Evaluation of a Web Platform to Record Lifestyle Habits in Subjects at Risk of Developing Type 2 Diabetes in a Middle-Income Population: Prospective Interventional Study

Abstract

Background Lifestyle is the focus of type 2 diabetes (T2D) prevention strategies. Prevention strategies using mobile health (mHealth)–based therapy have shown positive results for T2D prevention in high-income settings, but little is known about their effectiveness in low- and middle-income populations where the burden of T2D is substantial. “Vida Sana” is a web platform designed to record lifestyle habits and medication use within a lifestyle change program. Objective We sought to identify the barriers, feasibility, usability, and effectiveness of Vida Sana to record lifestyle habits in subjects at risk of developing T2D in a middle-income setting. Methods This was a 3-month prospective interventional study in Mexican individuals. A total of 77 subjects at risk of T2D (with prediabetes and BMI between 24 and 40 kg/m2) were selected. Feasibility was assessed by study retention. Usability was evaluated with the System Usability Scale (SUS). Effectiveness measures included changes in weight, body composition, BMI, glycated hemoglobin A1c (HbA1c), and fasting blood glucose from baseline to 3 months. Linear regression models were used to account for covariates. Results The feasibility of Vida Sana was 42%, with 33 subjects using the platform, and the usability was 48.7 (SD 14.24). Reported barriers to platform usage were; difficulty in accessing the platform from difficulty of use (12 subjects, 36%), lack of time to record their habits (11 subjects, 34%), lack of interest to record their habits (6 subjects, 18%), and lack of resources (4 subjects, 11%). The platform was effective for lowering glucose in fasting (–3.1 mg/dL vs –0.11 [SD 8.08] mg/dL; P=.038) and at 2 hours (–16.9 mg/dL vs 2.5 [SD 26.1] mg/dL; P=.045), body fat percentage (–1.3 [–2.2 to –0.7] vs –1.02 [–1.9 to –0.3]; P=.02), and waist circumference (–3.2 [SD 5.1] cm vs –1.7 [SD 5.0] cm; P=.02) independent of their age, sex, treatment, and education level. Conclusions The use of the web platform was effective for improving glycemic and anthropometric parameters in a population at risk of developing diabetes. Improving accessibility and ease of navigation could improve the acceptance of digital health solutions in a middle-income population.

The Use of Mobile Health Interventions for Outcomes among Middle-Aged and Elderly Patients with Prediabetes: A Systematic Review

“…This systematic review was comprised of 19 studies with randomized trial designs [ 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ] and 6 studies [ 55 , 56 , 57 , 58 , 59 , 60 ] with other types of trial designs (pragmatic trial and quasi-experimental). The features of the studies are detailed in Table 1 .…”

“…A total 1866 (94.7%) completed the studies from non-randomized trial design. There are eight studies [ 38 , 47 , 49 , 50 , 56 , 58 , 59 , 60 ] that samples of less than 100 participants. There were three studies with a sample size of more than 1300, two RCT studies [ 52 , 61 ] and 1 pragmatic study [ 57 ].…”

“…There were seven other studies that use a combination examination to establish the diagnosis of prediabetes. Bender, Sharit, Kunthi, Stewart, Sevilla, and Moravcova [ 42 , 45 , 49 , 56 , 59 , 60 ] used three tests, namely HbA1c, OGGT, and Fasting Glucose (FG) levels. Meanwhile, Fukuoka [ 47 ] used a combination of HbA1c and FG assays.…”

“…Bender’s study only intervened in Filipino Americans because they had a higher risk of developing type 2 diabetes [ 49 ]. The shortest studies lasted 3 months, and were found in the Sevilla, Kondo, and Griauzde [ 46 , 50 , 60 ] studies. Khunti’s study had the longest intervention which was 48 months.…”

“…In the Jadad score, the scale runs from 0 to 5, with a score of ≤2 indicating a low-quality report and a score of ≥3 indicating a high-quality report [ 33 ]. Six [ 55 , 56 , 57 , 58 , 59 , 60 ] studies have low quality, according to the analysis. This is due to the trial’s insufficiency of randomization in selecting participants.…”