scholarly journals A Novel Approach for Fully Automated, Personalized Health Coaching for Adults with Prediabetes: Pilot Clinical Trial (Preprint)

2017 ◽  
Author(s):  
Estelle Everett ◽  
Brian Kane ◽  
Ashley Yoo ◽  
Adrian Dobs ◽  
Nestoras Mathioudakis
Keyword(s):  
Weight Loss ◽  
Blood Glucose ◽  
Intervention Program ◽  
Retention Rate ◽  
Fasting Blood Glucose ◽  
Cost Effective ◽  
Novel Approach ◽  
Cost Effective Method ◽  
System Usability Scale ◽  
Metabolic Equivalent Of Task

BACKGROUND Prediabetes is a high-risk state for the future development of type 2 diabetes, which may be prevented through physical activity (PA), adherence to a healthy diet, and weight loss. Mobile health (mHealth) technology is a practical and cost-effective method of delivering diabetes prevention programs in a real-world setting. Sweetch (Sweetch Health, Ltd) is a fully automated, personalized mHealth platform designed to promote adherence to PA and weight reduction in people with prediabetes.  OBJECTIVE The objective of this pilot study was to calibrate the Sweetch app and determine the feasibility, acceptability, safety, and effectiveness of the Sweetch app in combination with a digital body weight scale (DBWS) in adults with prediabetes. METHODS This was a 3-month prospective, single-arm, observational study of adults with a diagnosis of prediabetes and body mass index (BMI) between 24 kg/m2 and 40 kg/m2. Feasibility was assessed by study retention. Acceptability of the mobile platform and DBWS were evaluated using validated questionnaires. Effectiveness measures included change in PA, weight, BMI, glycated hemoglobin (HbA1c), and fasting blood glucose from baseline to 3-month visit. The significance of changes in outcome measures was evaluated using paired t test or Wilcoxon matched pairs test. RESULTS The study retention rate was 47 out of 55 (86%) participants. There was a high degree of acceptability of the Sweetch app, with a median (interquartile range [IQR]) score of 78% (73%-80%) out of 100% on the validated System Usability Scale. Satisfaction regarding the DBWS was also high, with median (IQR) score of 93% (83%-100%). PA increased by 2.8 metabolic equivalent of task (MET)–hours per week (SD 6.8; P=.02), with mean weight loss of 1.6 kg (SD 2.5; P<.001) from baseline. The median change in A1c was −0.1% (IQR −0.2% to 0.1%; P=.04), with no significant change in fasting blood glucose (−1 mg/dL; P=.59). There were no adverse events reported. CONCLUSIONS The Sweetch mobile intervention program is a safe and effective method of increasing PA and reducing weight and HbA1c in adults with prediabetes. If sustained over a longer period, this intervention would be expected to reduce diabetes risk in this population. CLINICALTRIAL ClincialTrials.gov NCT02896010; https://clinicaltrials.gov/ct2/show/NCT02896010 (Archived by WebCite at http://www.webcitation.org/6xJYxrgse)

scholarly journals Association of a Self-Paid Medically Supervised Weight Management Program with Reversal of Obesity-Associated Impaired Fasting Glucose

2021 ◽  
Vol 11 (2) ◽  
pp. 386-394
Author(s):  
Vijaya Surampudi ◽  
Xinkai Zhou ◽  
Chi-Hong Tseng ◽  
David Heber ◽  
Zhaoping Li
Keyword(s):  
Weight Loss ◽  
Blood Glucose ◽  
Retrospective Analysis ◽  
Weight Management ◽  
Impaired Fasting Glucose ◽  
Fasting Glucose ◽  
Fasting Blood Glucose ◽  
Management Program ◽  
Weight Management Program ◽  
Glucose Levels

