Self-tracking of Physical Activity in People With Type 2 Diabetes

Kooiman, Thea; Groot, Martijn de; Hoogenberg, Klaas; Krijnen, Wim P.; Schans, Cees P. van der; Kooy, Adriaan

doi:10.1097/cin.0000000000000443

Cited by 67 publications

(79 citation statements)

References 40 publications

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“…Most of the studies (35/37, 95%) were parallel RCTs, while two studies used a factorial design and a cross-over design, respectively [ 79 , 101 ]. Among the parallel RCTs, 27 featured two arms [ 48 , 57 , 67 - 73 , 76 , 78 , 81 , 83 - 85 , 88 - 93 , 95 , 96 , 99 , 102 - 104 ], while eight featured multiple intervention arms [ 49 , 77 , 82 , 86 , 87 , 94 , 97 , 98 ]. For instance, Finkelstein et al [ 82 ] conducted an RCT with four groups; three groups receiving a Fitbit device and the other receiving interventional components differing in terms of the type of financial incentives.…”

Section: Resultsmentioning

confidence: 99%

“…As expected, there was a wide variety of Fitbit devices used in the included studies. Most of them (17/37, 46%) used clip-on devices such as Fitbit Zip [ 76 , 79 , 82 , 83 , 87 , 88 , 90 , 92 , 96 - 98 ], Fitbit One [ 48 , 68 , 81 , 84 , 94 ], and Fitbit Ultra [ 85 ]. Seven studies did not specify which model was used [ 49 , 67 , 69 , 70 , 95 , 101 , 102 ].…”

Section: Resultsmentioning

confidence: 99%

“…Use patterns with these devices were mentioned in 35% (13/37) of the studies. Beside reporting use or wear durations [ 49 , 88 , 103 ], the studies indicated Fitbit use as the frequency at which the subjects wore the device [ 48 , 67 , 93 , 95 , 96 ] and the number of subjects having Fitbit measurements [ 73 , 82 , 87 , 90 , 92 ]. This information was mainly assessed using device data or it was self-reported.…”

Section: Resultsmentioning

confidence: 99%

“…Most studies included some form of PA or other healthy lifestyle education component [ 49 , 67 , 68 , 70 , 72 , 73 , 82 , 84 , 86 , 87 , 90 , 99 , 103 ]. Other studies involved usual care [ 48 , 76 , 78 , 83 , 85 , 88 , 93 , 96 - 98 ], financial incentives [ 68 , 82 ], blinded wearables [ 94 , 101 ], or no intervention at all [ 77 , 79 , 81 , 91 , 92 ]. Participants in some control groups were put on a waiting list to receive the same intervention following a delay [ 57 , 69 , 71 , 89 ].…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Ringeval¹,

Wagner²,

Denford³

et al. 2020

J Med Internet Res

140

113

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Background Unhealthy behaviors, such as physical inactivity, sedentary lifestyle, and unhealthful eating, remain highly prevalent, posing formidable challenges in efforts to improve cardiovascular health. While traditional interventions to promote healthy lifestyles are both costly and effective, wearable trackers, especially Fitbit devices, can provide a low-cost alternative that may effectively help large numbers of individuals become more physically fit and thereby maintain a good health status. Objective The objectives of this meta-analysis are (1) to assess the effectiveness of interventions that incorporate a Fitbit device for healthy lifestyle outcomes (eg, steps, moderate-to-vigorous physical activity, and weight) and (2) to identify which additional intervention components or study characteristics are the most effective at improving healthy lifestyle outcomes. Methods A systematic review was conducted, searching the following databases from 2007 to 2019: MEDLINE, EMBASE, CINAHL, and CENTRAL (Cochrane). Studies were included if (1) they were randomized controlled trials, (2) the intervention involved the use of a Fitbit device, and (3) the reported outcomes were related to healthy lifestyles. The main outcome measures were related to physical activity, sedentary behavior, and weight. All the studies were assessed for risk of bias using Cochrane criteria. A random-effects meta-analysis was conducted to estimate the treatment effect of interventions that included a Fitbit device compared with a control group. We also conducted subgroup analysis and fuzzy-set qualitative comparative analysis (fsQCA) to further disentangle the effects of intervention components. Results Our final sample comprised 41 articles reporting the results of 37 studies. For Fitbit-based interventions, we found a statistically significant increase in daily step count (mean difference [MD] 950.54, 95% CI 475.89-1425.18; P<.001) and moderate-to-vigorous physical activity (MD 6.16, 95% CI 2.80-9.51; P<.001), a significant decrease in weight (MD −1.48, 95% CI −2.81 to −0.14; P=.03), and a nonsignificant decrease in objectively assessed and self-reported sedentary behavior (MD −10.62, 95% CI −35.50 to 14.27; P=.40 and standardized MD −0.11, 95% CI −0.48 to 0.26; P=.56, respectively). In general, the included studies were at low risk for bias, except for performance bias. Subgroup analysis and fsQCA demonstrated that, in addition to the effects of the Fitbit devices, setting activity goals was the most important intervention component. Conclusions The use of Fitbit devices in interventions has the potential to promote healthy lifestyles in terms of physical activity and weight. Fitbit devices may be useful to health professionals for patient monitoring and support. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42019145450; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145450

