Reversing type 2 diabetes in a Primary Care Anchored eHealth Lifestyle Coaching Program in Denmark: A Randomized Controlled Trial Har passerat
Onsdag 26 augusti 2020 16:15 - 17:00 Kliniska beslutstöd
Föreläsare: Carl J. Brandt
Background. Lifestyle interventions can revert and delay the onset of type 2 diabetes. This subsequently leads to fewer complications and increased longevity. A number of studies suggest that digital coaching based on real time monitoring can lead to weight loss and maybe reduction in HbA1c. We aimed to access if an eHealth lifestyle coaching program (Liva) for Type 2 diabetes(T2D) patients motivated to change lifestyle could lead to significant weight loss and improved HbA1c levels compared to usual care. Methods. In a randomized controlled trial 170 T2D patients were enrolled from March 2018 to March 2019 with 100 in the intervention and 70 in the control group. People were enrolled either through their GP, through the Danish diabetes organization or through social media. The intervention consisted of an initial face to face motivational interview followed up by digital health coaching through Liva. Results. At 6 months the average reduction in body weight was 3.91% in intervention group vs 1.77% in the control group (p=0.014%). There were 15 patients (20.5%) that lost between 5 to 10% and 8 patients (11.0%) lost more than 10% of their body weight in the intervention group. In comparison there were 5 patients (12.8%) that lost between 5 to 10% and 0 patients (0.0%) lost more than 10% of their body weight in the control group. HbA1c was reduced for 55 patients (75.34%) and even normalized for 24 patients (42.11%) who had elevated HbA1c at baseline (57 patients) in the intervention arm. In comparison, HbA1c was reduced for 28 patients (38.36%) and a normalization for 5 patients (16.67%) who had elevated HbA1c at baseline (30 patients) in the control arm (p=0.686 and p=0.016 respectively). Conclusion. It is possible to induce lifestyle change leading to relevant weight loss and normalization for HbA1c for more than twice as many patients using digital coaching compared to usual care. These findings suggest that using digital coaching based on real time monitoring though wearables and smartphones can lead to improved lifestyle that might reduce complications and improve longevity.
Vård på distans
Chef/Beslutsfattare, Politiker, Upphandlare/inköp/ekonomi/HR, Forskare (även studerande), Omsorgspersonal, Vårdpersonal, Patientorganisationer/Brukarorganisationer
Exempel från verkligheten, Nytta/effekt, Välfärdsutveckling, Personcentrering, samverkan över organisationsgränser, Kommun, Innovativ/forskning, Test/validering, Dokumentation, Appar
Carl J. Brandt Föreläsare
Carl J. Brandt is one of the pioneers in behavioural change through eHealth. In 2000 Carl co-founded the successful Internet site NetDoctor.co.uk followed by a number of other successful eHealth services including SlankeDoktor, SundhedsDoktor and Liva Healthcare in 2015. Liva Healthcare Ltd. has proven successful in the NHS National Diabetes Prevention Programme (NDPP). Carl is working as a GP and is employed part-time at the Research Unit for General Practice at the University of Southern Denmark as a postdoc on a Novo Nordisk Foundation Grant integrating digital coaching into a GP setting.