Aims: The progression of prediabetes to T2DM can be delayed through diet modification and weight management. However, the intensive lifestyle program is often not covered by medical insurance. This retrospective analysis evaluates the association of a patient self-paid weight management program on an improvement of blood sugar in overweight and obese patients with impaired fasting glucose (IFG). Methods: The medical records of 4634 patients who participated in the self-pay UCLA Weight Management Program were reviewed and 2572 patients met the criteria for this retrospective analysis to examine whether this program was associated with the reversal of IFG over 3 months among 1396 patients with normal fasting glucose (NFG) and 1176 with IFG. Results: The patients with IFG lost comparable amounts of weight (10.5 ± 1.3 kg) at three months, as did the subjects with NFG (10.1 ± 1.3 kg). Fasting blood glucose in the IFG group decreased from 108.49 ± 6.4 to 101.8 ± 9.41 mg/dL (p < 0.0001) after three months. There were also significant reductions in triglycerides, and both systolic and diastolic blood pressure in both groups in association with weight loss. Conclusion: Our medically supervised self-pay multidisciplinary weight management program was associated with reduced fasting blood glucose levels in patients with IFG over three months with comparable weight loss to patients with NFG.

scholarly journals 3461 A community-based, low calorie dietary intervention for the prevention and remission of type 2 diabetes mellitus

2019 ◽  
Vol 3 (s1) ◽  
pp. 137-137
Author(s):  
Kim Qumby ◽  
Colette George ◽  
Ian Hambleton ◽  
Patrick Olivier ◽  
Nigel Unwin
Keyword(s):  
Weight Loss ◽  
Blood Glucose ◽  
Dietary Intervention ◽  
Fasting Blood Glucose ◽  
Community Setting ◽  
Diabetes Remission ◽  
Dietary Advice ◽  
Low Calorie ◽  
Health Team ◽  
Physical Measurements

OBJECTIVES/SPECIFIC AIMS: The aim is to investigate if sustained weight loss due to caloric restriction can be achieved in a community setting, using faith-based organisations (FBOs) as hubs; and if this weight loss can lead to the re-establishment of normal metabolism (using the normalisation of blood sugar levels while off glucose lowering medication as a proxy) in a person with pre-diabetes or T2DM. METHODS/STUDY POPULATION: Members of the FBO with either a diagnosis of T2DM for <6 years or pre-diabetes as defined by the American Diabetes Association (ADA); and a Body Mass index (BMI) of ≥27 kg/m2 are eligible. After counselling, participants will be placed on a 12 week low calorie liquid diet, supplemented by low carbohydrate vegetables, totalling approximately 840 kcal/day. During this time, participants will be monitored weekly at their FBO by trained members of their congregation, with oversight from the study team, for change in weight, fasting blood glucose, waist and hip circumference and blood pressure. This will be followed by a 3 month period during which participants will receive ongoing dietary advice as they transfer to a balanced, reduced calorie, solid diet. Physical measurements will be monitored monthly during this 3 month period. The next 6 months is a period where the participants and the FBO health team move towards ‘independence’. This involves further training of the FBO health team and participants in healthy lifestyle habits; and a commitment by the leadership of the FBO to assume ‘ownership’ for NCD monitoring within their community. Physical measurements will be repeated at the end of one year. RESULTS/ANTICIPATED RESULTS: Based on previous studies, we expect that participants who are compliant to the diet will lose approximately 2.2 kg per week over the 12 week period. This will be associated with rapid (within 1 week) normalisation of fasting blood glucose levels (<7mmol / L). We expect that, due to the accessibility of NCD monitoring and support, that participants to be satisfied with their care and compliant to their regime and that the results of the first 12 weeks will be sustained at the 12 month follow up. We expect that the FBO leadership will assume the responsibility of continuing and NCD programme, not only for the local congregation but for the surrounding community. DISCUSSION/SIGNIFICANCE OF IMPACT: Diabetes remission with a low calorie diet is a viable intervention for T2DM remission however social support is key to an individual’s success. This novel study which proposes institution of a diabetes remission intervention which fits into the participant’s locale and involves peer support, should increase long-term success.

scholarly journals Effect of different extracts of Aloe Vera gel (Aloe Barbadensis) on blood glucose level of alloxan induced hyperglycaemic mice

