow-up in the app group
Evidence Summary
| Intervention | Outcome | Measured Change | Study Effect |
|---|---|---|---|
 Rama App (Devices & Technology) |  Fasting Plasma Glucose (Glycemic Control) | Decrease | Mixed |
Rama App (Devices & Technology) | HbA1c (Glycemic Control) | Decrease | Limited |
Rama App (Devices & Technology) |  Self-management behaviors (Adherence & Engagement) | Increase | Limited |
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Evidence Suggest
- At 6 months, mean HbA1c was 7.8% in the app group and 8.1% in the control group, but the between-group difference was not statistically significant.
- Fasting plasma glucose was significantly lower at 6 months in the subgroup younger than 65 years assigned to the app.
- The intervention group showed significantly higher DSMES scores from baseline to 6 months, suggesting support for self-management behaviors.
Who this applies to
These findings apply most directly to adults with uncontrolled type 2 diabetes in outpatient care who can use a smartphone. The results are especially relevant to Thai or similar Asian settings where local food databases may improve the usefulness of nutrition tracking.
Keep in Mind
The app was tested on top of diabetes self-management education and support, not instead of it. Because both groups received education, the study mainly shows whether the app adds extra benefit beyond usual structured care. The main HbA1c result was not clearly different, and the strongest glucose signal appeared in a younger subgroup.
Between the Lines
- This was a single-center study with 129 participants.
- The trial was open label, so participant behavior may have been influenced by knowing group assignment.
- Six-month analyses excluded participants with missing outcome data rather than using full intention-to-treat methods.
- Average app adherence was moderate, which may have limited the size of any benefit.
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Journal Reference
Wongdama S, Paemueang W, Sriphrapradang C. A tailor-made mobile app with a local cuisine database for self-management of type 2 diabetes mellitus: randomized controlled trial. JMIR Diabetes. 2025;10:e83685. doi:10.2196/83685
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