scholarly journals The Effect of an mHealth remote monitoring exercise intervention on clinical outcomes in type 2 diabetes patients: a randomized controlled study (Preprint)

2020 ◽  
Author(s):  
Jing Li ◽  
Dong Wei ◽  
Lingyun Ouyang ◽  
Shuyi Liu ◽  
Shuyi Liu ◽  
...  

BACKGROUND Exercise has been recommended as a cornerstone for diabetes management. Supervised exercise is more effective than unsupervised exercise, but is less convenient and inaccessible for most subjects. Exercise under remote monitoring by fitness app and heart rate band may be useful to improve exercise efficiency. OBJECTIVE To determine the feasibility and effectiveness of exercise on type 2 diabetes under remote monitoring using fitness app and heart rate monitor compared with traditional exercise. METHODS This is a prospective, multi-center, randomized controlled trial (RCT). Type 2 diabetic patients without severe complications or comorbidities were recruited. Both groups were asked to follow the same exercise prescription. The app group was given heart rate band plus remote monitoring by app, while the control group was given traditional exercise guidance. Cardiopulmonary endurance, indices of body composition, and other parameters were assessed before and after intervention. The study had an average follow-up of 3 months. RESULTS 101 patients were enrolled and 85 completed the study. With the exception of age and history of hypertension, two groups were similar in most clinical measures. Self-reported total exercise time in control group was longer than app-recorded time in app group (214 vs 193 min/week). However, compared with control group, app group had a larger increase in cardiopulmonary endurance (-2.0 vs 1.0 beats/min, p=0.023) and a larger decrease in body-fat percentage (-1.8 vs-0.8%, p=0.013). There was no difference in HbA1c between two groups, yet four subjects in app group stopped taking hypoglycemic drugs and nine lowered drug dosage, compared with one and two in the control group. There were no serious adverse reactions in both groups. CONCLUSIONS This was the first pragmatic RCT in China that tested the feasibility and preliminary efficacy of the effect of exercise under remote monitoring using app and heart rate band. This study suggested that exercise remotely supervised by app and heart rate band were more effective than unsupervised exercise in patients with type 2 diabetes. CLINICALTRIAL Chinese Clinical Trial Registry number, ChiCTR1800015963

2019 ◽  
Vol 2 (3) ◽  
pp. 135-141
Author(s):  
Ratna Dewi ◽  
Rostinah Manurung ◽  
Sarmaida Siregar

Appropriate diet and physical exercise is part of diabetes management. The role of health professionals is critical to regulating the lifestyle of type 2 DM patients. The study aimed at examining the effectiveness of cell phone-based mentoring on dietary compliance. A quasi-experimental study design, pre and post-test equivalent with the control group. The research was conducted at Bromo Medan Health Center. We recruited 84 diabetic patients and divided into the experimental and control group. The findings showed there was a positive effect on the patients in the experimental group who received the program than patients in the control group who did not receive the application. This strategy is essential and recommended to apply in the routine diet at home. Keywords: short message service (SMS), diet compliance, type 2 diabetes mellitus


2020 ◽  
Author(s):  
Robert Mutagwanya ◽  
Christine Magala Nyago ◽  
Fredrick Nelson Nakwagala

Abstract Background: Consumption of a varied diet reduces the risk of developing a deficiency or excess of any one nutrient. One of the three corner stones of diabetes management is diet and therefore, dietary diversity is key among diabetes patients. Objective: The objective of this study was to establish the impact of nutrition education on the dietary diversity scores (DDS) among type 2 diabetes patients. Methods: Kant et al method was used for scoring dietary diversity. Data were analyzed using the statistical package for social sciences (SPSS version 21). Pair sample t-test was used to compare total DDS after and before nutrition education. P< 0.05 was considered as statistically significant.Subjects: One hundred type 2 diabetic patients were randomly selected and divided into two groups of intervention and control (50 patients in each group) to participate in the study. Data were collected using a pre-tested questionnaire before and after intervention every after one month for a period of four months of intervention.Results: The average age of patients who participated in the study was 48 (40–51) years. Most of the patients were females (65.39%), compared to males (34.01%). At the end of the study period of four months, DDS in the control group decreased from 40.08% to 38.49% (p=0.064) while in the intervention group, DDS increased from 35.30 % to 54.20% (p<0.001). Conclusion: Dietary diversity increased after nutrition education among type 2 diabetes patients.Trial registration: The study was registered and approved on 17th April 2013 by the Research and Ethics committee of Mulago Hospital and Institutional Review Board of Mulago hospital (Protocol MREC 113).


2018 ◽  
Vol 3 ◽  
pp. 139
Author(s):  
J. Jaime Miranda ◽  
María Lazo-Porras ◽  
Antonio Bernabe-Ortiz ◽  
M. Amalia Pesantes ◽  
Francisco Diez-Canseco ◽  
...  