2016 ◽  
Vol 44 (2) ◽  
pp. 61-66
Author(s):  
Shammin Haque ◽  
Ferdous Ara ◽  
Md Jalaluddin Iqbal ◽  
Sheikh Nazrul Islam
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Fasting Blood Glucose ◽  
Aloe Vera ◽  
Ethanolic Extract ◽  
Cost Effective ◽  
Aloe Barbadensis ◽  
Aloe Vera Gel ◽  
Dried Extract

This study was conducted to evaluate the effect of different extracts of Aloe Vera gel in alloxan induced hyperglycaemic mice.Three different extracts of Aloe Vera gel (dried extract, ethanolic extract and fresh raw extract) were orally administered at 300 mg/kg body weight for 28 days. The fasting blood glucose level was estimated both in normal and alloxan induced hyperglycaemic mice. It was found that, when compared with the control, there was a significant reduction in blood glucose level in all three experimental groups. Ethanolic and fresh raw gel extracts were more effective than the dried extract. The extracts produced similar results when compared with gliclazide. It can be concluded that, the administration of Aloe Vera gel extract significantly decreases blood glucose level in hyperglycaemic mice. Aloe Vera gel can therefore be a natural remedy and a cost effective resource for the management of diabetes.Bangladesh Med J. 2015 May; 44 (2): 61-66

scholarly journals Community health worker-led, technology-enabled private sector intervention for diabetes and hypertension management among urban poor: a retrospective cohort study from large Indian metropolitan city

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045246
Author(s):  
Sarang Deo ◽  
Preeti Singh
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Private Sector ◽  
Community Health ◽  
Low Income ◽  
Retrospective Cohort ◽  
Retention Rate ◽  
Fasting Blood Glucose ◽  
Mean Difference ◽  
Secondary Outcome

ObjectivesWe assessed the effectiveness of community health workers (CHWs)-led, technology-enabled programme as a large-scale, real-world solution for screening and long-term management of diabetes and hypertension in low-income and middle-income countries.DesignRetrospective cohort design.SettingForty-seven low-income neighbourhoods of Hyderabad, a large Indian metropolis.ParticipantsParticipants (aged ≥20 years) who subscribed to an ongoing community-based chronic disease management programme employing CHWs and technology to manage diabetes and hypertension.Primary and secondary outcome measuresWe used deidentified programme data between 1 March 2015 and 8 October 2018 to measure participants’ pre-enrolment and post-enrolment retention rate and within time-interval mean difference in participants’ fasting blood glucose and blood pressure using Kaplan-Meier and mixed-effect regression models, respectively.Results51 126 participants were screened (median age 41 years; 65.2% women). Participant acquisition rate (screening to enrolment) was 4%. Median (IQR) retention period was 163.3 days (87.9–288.8), with 12 months postenrolment retention rate as 16.5% (95% CI 14.7 to 18.3). Reduction in blood glucose and blood pressure levels varied by participants’ retention in the programme. Adjusted mean difference from baseline ranged from −14.0 mg/dL (95% CI −18.1 to −10.0) to −27.9 mg/dL (95% CI −47.6 to −8.1) for fasting blood glucose; −2.7 mm Hg (95% CI −7.2 to 2.7) to −7.1 mm Hg (95% CI −9.1 to −4.9) for systolic blood pressure and −1.7 mm Hg (95% CI −4.6 to 1.1) to −4.2 mm Hg (95% CI −4.9 to −3.6) for diastolic blood pressure.ConclusionsCHW-led, technology-enabled private sector interventions can feasibly screen individuals for non-communicable diseases and effectively manage those who continue on the programme in the long run. However, changes in the model (eg, integration with the public health system to reduce out-of-pocket expenditure) may be needed to increase its adoption by individuals and thereby improve its cost-effectiveness.

