Improved Glycemic Control With a Digital Health Intervention in Adults With Type 2 Diabetes: Retrospective Study (Preprint)

2021 ◽  
Author(s):  
Gretchen Zimmermann ◽  
Aarathi Venkatesan ◽  
Kelly Rawlings ◽  
Michael Scahill
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Digital Health ◽  
Management Program ◽  
Health Intervention ◽  
Diabetes Management Program ◽  
Program Engagement

BACKGROUND Traditional lifestyle interventions have shown limited success in improving diabetes related outcomes. Digital interventions with continuously available support and personalized educational content may offer unique advantages for self-management and glycemic control. OBJECTIVE In the present study, we evaluate changes in glycemic control among participants with type 2 diabetes who enrolled in a digital diabetes management program. METHODS The study employed a single-arm, retrospective design. A total of 950 participants with a HbA1c baseline value of at least 7.0% enrolled in the Vida Health Diabetes Management Program. The intervention included one-to-one remote sessions with a Vida provider and structured lessons and tools related to diabetes management. Hemoglobin A1c (HbA1c) was the primary outcome measure. A total of 258 (27.2%) participants had a follow-up HbA1c completed at least 90 days from program start. Paired t-tests were utilized to evaluate changes in HbA1c between baseline and follow-up. Additionally, a cluster-robust multiple regression analysis was employed to evaluate the relationship between high and low program engagement and HbA1c change. A repeated measures ANOVA was used to evaluate difference in HbA1c as a function of measurement period (ie, pre-Vida enrollment, baseline, and post-enrollment follow-up). RESULTS We observed a significant reduction in HbA1c of -0.81 points between baseline (M = 8.68, SD = 1.7) and follow-up (M = 7.88, SD = 1.46), t(257) = 7.71, P = .00). Among participants considered high-risk (baseline HbA1c >= 8), there was an average reduction of -1.44 points between baseline (M = 9.73, SD = 1.68) and follow-up (M = 8.29, SD = 1.64), t(139) = 9.14, P = .00). Additionally, average follow-up HbA1c (M = 7.82, SD = 1.41) was significantly lower than pre-enrollment HbA1c (M = 8.12, SD = 1.46), F(2, 210) = 22.90, P = .00. There was also significant effect of engagement on HbA1c change, β = -.60, P = .00, such that high engagement was associated with a greater decrease in HbA1c (M = -1.02, SD = 1.60) compared to low-engagement, (M = -.61, SD = 1.72). CONCLUSIONS The present study revealed clinically meaningful improvements in glycemic control among participants enrolled in a digital diabetes management intervention. Higher program engagement was associated with greater improvements in HbA1c. The findings of the present study suggest that digital health intervention may represent an accessible, scalable, and effective solution to diabetes management and improved HbA1c. The study was limited by a non-randomized, observational design and limited post-enrollment follow-up data.

scholarly journals Design, implementation, and evaluation of a pediatric and adolescent type 2 diabetes management program at a tertiary pediatric center

2014 ◽  
pp. 321 ◽  
Author(s):  
M. Constantine Samaan ◽  
Marlie Valencia ◽  
Connie Cheung ◽  
Boguslaw Wilk ◽  
Keith Lau ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Management ◽  
Management Program ◽  
Diabetes Management Program ◽  
Pediatric Center

scholarly journals Improved Glycemic Control With a Digital Health Intervention in Adults With Type 2 Diabetes: Retrospective Study (Preprint)

JMIR Diabetes ◽  
10.2196/28033 ◽  
2021 ◽  
Author(s):  
Gretchen Zimmermann ◽  
Aarathi Venkatesan ◽  
Kelly Rawlings ◽  
Michael Scahill
Keyword(s):  
Type 2 Diabetes ◽  
Retrospective Study ◽  
Glycemic Control ◽  
Digital Health ◽  
Health Intervention

scholarly journals Exploration of Fatalism and Religiosity by Gender and Varying Levels of Engagement Among Mexican-American Adults of a Type 2 Diabetes Management Program

