Impact of a Digital Lifestyle Intervention on Diabetes Self-Management: A Pilot Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.2.1. Eligibility
2.2.2. Recruitment
2.3. Study Procedures
2.4. Intervention
2.5. Comparator
2.6. Outcome Measurement
2.7. Sample Size
2.8. Statistical Analysis
3. Results
3.1. Participant Characteristics
3.2. Effects on Glycemic Control
3.3. Effects on Metabolic Parameters
3.4. Effects on Patient Reported Outcomes
3.5. Effects on App Reported Data
3.5.1. Food Intake
3.5.2. Physical Activity
3.5.3. Self-Management
4. Discussion
Strengths & Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Screenshots of the App
Appendix B. Meal Photos
References
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Retrospective | Baseline | Follow-Up | Change | p-Value | |
---|---|---|---|---|---|
−3 months | +3 months | ||||
n = 42 * | |||||
HbA1c (%) Control group | 8.2 ± 1.3 | 7.9 ± 1.0 | - | −0.3 ± 1.1 | 0.27 |
HbA1c (%) Intervention group | - | 7.9 ± 1.0 | 6.9 ± 0.9 | −0.9 ± 1.1 | <0.001 |
n = 37 * | |||||
Intervention group | |||||
Weight (kg) | - | 105.2 ± 18.5 | 100.9 ± 17.6 | −4.3 ± 4.5 | <0.001 |
BMI (kg/m2) | - | 35.1 ± 7.3 | 33.6 ± 7.1 | −1.4 ± 1.5 | <0.001 |
Waist circumference (cm) | - | 121.1 ± 16.5 | 115.4 ± 17.4 | −5.7 ± 15.0 | 0.03 |
Fasting glucose (mmol/L) | - | 7.4 ± 1.4 | 6.8 ± 1.5 | −0.6 ± 1.3 | 0.01 |
Baseline HbA1c (%) | Follow-Up HbA1c (%) | Change in HbA1c (%) | p-Value | p-Value between Groups | |
---|---|---|---|---|---|
n = 42 | |||||
<55 years (n = 12) | 8.42 ± 0.95 | 7.09 ± 1.12 | −1.32 ± 1.25 | 0.004 | 0.20 |
>55 years (n = 30) | 7.66 ± 0.97 | 6.88 ± 0.78 | −0.78 ± 0.98 | <0.001 | |
n = 42 | |||||
Baseline HbA1c < 8% (n = 24) | 7.17 ± 0.44 | 6.74 ± 0.76 | −0.43 ± 0.75 | 0.01 | <0.001 |
Baseline HbA1c > 8% (n = 18) | 8.81 ± 0.77 | 7.21 ± 0.97 | −1.61 ± 1.1 | <0.001 | |
n = 42 | |||||
Baseline BMI < 30 (n = 12) | 7.68 ± 1.05 | 7.07 ± 0.77 | −0.6 ± 0.98 | 0.06 | 0.16 |
Baseline BMI > 30 (n = 30) | 7.99 ± 1 | 6.89 ± 0.94 | −1.10 ± 1.11 | <0.001 | |
n = 26 * | |||||
Duration < 8.5 years (n = 15) | 7.6 ± 1.14 | 6.76 ± 0.88 | −0.84 ± 1.31 | 0.008 | 0.58 |
Duration > 8.5 years (n = 11) | 8.21 ± 0.64 | 7.1 ± 1.04 | −1.12 ± 1.19 | 0.03 | |
n = 42 | |||||
Male (n = 23) | 7.88 ± 0.98 | 6.86 ± 0.88 | −1.02 ± 1.1 | <0.001 | 0.57 |
Female (n = 19) | 7.86 ± 1.08 | 7.04 ± 0.91 | −0.83 ± 1.07 | 0.003 |
Baseline | Follow-Up | p-Value | |
---|---|---|---|
+3 months | |||
n = 37 | |||
PHQ-9 | |||