Physiological and Therapeutic Outcomes of Intermittent Fasting versus Calorie-Restriction Diet in Patients suffering from Metabolic Syndrome

2019 ◽  
Vol 3 (1) ◽  
pp. 4-19
Author(s):  
Doreen Susanne Micallef
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Weight Loss ◽  
Blood Glucose ◽  
Calorie Restriction ◽  
Fasting Blood Glucose ◽  
Hdl Cholesterol ◽  
Intermittent Fasting ◽  
Retrospective Case ◽  
Restriction Diet

The main objective of this study was to determine whether an intermittent fasting diet in combination with a CR diet results in better outcomes on risk factors associated with metabolic syndrome (such as lowering of triglycerides, fasting blood glucose, and blood pressure decrease in abdominal obesity and an increase in HDL-cholesterol and related weight loss for both male and female patients) than with a conventional CR diet alone. A 12-week retrospective case-control study was carried out and involved 78 females and 22 males who exhibited or were receiving medications for three or more conditions related to metabolic syndrome and who completed the study out of 120 participants at baseline. These were randomly assigned to either a conventional calorie-restriction diet or to an intermittent-fasting diet. Relevant baseline parameters were measured during the first encounter and were then repeated after twelve weeks. Professional contact was maintained on a fortnightly basis for both groups. Subjects randomly assigned to the intermittent fasting diet lost more weight than subjects on a conventional calorie-restriction diet after 12 weeks (mean ± SD, 5.7 ± 3.2 kg vs 11.4 ± 6.4 kg; p < 0.001). There were also statistically significant decreases in waist circumference (10.1 ± 7.2 cm vs 4.5 ± 3.3 cm; p < 0.001), serum triglycerides (0.31 ± 0.29 mmol/l vs 0.16 ± 0.16 mmol/l; p = 0.002), and systolic blood pressure (11.1 ± 8.2 mm Hg vs 5.2 ± 4.8 mm Hg; p < 0.001) and an increase in HDL-cholesterol (0.25 ± 0.16 vs 0.14 ± 0.15 mmol/l; p = 0.001). However, no statistically significant changes in diastolic blood pressure and fasting blood glucose were recorded. The intermittent fasting diet gave better weight loss outcomes (6.67% vs 12.35%) than did the conventional calorie restriction diet when compared to the baseline weight after the conclusion of the 12-week programme. The intermittent fasting diet was also associated with statistically significant improvements in four out of the six parameters measured and associated with metabolic syndrome. Longer-term studies are required to determine whether these outcomes will be maintained over longer periods of time assuming that there is compliance by the participants.

Abstract P199: A Digital Health Platform For Weight Loss In Metabolic Syndrome: A 6-month Prospective Study In China

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Conor Senecal ◽  
Maria Collazo-Clavell ◽  
Mariza de Andrade ◽  
Lilach O Lerman ◽  
Amir Lerman ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Weight Loss ◽  
Prospective Study ◽  
Digital Health ◽  
Cost Effective ◽  
Smartphone Application ◽  
Meal Replacement ◽  
Face To Face ◽  
Cost Effective Method ◽  
Metabolic Syndrome Components

Introduction: Metabolic Syndrome represents a constellation of findings known to increase cardiovascular risk and all-cause mortality and is becoming more frequent in China. Smartphone applications may provide a cost-effective method to engage in weight loss and improve metabolic syndrome components. Methods: Prospective study of changes in weight and metabolic syndrome risk factors at 6 weeks and 6 months using a smartphone application utilizing a wireless scale, meal replacement biscuits and e-coaching in China. All participants had or were at high risk for metabolic syndrome and all interaction was online, without face to face contact. Results: 218 individuals ,55% female, participated. Median weight loss at 6 weeks and 6 months was 7.3kg and 8.4 kg (P<0.001) respectively. At baseline, 60% met a diagnosis of metabolic syndrome this dropped to 38% at 6 weeks (P<0.001) and stayed at 38% at 6 months (P<0.001). At 6 week the prevalence of all components of metabolic syndrome were improved (P<0.05) except HDL. Conclusions: A smartphone weight loss platform that utilizes a wireless scale, meal replacement biscuits and e-coaching was associated with significant weight loss and improvement in several metabolic syndrome components at 6 weeks and 6 months. This program may provide a scalable intervention against metabolic syndrome, especially in developing countries such as China.

