Evaluation of an Electronic Platform to Record Lifestyle Habits in Subjects at Risk of Developing Type 2 Diabetes in a Middle-Income Population

Abstract

Objectives Lifestyle is the main focus of 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 its effectiveness in low- and middle-income populations where the burden of T2D is substantial. We sought to identify barriers, feasibility, usability, and effectiveness of an electronic platform “Vida Sana”, to record lifestyle habits in subjects at risk of developing type 2 diabetes in a middle-income setting. Methods This was a 3-month 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, anthropometric measures, glycated hemoglobin (HbA1c), and fasting blood glucose from baseline to 3-month visit. Linear regression models were used to account for covariates. Results The feasibility of Vida Sana was 42.8% (n = 33 subjects), and the usability was 48.7% ± 14.2. The barriers reported for not using the platform were difficulty for access to the platform (36.3%), lack of time to record their habits (34.0%) lack of interest to record their habits (18.18%), and lack of resources (11.3%) (computer or internet). The platform was effective for lowering glucose in fasting (−3.1 mg/dL vs −0.11 ± 8.08; P = 0.038) and at 2 hr (−16.9 mg/dL vs 2.5 ± 26.1; P = 0.045), body fat % (−1.3 (−2.2 – −0.7) s −1.02 (−1.9 - −0.3); P = 0.024), and waist circumference (−3.2 ± 5.1 cm vs −1.7 ± 5.0; 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. Funding Sources Miguel Aleman Medical Research Award.