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 (Preprint)

Abstract

BACKGROUND Lifestyle is the main focus of the Type 2 diabetes (T2D) prevention strategies. mHealth-based therapy has proved 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. OBJECTIVE We sought to identify barriers, feasibility, usability and effectiveness of an electronic platform “Visa Sana”, to record lifestyle habits in subjects at risk of developing type 2 diabetes in a middle-income setting. METHODS This was a 3-months prospective interventional study of subjects at risk of T2D (prediabetes and body mass index (BMI) between 24 kg/m2 and 40 kg/m2.) 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 (HbA1c), and fasting blood glucose from baseline to 3-months visit. Lineal regression models were used to account for covariates. RESULTS The feasibility of Vida Sana was 42.8% (n=33 subjects), and the usability was 48.71% + 14.24. The barriers reported for not using the platform were difficulty for access to the platform (36.36%), lack of time to record their habits (34.09%) lack of interest to record their habits (18.18%), and lack of resources (11.36%) The platform was effective for lowering glucose in fasting (-3.18mg/dL vs -0.11+8.08; p = 0.038) and at 2hr (-16.97mg/dL vs 2.59 + 26.14; p = 0.045) , body fat percent (-1.36 (-2.23 – - 0.75) vs -1.02 (-1.92 - -0.31); p=0.024), and waist circumference (-3.92 + 5.13cm vs -1.73 + 5.01; p=0.023) independent their age, sex, treatment and education attainment. CONCLUSIONS The use of an electronic platform was effective to improve glycemic and anthropometric parameters in a population at risk of developing diabetes. Improving accessibility and ease of navigation could be objectives to improve the acceptance of mobile applications in a middle-income population.