2021 ◽  
Vol 9 ◽  
Author(s):  
Cindy Lynn Salazar-Collier ◽  
Belinda M. Reininger ◽  
Anna V. Wilkinson ◽  
Steven H. Kelder
Keyword(s):  
Type 2 Diabetes ◽  
Mexican American ◽  
Diabetes Management ◽  
Healthcare Setting ◽  
Structured Interview ◽  
Management Program ◽  
Care Management Program ◽  
Diabetes Management Program

Objectives: Purpose of study is to explore the roles religiosity and fatalistic beliefs play in diabetes management among newly, currently, and long-term enrolled Mexican-American participants in a Type 2 diabetes mellitus (T2DM) chronic care management program.Methods: In 2017, study participants (n = 15) completed a semi-structured interview in their preferred language (English or Spanish). Sample was stratified by amount of time individual had been enrolled as a participant of the Salud y Vida program: newly, currently, or long-term. Interviews assessed religious beliefs, beliefs concerning the cause(s) of diabetes, perceived relationship between religiosity and fatalistic beliefs with T2DM management, and the appropriateness of discussing such topics with a health professional. Interview responses were analyzed using ATLAS.ti 8.Results: Themes identified included: perceived autonomy over diabetes prognosis, motivators for self-care, discussions of personal beliefs in the healthcare setting, and the church's role in diabetes management.Conclusions: Among this sample, religiosity and religious fatalism played a complex role in coping with and managing diabetes. Long-term enrolled and male participants expressed beliefs of divine control over health, and a connection between religiosity and health behavior. Long-term enrolled participants felt religious and fatalistic beliefs may be suitable and beneficial to discuss in the healthcare setting.

scholarly journals Lysulin and Testing HbA1c in the Pharmacy or at Home-How the Pharmacist can help their Customers with Diabetes to Better Health

2019 ◽  
pp. 30-32
Author(s):  
John F Burd
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Management ◽  
Nutritional Supplement ◽  
Management Program ◽  
Lifestyle Changes ◽  
Healthcare Team ◽  
Double Blind ◽  
Diabetes Management Program ◽  
At Home

Pharmacists can be part of the healthcare team to help people with diabetes and prediabetes to better health. Obesity and type 2 diabetes are a worldwide epidemic and a problem that can be helped dramatically with lifestyle changes (diet and exercise) combined with treatment with drugs and supplements. Lysulin is a patent-pending nutritional supplement that contains lysine, zinc and vitamin C and has been shown in double blind placebo controlled studies to help people with prediabetes and type 2 diabetes to better glycemic control and lower their HbA1c. The pharmacist needs to be aware of this breakthrough and inform his customers of the availability of this new product for improving their health. In addition, HbA1c testing at the pharmacy or at home can be very useful in helping people with diabetes know how well their diabetes management program is working.

Glycemic Relapse in a Collaborative Primary Care-Based Type 2 Diabetes Management Program

2021 ◽  
Author(s):  
Sarah E. Wheeler ◽  
Tamara Struebing ◽  
Rachel L.C. Drury ◽  
Lauren Caruso ◽  
Bi Qing Teng ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Diabetes Management ◽  
Management Program ◽  
Diabetes Management Program ◽  
Collaborative Primary Care

scholarly journals A Mobile Lifestyle Management Program (GlycoLeap) for People With Type 2 Diabetes: Single-Arm Feasibility Study (Preprint)

2018 ◽  
Author(s):  
David Koot ◽  
Paul Soo Chye Goh ◽  
Robyn Su May Lim ◽  
Yubing Tian ◽  
Teng Yan Yau ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Feasibility Study ◽  
User Satisfaction ◽  
Primary Outcome ◽  
Management Program ◽  
Secondary Outcome ◽  
Lifestyle Management ◽  
Program Engagement

