Reversing Type 2 Diabetes in a Primary Care-Anchored eHealth Lifestyle Coaching Programme in Denmark: A Randomised Controlled Trial

Abstract

The goal of this trial was to investigate whether an eHealth lifestyle coaching programme led to significant weight loss and decreased Haemoglobin A1c (HbA1c) in patients with type 2 diabetes. In an RCT, 170 patients were enrolled from 2018 to 2019 for intervention or control. Inclusion criteria were diagnosed with type 2 diabetes, BMI 30–45 kg/m2, and aged 18–70 years. Exclusion criteria were lacks internet access, pregnant or planning a pregnancy, or has a serious disease. Primary and secondary outcomes were a reduction in body weight and HbA1c. At six months, 75 (75%) patients in the intervention group and 53 (76%) patients in the control group remained in the trial. The mean body weight loss was 4.2 kg (95% CI, −5.49; −2.98) in the intervention group and 1.5 kg (95% CI, −2.57; −0.48) in the control group (p = 0.005). In the intervention group, 24 out of 62 patients with elevated HbA1c at baseline (39%) had a normalized HbA1c < 6.5% at six months, compared to 8 out of 40 patients with elevated HbA1c at baseline (20%) in the control group (p = 0.047). The eHealth lifestyle coaching programme can lead to significant weight loss and decreased HbA1c among patients with type 2 diabetes, compared to standard care.

Long-term weight loss in a 24-month primary care-anchored telehealth lifestyle coaching program: Randomized controlled trial

“…These results are expected to be clinically relevant for patients with T2D when weight loss is sustained for more than two years. 22 Moreover, these findings support that using telehealth 23 lifestyle coaching has comparable remission rates with other more intensive resource-heavy weight-reducing strategies in patients with T2D and probably also for other chronic conditions with overweight as an important issue. 2,3 The importance of the empathic relationship between the person living with obesity and the health care professional delivering the coaching is known from traditional motivational interviewing 24 and previous qualitative studies suggest that this is equally important when using a combination of face-to-face consultations and a collaborative telehealth tool.…”

“…These results are expected to be clinically relevant for patients with T2D when weight loss is sustained for more than two years. 22 Moreover, these findings support that using telehealth 23 lifestyle coaching has comparable remission rates with other more intensive resource-heavy weight-reducing strategies in patients with T2D and probably also for other chronic conditions with overweight as an important issue. 2,3…”

Telenursing needs and influencing factors in patients with type 2 diabetes mellitus: A cross‐sectional study

“…Service prices, health insurance policies and health management privacy also affect social and policy‐related resource access (Ben‐Assuli, 2022; Huter et al, 2022). Christensen et al (2022) showed that an electronic health guidance regimen combined with basic health resources can significantly reduce body weight and HbA1c in patients with T2DM. Based on this study, diabetes‐related medical resources played a key role in telenursing implementation, but patients also play an important role.…”

“…Ladner et al (2022) showed that diabetes telenursing has more potential in rural areas. Studies have shown that (Christensen et al, 2022;Crowley et al, 2022;Iversen et al, 2020;Sjöström et al, 2021;Zhang et al, 2022) telenursing for diabetes can improve blood sugar control (Goh et al, 2021), induce behavioural changes, reduce hospitalization and prevent complications, thereby improving at-home diabetic self-management (María Gómez et al, 2022).The implementation of self-management behaviours requires access to disease-related social support resources, including but not limited to family, friends, medical professionals and reliable information sources (Glasgow et al, 2000). In reality, telenursing is the telematics-based remote implementation of in-person care services (Al-Badri et al, 2022), which by its very nature still depends on actual nursing resources (Anderson et al, 2022).…”

Demystifying diabetes health coaching: A scoping review unveiling the ‘who’ and ‘where’ of health coaching for adults with type 2 diabetes

“…Nine study interventions were delivered in 3 months or less 17,18,30,31,[33][34][35][36]43 and 10 interventions lasted 5-6 months. [22][23][24][25]28,29,32,[40][41][42] Seven study interventions were 1 year long, 16,20,21,26,37,38,44 and three interventions were longer than 1 year. 19,27,39 Most studies evaluated the effects of DHC up until the end of the intervention while 31% of studies continued to conduct follow-ups post-inte rvention, 16,21,25,29,[34][35][36][41][42][43] with the furthest follow-up occurring 17-months post-intervention.…”