Background: Incentives play a role in introducing health-related benefits, but no interventions using mixed incentives, i.e. a combination of individual and group incentives, have been tested in individuals with type 2 diabetes mellitus (T2DM). We evaluated the feasibility of implementing individual- and mixed-incentives, with and without a supportive partner, on glycated haemoglobin (HbA1c) control and weight loss among patients with T2DM. Methods: This is a feasibility, sex-stratified, single-blinded, randomized controlled study in individuals with T2DM. All participants received diabetes education and tailored goal setting for weight and glycated haemoglobin (HbA1c). Participants were randomly assigned into three arms: individual incentives (Arm 1), mixed incentives-altruism (Arm 2), and mixed incentives-cooperation (Arm 3). Participants were accompanied by a diabetes educator every other week to monitor targets, and the intervention period lasted 3 months. The primary outcome was the change in HbA1c at 3 months from baseline. Weight and change body mass index (BMI) were considered as secondary outcomes. Results: Out of 783 patients screened, a total of 54 participants, 18 per study arm, were enrolled and 44 (82%) completed the 3-month follow-up. Mean baseline HbA1c values were 8.5%, 7.9% and 8.2% in Arm 1, Arm 2, and Arm 3, respectively. At 3 months, participants in all three study arms showed reductions in HbA1c ranging from -0.9% in Arm 2 to -1.4% in Arm 1. Weight and BMI also showed reductions. Conclusions: Individual and mixed cash incentives show important reductions in HbA1c, weight and BMI in patients with type 2 diabetes mellitus after 3 months.  Recruitment and uptake of the intervention were successfully accomplished demonstrating feasibility to conduct larger effectiveness studies to test individual and mixed economic incentives for diabetes management. Registration: ClinicalTrials.gov Identifier NCT02891382


2020 ◽  
Vol 8 (1) ◽  
pp. e001030 ◽  
Author(s):  
Qinglin Lou ◽  
Qing Ye ◽  
Haidi Wu ◽  
Zhiyong Wang ◽  
Robert S Ware ◽  
...  

ObjectivesHighly efficient diabetes management programs are needed for tackling diabetes in China. This study aimed to assess the effectiveness of a clinic-based intensified diabetes management model (C-IDM) in Mainland China.Research design and methodsA 2-year clinic-based randomized controlled trial was conducted among patients with type 2 diabetes in Nanjing, China. The C-IDM intervention components comprised four domains (disease targeting management, express referral channel, expert visit, patients’ self-management) and an integrated running system (disease control centers, general hospitals and local clinics). Control group participants received their usual care, while intervention participants received both the C-IDM package and the usual services. The primary outcome variable was change of hemoglobin A1c (HbA1c). Mixed-effects models were used to compute effect estimates and 95% CI with consideration of both individual and cluster-level confounders.ResultsOverall, 1095 of 1143 participants were assessed at study completion. The mean change in HbA1c was significantly greater in the intervention group than in the control group (mean difference (MD)=−0.57, 95% CI −0.79 to –0.36). Similar results were observed for change in body mass index (MD=−0.29, 95% CI −0.49 to –0.10). Participants in the intervention group were more likely to achieve normal HbA1c and body weight compared with their counterparts in control group after adjusting for potentially confounding variables (adjusted OR=1.94, 95% CI 1.35 to 2.81 and 1.79, 95% CI 1.13 to 2.85, respectively).ConclusionsThe C-IDM model is feasible and effective in large-scale management of patients with type 2 diabetes in China. It has public health implications for tackling the burden of diabetes in China.Trial registration numberChiCTR-IOR-15006019.


2018 ◽  
Vol 3 ◽  
pp. 139
Author(s):  
J. Jaime Miranda ◽  
María Lazo-Porras ◽  
Antonio Bernabe-Ortiz ◽  
M. Amalia Pesantes ◽  
Francisco Diez-Canseco ◽  
...  

Background: Incentives play a role in introducing health-related benefits, but no interventions using mixed incentives, i.e. a combination of individual and group incentives, have been tested in individuals with type 2 diabetes mellitus (T2DM). We evaluated the feasibility of implementing individual- and mixed-incentives, with and without a supportive partner, on glycated haemoglobin (HbA1c) control and weight loss among patients with T2DM. Methods: This is a feasibility, sex-stratified, single-blinded, randomized controlled study in individuals with T2DM. All participants received diabetes education and tailored goal setting for weight and glycated haemoglobin (HbA1c). Participants were randomly assigned into three arms: individual incentives (Arm 1), mixed incentives-altruism (Arm 2), and mixed incentives-cooperation (Arm 3). Participants were accompanied by a diabetes educator every other week to monitor targets, and the intervention period lasted 3 months. The primary outcome was the change in HbA1c at 3 months from baseline. Weight and change body mass index (BMI) were considered as secondary outcomes. Results: Out of 783 patients screened, a total of 54 participants, 18 per study arm, were enrolled and 44 (82%) completed the 3-month follow-up. Mean baseline HbA1c values were 8.5%, 7.9% and 8.2% in Arm 1, Arm 2, and Arm 3, respectively. At 3 months, participants in all three study arms showed reductions in HbA1c ranging from -0.9% in Arm 2 to -1.4% in Arm 1. Weight and BMI also showed reductions. Conclusions: Individual and mixed cash incentives show important reductions in HbA1c, weight and BMI in patients with type 2 diabetes mellitus after 3 months.  Recruitment and uptake of the intervention were successfully accomplished demonstrating feasibility to conduct larger effectiveness studies to test individual and mixed economic incentives for diabetes management. Registration: ClinicalTrials.gov Identifier NCT02891382