BACKGROUND Singapore’s current prevalence of diabetes exceeds 13.6%. Although lifestyle modification can be effective for reducing the risks for complications of type 2 diabetes mellitus (T2DM), traditional lifestyle interventions are often difficult to administer in the primary care setting due to limited resources. Mobile health apps can address these limitations by offering low-cost, adaptable, and accessible platforms for disseminating lifestyle management interventions. OBJECTIVE Using the RE-AIM evaluation framework, this study assessed the potential effectiveness and feasibility of GlycoLeap, a mobile lifestyle management program for people with T2DM, as an add-on to standard care. METHODS This single-arm feasibility study recruited 100 patients with T2DM and glycated hemoglobin (HbA1c) levels of ≥7.5% from a single community health care facility in Singapore. All participants were given access to a 6-month mobile lifestyle management program, GlycoLeap, comprising online lessons and the Glyco mobile phone app with a health coaching feature. The GlycoLeap program was evaluated using 4 relevant dimensions of the RE-AIM framework: (1) reach (percentage who consented to participate out of all patients approached), (2) effectiveness (percentage point change in HbA1c [primary outcome] and weight loss [secondary outcome]), (3) implementation (program engagement as assessed by various participatory metrics), and (4) maintenance (postintervention user satisfaction surveys to predict the sustainability of GlycoLeap). Participants were assessed at baseline and at follow-up (≥12 weeks after starting the intervention). RESULTS A total of 785 patients were approached of whom 104 consented to participate, placing the reach at 13.2%. Four were excluded after eligibility screening, and 100 patients were recruited. Program engagement (implementation) started out high but decreased with time for all evaluated components. Self-reported survey data suggest that participants monitored their blood glucose on more days in the past week at follow-up compared to baseline (P<.001) and reported positive changes to their diet due to app engagement (P<.001) (implementation). Primary outcome data were available for 83 participants. Statistically significant improvements were observed for HbA1c (–1.3 percentage points, P<.001) with greater improvements for those who logged their weight more often (P=.007) (effectiveness). Participants also had a 2.3% reduction in baseline weight (P<.001) (effectiveness). User satisfaction was high with 74% (59/80) and 79% (63/80) of participants rating the app good or very good and claiming that they would probably or definitely recommend the app to others, respectively (maintenance). CONCLUSIONS Although measures of program engagement decreased with time, clinically significant improvements in HbA1c were achieved with the potential for broader implementation. However, we cannot rule out that these improvements were due to factors unrelated to GlycoLeap. Therefore, we would recommend evaluating the effectiveness and cost effectiveness of GlycoLeap using a randomized controlled trial of at least 12 months. CLINICALTRIAL ClinicalTrials.gov NCT03091517; https://clinicaltrials.gov/ct2/show/NCT03091517 (Archived by WebCite at http://www.webcitation.org/77rNqhwRn)

scholarly journals Clinical Features, Biochemical Profile, and Response to Standard Treatment in Lean, Normal-Weight, and Overweight/Obese Indian Type 2 Diabetes Patients

2021 ◽  
Vol 17 (2) ◽  
pp. 68-74
Author(s):  
Ahmad Faraz ◽  
Hamid Ashraf ◽  
Jamal Ahmad
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Normal Weight ◽  
Cross Sectional ◽  
Northern India

BACKGROUND: Much evidence is available on the relationship between type 2 diabetes mellitus (T2D) and obesity, but less on T2D in lean individuals. AIM: This study was conducted in 12,069 T2D patients from northern India to find out which clinical and biochemical features are related to lean, normal weight, and overweight/obese T2D patients. METHODS: The study was conducted at two endocrine clinics in northern India as a retrospective cross-sectional study. The records of all patients who attended these clinics from January 2018 to December 2019 were screened. After screening 13,400 patients, 12,069 were labelled as type 2 diabetes mellitus according to the criteria of the American Diabetes Association, 2020, and were included in the study. The patients were subdivided into the three groups by their body mass index (BMI): lean (BMI < 18), normal weight (BMI = 18-22.9), overweight/obese (BMI ≥ 23). The study evaluated how the three subgroups responded to standard diabetes management, including antidiabetic medication and lifestyle interventions. RESULTS: Of a total of 12,069 patients 327 (2.7%) were lean, 1,841 (15.2%) of normal weight, and 9,906 (82.1%) overweight/obese. Lean patients were younger, but had more severe episodes of hyperglycemia. All three subgroups experienced significant improvements in glycemic control during follow-up; HbA1c values were significantly lowered in the overweight/obese group during follow-up compared with baseline. CONCLUSIONS: While overweight/obese patients could benefit from the improvements in glycemic control achieved by lowering HbA1c, lean and normal-weight patients had more severe and difficult-to-control hyperglycemia.

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