Depression severity (n) | 0.36 | ||
Minimal | 15 | 16 | |
Mild | 13 | 15 | |
Moderate | 5 | 1 | |
Moderately severe | 3 | 3 | |
Severe | 1 | 2 | |
SF-12 | |||
PCS score | 42.1 ± 9.6 | 45.4 ± 9.1 | 0.01 |
MCS score | 42.1 ± 12.6 | 45.1 ± 13.6 | 0.06 |
SDSCA | |||
General Diet | 5.3 ± 1.2 | 5.5 ± 1.3 | 0.30 |
Specific Diet | 4.6 ± 1.5 | 4.5 ± 1.7 | 0.77 |
Exercise | 3.7 ± 2.1 | 4.2 ± 1.8 | 0.10 |
Blood-Glucose Testing | 4.7 ± 2.9 | 4.6 ± 2.9 | 0.50 |
Footcare | 2.4 ± 2.4 | 2.3 ± 2.4 | 0.70 |
Overall Scale | 4.1 ± 1.2 | 4.2 ± 1.2 | 0.47 |
Baseline | Follow-Up | Change | p-Value | |
---|---|---|---|---|
+3 months | ||||
Meal Evaluation * | ||||
n = 24 | ||||
Portion size | 2.44 ± 0.40 | 2.18 ± 0.36 | −0.26 ± 0.46 | 0.01 |
Protein | 2.61 ± 0.56 | 2.28 ± 0.47 | −0.32 ± 0.67 | 0.03 |
Carbohydrate | 3.07 ± 0.51 | 2.68 ± 0.56 | −0.38 ± 0.71 | 0.01 |
Fat | 2.96 ± 0.69 | 2.59 ± 0.50 | −0.37 ± 0.72 | 0.02 |
Fiber | 3.33 ± 0.56 | 2.82 ± 0.54 | −0.51 ± 0.63 | <0.001 |
Vegetable | 3.31 ± 0.92 | 2.67 ± 1.00 | −0.64 ± 0.95 | 0.003 |
Processed food | 2.10 ± 0.50 | 1.80 ± 0.43 | −0.30 ± 0.50 | 0.007 |
Overall grade | 3.08 ± 0.39 | 2.71 ± 0.36 | −0.36 ± 0.42 | <0.001 |
Self-efficacy | ||||
n = 29 | ||||
In-app questionnaire ** | ||||
Ability to select proper food | 4.86 ± 1.67 | 6.85 ± 1.74 | 1.99 ± 1.75 | <0.001 |
Ability to be more active | 6.45 ± 2.16 | 7.76 ± 2.42 | 1.31 ± 2.32 | 0.005 |
Diabetes management | 5.89 ± 2.47 | 7.76 ± 2.42 | 1.89 ± 2.50 | <0.001 |
Weight Change | |
---|---|
Constant | 8.286 (3.057) * |
Lesson reading time | −0.392 (0.183) * |
Habit compliance | −0.068 (3.341) * |
Self-monitoring | −0.166 (0.028) ** |
Observations | 41 |
R2 | 0.43 |
Adjusted R2 | 0.39 |
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Bretschneider, M.P.; Klásek, J.; Karbanová, M.; Timpel, P.; Herrmann, S.; Schwarz, P.E.H. Impact of a Digital Lifestyle Intervention on Diabetes Self-Management: A Pilot Study. Nutrients 2022, 14, 1810. https://doi.org/10.3390/nu14091810
Bretschneider MP, Klásek J, Karbanová M, Timpel P, Herrmann S, Schwarz PEH. Impact of a Digital Lifestyle Intervention on Diabetes Self-Management: A Pilot Study. Nutrients. 2022; 14(9):1810. https://doi.org/10.3390/nu14091810
Chicago/Turabian StyleBretschneider, Maxi Pia, Jan Klásek, Martina Karbanová, Patrick Timpel, Sandra Herrmann, and Peter E. H. Schwarz. 2022. "Impact of a Digital Lifestyle Intervention on Diabetes Self-Management: A Pilot Study" Nutrients 14, no. 9: 1810. https://doi.org/10.3390/nu14091810