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Ringeval¹,

Wagner²,

Denford³

et al. 2020

J Med Internet Res

140

113

View full text Add to dashboard Cite

show abstract

“…Based on two RCTs where patients at risk of foot ulceration participated in a training programme that increased their weight‐bearing activity, but where this did not result in increased incidence of ulceration, we suggest to consider advising people at low or moderate risk for ulceration (IWGDF 1 or 2) that a small increase in the level of weight‐bearing daily activities is likely to be safe. We define a small increase as 1000 steps/day, based on the increases seen in these two studies, and an RCT that showed such an increase to be beneficial for glycaemic control in people with diabetes . It is advisable to increase daily steps by a maximum of 10% per week, until a person reaches an overall increase of 1000 steps/day in comparison to baseline.…”

Section: Treating Risk Factors For Ulcerationmentioning

confidence: 99%

Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update)

Bus

Lavery

Monteiro‐Soares

et al. 2020

Diabetes Metabolism Res

365

609

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The International Working Group on the Diabetic Foot (IWGDF) has published evidence‐based guidelines on the prevention and management of diabetic foot disease since 1999. This guideline is on the prevention of foot ulceration in persons with diabetes and updates the 2015 IWGDF prevention guideline. We followed the GRADE methodology to devise clinical questions and critically important outcomes in the PICO format, to conduct a systematic review of the medical‐scientific literature, and to write recommendations and their rationale. The recommendations are based on the quality of evidence found in the systematic review, expert opinion where evidence was not available, and a weighing of the benefits and harms, patient preferences, feasibility and applicability, and costs related to the intervention. We recommend to screen a person at very low risk for ulceration annually for loss of protective sensation and peripheral artery disease and persons at higher risk at higher frequencies for additional risk factors. For preventing a foot ulcer, educate the at‐risk patient about appropriate foot self‐care and treat any pre‐ulcerative sign on the foot. Instruct moderate‐to‐high risk patients to wear accommodative properly fitting therapeutic footwear, and consider instructing them to monitor foot skin temperature. Prescribe therapeutic footwear that has a demonstrated plantar pressure relieving effect during walking to prevent plantar foot ulcer recurrence. In patients that fail non‐surgical treatment for an active or imminent ulcer, consider surgical intervention; we suggest not to use a nerve decompression procedure. Provide integrated foot care for high‐risk patients to prevent ulcer recurrence. Following these recommendations will help health care professionals to provide better care for persons with diabetes at risk of foot ulceration, to increase the number of ulcer‐free days, and to reduce the patient and health care burden of diabetic foot disease.

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Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes

Yogasingam

Konnyu

Lépine

et al. 2023

Cochrane Database of Systematic Reviews

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Background There is a large body of evidence evaluating quality improvement (QI) programmes to improve care for adults living with diabetes. These programmes are often comprised of multiple QI strategies, which may be implemented in various combinations. Decision‐makers planning to implement or evaluate a new QI programme, or both, need reliable evidence on the relative effectiveness of different QI strategies (individually and in combination) for different patient populations. Objectives To update existing systematic reviews of diabetes QI programmes and apply novel meta‐analytical techniques to estimate the effectiveness of QI strategies (individually and in combination) on diabetes quality of care. Search methods We searched databases (CENTRAL, MEDLINE, Embase and CINAHL) and trials registers (ClinicalTrials.gov and WHO ICTRP) to 4 June 2019. We conducted a top‐up search to 23 September 2021; we screened these search results and 42 studies meeting our eligibility criteria are available in the awaiting classification section. Selection criteria We included randomised trials that assessed a QI programme to improve care in outpatient settings for people living with diabetes. QI programmes needed to evaluate at least one system‐ or provider‐targeted QI strategy alone or in combination with a patient‐targeted strategy. ‐ System‐targeted: case management (CM); team changes (TC); electronic patient registry (EPR); facilitated relay of clinical information (FR); continuous quality improvement (CQI). ‐ Provider‐targeted: audit and feedback (AF); clinician education (CE); clinician reminders (CR); financial incentives (FI). ‐ Patient‐targeted: patient education (PE); promotion of self‐management (PSM); patient reminders (PR). Patient‐targeted QI strategies needed to occur with a minimum of one provider or system‐targeted strategy. Data collection and analysis We dual‐screened search results and abstracted data on study design, study population and QI strategies. We assessed the impact of the programmes on 13 measures of diabetes care, including: glycaemic control (e.g. mean glycated haemoglobin (HbA1c)); cardiovascular risk factor management (e.g. mean systolic blood pressure (SBP), low‐density lipoprotein cholesterol (LDL‐C), proportion of people living with diabetes that quit smoking or receiving cardiovascular medications); and screening/prevention of microvascular complications (e.g. proportion of patients receiving retinopathy or foot screening); and harms (e.g. proportion of patients experiencing adverse hypoglycaemia or hyperglycaemia). We modelled the association of each QI strategy with outcomes using a series of hierarchical multivariable meta‐regression models in a Bayesian framework. The previous version of this review identified that different strategies were more or less effective depending on baseline levels of outco...

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Self-tracking of Physical Activity in People With Type 2 Diabetes

Cited by 67 publications

References 40 publications

Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update)

Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes

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