2014 ◽  
Vol 155 (22) ◽  
pp. 865-870 ◽  
Author(s):  
Krisztina Nagy ◽  
Evelin Sipos ◽  
Taha El Hadj Othmane

Introductions: Heart rate variability is reduced among patients with hypertension or those with diabetes mellitus. Hypertension and diabetes show frequent co-morbidity, but it is still not entirely clear whether heart arte variability is reduced in non-diabetic patients with hypertension. Aim: The aim of the authors was to evaluate the heart rate variability in hypertensive patients with and without diabetes and in control subjects. Method: 130 patients with hypertension, 48 patients with hypertension and type 2 diabetes mellitus, and 87 control subjects were involved in the study. Minimum, mean and maximum heart rate, and parameters of heart rate variability were measured. Results: The mean of minimum heart rate did not differ significantly between the three groups. However, all other parameters were significantly reduced in patients with hypertension with and without diabetes as compared to the control group. No significant differences were observed between hypertensive patients with and without diabetes mellitus. Conclusions: Heart rate variability is significantly reduced in non-diabetic patients with hypertension. It seems that type 2 diabetes results in no further significant reduction of heart rate variability in patients with hypertension. Orv. Hetil., 2014, 155(22), 865–870.


2019 ◽  
Vol 3 ◽  
pp. 139
Author(s):  
J. Jaime Miranda ◽  
María Lazo-Porras ◽  
Antonio Bernabe-Ortiz ◽  
M. Amalia Pesantes ◽  
Francisco Diez-Canseco ◽  
...  

Background: Incentives play a role in introducing health-related benefits, but no interventions using mixed incentives, i.e. a combination of individual and group incentives, have been tested in individuals with type 2 diabetes mellitus (T2DM). We evaluated the feasibility of implementing individual- and mixed-incentives, with and without a supportive partner, on glycated haemoglobin (HbA1c) control and weight loss among patients with T2DM. Methods: This is a feasibility, sex-stratified, single-blinded, randomized controlled study in individuals with T2DM. All participants received diabetes education and tailored goal setting for weight and glycated haemoglobin (HbA1c). Participants were randomly assigned into three arms: individual incentives (Arm 1), mixed incentives-altruism (Arm 2), and mixed incentives-cooperation (Arm 3). Participants were accompanied by a diabetes educator every other week to monitor targets, and the intervention period lasted 3 months. The primary outcome was the change in HbA1c at 3 months from baseline. Weight and change body mass index (BMI) were considered as secondary outcomes. Results: Out of 783 patients screened, a total of 54 participants, 18 per study arm, were enrolled and 44 (82%) completed the 3-month follow-up. Mean baseline HbA1c values were 8.5%, 7.9% and 8.2% in Arm 1, Arm 2, and Arm 3, respectively. At 3 months, participants in all three study arms showed reductions in HbA1c ranging from -0.9% in Arm 2 to -1.4% in Arm 1. Weight and BMI also showed reductions. Conclusions: Individual and mixed cash incentives show important reductions in HbA1c, weight and BMI in patients with type 2 diabetes mellitus after 3 months.  Recruitment and uptake of the intervention were successfully accomplished demonstrating feasibility to conduct larger effectiveness studies to test individual and mixed economic incentives for diabetes management. Registration: ClinicalTrials.gov Identifier NCT02891382


Author(s):  
Shah Namrata Vinubhai ◽  
Pardeep Agarwal ◽  
Bushra Fiza ◽  
Ramkishan Jat

Background: Serum ferritin is known as an index for body iron stores also as an inflammatory marker and it is influenced by several disease. We were looking for a correlation between HbA1c and S. Ferritin in type 2 DM. Methodology: The present study a total of 150 participants were enrolled of which 100 were confirmed cases of Type 2 Diabetes Mellitus and rest 50 age and sex matched healthy subjects constituted the control group. All were screened for HbA1c, Fasting blood sugar, Post prandial blood sugar and S.Ferritin. Results: A highly significant variation and positive correlation was observed with respect to S.Ferritin and HbA1c levels. Mean S.Ferritin was high in the subgroup with poor glycemic control. Conclusion: The fasting, post prandial sugar levels, HbA1c and S.Ferritin were significantly higher in the diabetic subjects. This study shows a positive correlation between HbA1c and S. Ferritin levels. So we can conclude that in diabetic patients S. Ferritin may serve as an independent marker of poor glycemic and metabolic control. Keywords: Serum ferritin, Type 2 Diabetes Mellitus, HbA1c.


Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 29-LB
Author(s):  
YUTA YOSHIZAWA ◽  
MICHIHIRO HOSOJIMA ◽  
HIDEYUKI KABASAWA ◽  
NAOHITO TANABE ◽  
TADAHIRO KITAMURA ◽  
...  

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