Effects of Feedback From Self-Monitoring Devices on Lifestyle Changes in Workers with Diabetes: 3-Month Randomized Controlled Pilot Trial

Abstract

Background Although lifestyle interventions are useful in the prevention and management of diabetes, they can be expensive and time-consuming. There is some evidence on the effectiveness of automated mobile technology for health self-monitoring; however, few studies have used such devices in the occupational health field. Objective We aimed to examine the effectiveness of a digital self-monitoring device on glucose levels and activity of workers with diabetes in Japan. The primary outcomes were changes in blood glucose levels, and the secondary outcomes were changes in weight and BMI. Methods A 2-arm randomized controlled pilot trial was conducted with workers from 23 organizations. The intervention group (n=50) wore an armband activity monitor, a body composition monitor, and a blood pressure monitor for 3 months and received semiautomated weekly email messages tailored to their device data. The control group (n=53) engaged in no self-monitoring. Messages were developed by a physician and a dietician. Postintervention changes in blood glucose levels, weight, and BMI were compared between the intervention and control groups, using blood tests and questionnaires. Results At the end of 3 months, the intervention group showed significantly lower blood glucose levels (HbA1c: intervention group mean 6.4% (SD 0.3%) vs control group mean 6.6% (SD 0.3%); Cohen d=0.7, 95% CI 0.2-1.1; P=.009). There were no significant between-group differences in weight and BMI. Conclusions Mobile digital self-monitoring was effective in improving blood glucose levels in workers with diabetes. The use of digital health devices is a cost-effective way of implementing health self-monitoring for large numbers of individuals in the workplace. However, due to the large volume of missing values in this study, we need to be careful in interpreting the results, and well-designed intervention studies need to be conducted. Trial Registration University Hospital Medical Information Network UMIN000023651; https://upload.umin.ac.jp/cgi-open-bin/icdr/ctr_view_cb.cgi?recptno=R000027244&flwp_key=1008PYbOcXKmk7CAg4Th1FWS

Effectiveness of Digital Health Intervention Strategies on Type 2 Diabetes Management：A Systematic Review and Network Meta-Analysis (Preprint)

“…A total of 27 RCTs [14,50,[53][54][55]57,59,60,66,68,70,72,74,77,78,80,82,84,85,87,88,93,94,[96][97][98]100] assessed the effects of 12 different DHI strategy combinations on HbA1c levels in patients with type 2 diabetes. These 12 strategy combinations encompassed: (1) ABCDEFGHIJKLMNOQR (action planning, communication, cues, engagement, feedback, goal setting, guide, identity, management, model/demonstrate, monitor, prompt, restructure, reward, shape, support, tailor), ( 2) ABDEFGIKLOPQ (action planning, communication, engagement, feedback, goal setting, guide, management, monitor, prompt, shape, stimulate, support), ( 3) FGIKQ (goal setting, guide, management, monitor, support), ( 4)BGKR (communication, guide, monitor, tailor), ( 5) EGIKPR (feedback, guide, management, monitor, stimulate, tailor), ( 6) EKP (feedback, monitor, stimulate), ( 7) DGIKPQR (engagement, guide, management, monitor, stimulate, support, tailor), ( 8) BDFIQ (communication, engagement, goal setting, management, support), (9) BDGI (communication, engagement, guide, management), ( 10) BDGKNOP (communication, engagement, guide, monitor, reward, shape, stimulate), (11) DFGKP (engagement, goal setting, guide, monitor, stimulate), ( 12) GIK (guide, management, monitor).…”

“…(3) The effects of strategy combinations on BMI A total of 11 randomized controlled trials (RCTs) [60,66,70,[72][73][74]78,84,85,97,98] assessed the effects of 9 different DHI strategy combinations on BMI levels in patients with type 2 diabetes. These 9 strategy combinations encompassed: (1) FGIKQ (goal setting, guide, management, monitor, support), ( 2) BGKR (communication, guide, monitor, tailor), ( 3) EKP (feedback, monitor, stimulate), ( 4) BDFGIKLOPQ (communication, engagement, goal setting, guide, management, monitor, prompt, shape, stimulate, support), ( 5) DGIKPQR (engagement, guide, management, monitor, stimulate, support, tailor), ( 6) BDGI (communication, engagement, guide, management), ( 7) DFGKP (engagement, goal setting, guide, monitor, stimulate), ( 8) GIK (guide, management, monitor), ( 9) BDFIQ (communication, engagement, goal setting, management, support).…”

“…(4) The effects of strategy combinations on weight loss A total of 8 RCTs [50,52,70,72,73,84,85,98] assessed the effects of 7 different DHI strategy combinations on weight loss in patients with type 2 diabetes. These 7 strategy combinations encompassed: (1) ABCDEFGHIJKLMNOQR (action planning, communication, cues, engagement, feedback, goal setting, guide, identity, management, model/demonstrate, monitor, prompt, restructure, reward, shape, support, tailor), ( 2) ABCDEFGHIJKLNO (action planning, communication, cues, engagement, feedback, goal setting, guide, identity, management, model/demonstrate, monitor, prompt, reward, shape), ( 3) BGKR (communication, guide, monitor, tailor), ( 4) EKP (feedback, monitor, stimulate), ( 5) BDFGIKLOPQ (communication, engagement, goal setting, guide, management, monitor, prompt, shape, stimulate, support), ( 6) DFGKP (engagement, goal setting, guide, monitor, stimulate), ( 7) BDFIQ (communication, engagement, goal setting, management, support).…”