Collecting Parent Reports of Behaviour: A Clinical Note

1992 ◽  
Vol 9 (1) ◽  
pp. 50-51 ◽  
Author(s):  
Colin MacDougall
Keyword(s):  
Intervention Program ◽  
Cost Effective ◽  
Easy Access ◽  
Health Clinic ◽  
Management Skills ◽  
Behaviour Management ◽  
Clinical Note ◽  
Parent Reports ◽  
Cost Effective Method ◽  
Children’S Behaviour

The aim of this clinical note is to describe a cost effective method of collecting parent reports of their children's behaviour, and to stimulate research and discussion about its application.The method was developed in a community based children's mental health clinic which saw many parents who sought help to improve the noncompliant behaviour of their children. Behavioural methods were used extensively because they often lead to lasting changes, are cost effective, and are accepted by parents.An 8-week group program taught parents to observe and record their children's behaviour, and to use these records with behaviour management skills and problem-solving techniques to develop their own approach to discipline. Behaviour management skills included reinforcement, time-out, extinction, effective use of commands, house rules, and contracts.Therapists wanted to collect data frequently to assess problems, tailor an intervention program for the family's needs, and to evaluate the extent and maintenance of change. In addition, therapists wished to monitor the client's progress and involvement with the program and take early steps to correct any problems. The research component required regular data to evaluate the overall outcome and to analyse the effect of particular components of the program.Unfortunately, the methodological standard of using independent observers to rate changes in the behaviour of families was judged to be inappropriate in the clinic. With a small number of staff facing a high demand for services, it was argued that the expense of independent observers was difficult to justify. Staff favouring nonbehavioural approaches and those less enthusiastic about research perceived the use of independent observers as intrusive and unwieldy. There was no easy access to researchers, grant funds, or tertiary institutions who could assist.

scholarly journals Effect of time restricted eating on body weight and fasting glucose in participants with obesity: results of a randomized, controlled, virtual clinical trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pamela M. Peeke ◽  
Frank L. Greenway ◽  
Sonja K. Billes ◽  
Dachuan Zhang ◽  
Ken Fujioka
Keyword(s):  
Clinical Trial ◽  
Weight Loss ◽  
Body Weight ◽  
Blood Glucose ◽  
Dietary Intervention ◽  
Fasting Blood Glucose ◽  
Exercise Program ◽  
Management Program ◽  
Controlled Clinical Trial ◽  
Randomized Controlled

Abstract Background Time restricted eating (TRE) is an emerging dietary intervention for weight loss that is hypothesized to reinforce the metabolic benefits of nightly fasting/ketosis. This pilot study investigated the effectiveness of a daily 14-h metabolic fast (14:10 TRE beginning after dinner, a “fasting snack” at hour 12, and ending with breakfast 14 h later) combined with a commercial weight management program on body weight and fasting blood glucose (FBG) in individuals with obesity. We also investigated the effect of the low-calorie, high-fat, low-carbohydrate, and low-protein “fasting snack” on blood glucose. Methods This 8-week, randomized, controlled, clinical trial included men and women (BMI ≥ 30 kg/m2) between June and October 2020. Study procedures were conducted remotely. Participants were randomized to 14:10 or 12-h TRE (12:12, active comparator) and prescribed a diet (controlled for calories and macronutrient composition) and exercise program that included weekly customized counseling and support. The primary outcome was change from baseline in body weight in the 14:10 group. Results Of the 78 randomized participants, 60 (n = 30/group) completed 8 weeks. The LS mean change from baseline in weight in the 14:10 group was −8.5% (95% CI −9.6 to −7.4; P < 0.001) and −7.1% (−8.3 to −5.8; P < 0.001) in the 12:12 group (between group difference −1.4%; −2.7 to −0.2; P < 0.05). There was a statistically significant LS mean change from baseline to week 8 in FBG in the 14:10 group of −7.6 mg/dl (95% CI −15.1 to −0.1; P < 0.05) but not in the 12:12 group (−3.1 mg/dl, −10.0 to 3.7; P = NS). Both interventions resulted in a larger reduction in FBG in participants with elevated FBG (≥100 mg/dl) at baseline (both P < 0.05). Conclusions In participants with obesity who completed 8 weeks of the 14:10 TRE schedule combined with a commercial weight loss program, there was statistically significant and clinically meaningful weight loss and improvements in FBG.

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