Effect of self-managed lifestyle treatment on glycemic control in patients with type 2 diabetes

Abstract

The lack of effective, scalable solutions for lifestyle treatment is a global clinical problem, causing severe morbidity and mortality. We developed a method for lifestyle treatment that promotes self-reflection and iterative behavioral change, provided as a digital tool, and evaluated its effect in 370 patients with type 2 diabetes (ClinicalTrials.gov identifier: NCT04691973). Users of the tool had reduced blood glucose, both compared with randomized and matched controls (involving 158 and 204 users, respectively), as well as improved systolic blood pressure, body weight and insulin resistance. The improvement was sustained during the entire follow-up (average 730 days). A pathophysiological subgroup of obese insulin-resistant individuals had a pronounced glycemic response, enabling identification of those who would benefit in particular from lifestyle treatment. Natural language processing showed that the metabolic improvement was coupled with the self-reflective element of the tool. The treatment is cost-saving because of improved risk factor control for cardiovascular complications. The findings open an avenue for self-managed lifestyle treatment with long-term metabolic efficacy that is cost-saving and can reach large numbers of people.

What Intervention Elements Drive Weight Loss in Blended-Care Behavior Change Interventions? A Real-World Data Analysis with 25,706 Patients

“…One reason for focusing on digital intervention elements is that they enable self-care through assisting with self-management in patients’ everyday lives. A recent study by Dwibedi et al [ 35 ] demonstrated that digital self-management, even without HCP-involvement, was beneficial for body weight, blood glucose levels, systolic blood pressure, and insulin resistance in patients with type 2 diabetes. Assisted self-management with digital means can be realized in multiple ways.…”

Digital innovations for retinal care in diabetic retinopathy

“…Wearables are smart devices that can be worn or Recently, Internet of Wearable Things (IoWT) has emerged as a new segment of IoT [57], empowered by the tremendous growth in the number of interconnected hand-held devices from year to year [58]. Chronic disease management, such as DM, is one field of health care in which IoT is expected to have significant impacts [59]. Dwibedi et al found that using a digital lifestyle tool at least bimonthly significantly improved metabolic control in patients with T2DM and the improvement was sustained during 2 years [59].…”

“…Chronic disease management, such as DM, is one field of health care in which IoT is expected to have significant impacts [59]. Dwibedi et al found that using a digital lifestyle tool at least bimonthly significantly improved metabolic control in patients with T2DM and the improvement was sustained during 2 years [59].…”

Formative Qualitative Research: Design Considerations for a Self-Directed Lifestyle Intervention for Type-2 Diabetes Patients Using Human-Centered Design Principles in Benin

“…Advances in T2D management indicate that medical treatments combined with sustained lifestyle changes such as regular exercise and a healthy diet significantly improve patients’ glycemic control and overall health outcomes [ 9 , 10 ]. There is evidence that self-directed interventions that empower people with diabetes can effectively control biochemical and physical parameters.…”

“…The fatigue from long-term management of T2D sometimes deters patients’ adherence to medical treatments and lifestyle recommendations leading to worse glycemic and health outcomes. The negative impacts of non-adherence to T2D therapies and lifestyle recommendations are particularly severe among populations living in resource-constraint settings, where social safety nets are almost non-existent, and/or where remedial clinical treatments are not accessible to most of the population [ 9 ]. The considerable burden of poorly managed T2D in low-resource contexts establishes the imperative to design and implement disease management strategies responsive to people’s needs and well adapted to constraints within their contexts.…”