scholarly journals Remote Lifestyle Coaching Plus a Connected Glucose Meter with Certified Diabetes Educator Support Improves Glucose and Weight Loss for People with Type 2 Diabetes

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jennifer B. Bollyky ◽  
Dena Bravata ◽  
Jason Yang ◽  
Mark Williamson ◽  
Jennifer Schneider
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Cost Effective ◽  
Connected Health ◽  
Diabetes Educator ◽  
Glucose Meter ◽  
Program Costs ◽  
To Receive ◽  
Diabetes Educators

Background. Connected health devices with lifestyle coaching can provide real-time support for people with type 2 diabetes (T2D). However, the intensity of lifestyle coaching needed to achieve outcomes is unknown. Methods. Livongo provides connected, two-way messaging glucose meters, unlimited blood glucose (BG) test strips, and access to certified diabetes educators. We evaluated the incremental effects of adding lifestyle coaching on BG, estimated HbA1c, and weight. We randomized 330 eligible adults (T2D, HbA1c > 7.5%, BMI ≥ 25) to receive no further intervention (n=75), a connected scale (n=115), scale plus lightweight coaching (n=73), or scale plus intense coaching (n=67) for 12 weeks. We evaluated the change in outcomes using ANOVA. Results. Livongo participation alone resulted in improved BG control (mean HbA1c declined: 8.5% to 7.5%, p=0.01). Mean weight loss and additional BG decreases were higher in the intensive compared with the lightweight coaching and scale-only groups (weight change (lb): −6.4, −4.1, and −1.1, resp., p=0.01; BG change (mg/dL): −19.4, −11.3, and −2.9, resp., p=0.02). The estimated 12-week program costs were 5.5 times more for intensive than lightweight coaching. Conclusion. Livongo participation significantly improves BG control in people with T2D. Additional lifestyle coaching may be a cost-effective intervention to achieve further glucose control and weight loss.

scholarly journals The Effect of a Cellular-Enabled Glucose Meter on Glucose Control for Patients With Diabetes: Prospective Pre-Post Study

JMIR Diabetes ◽  
10.2196/14799 ◽  
2019 ◽  
Vol 4 (4) ◽  
pp. e14799 ◽  
Author(s):  
Jennifer B Bollyky ◽  
Stephanie T Melton ◽  
Tong Xu ◽  
Stefanie L Painter ◽  
Brian Knox
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
The United States ◽  
South Florida ◽  
World Health ◽  
Target Range ◽  
Depression Symptoms ◽  
Diabetes Educator ◽  
Glucose Meter

Background Diabetes is a global epidemic affecting approximately 30 million people in the United States. The World Health Organization recommends using technology and telecommunications to improve health care delivery and disease management. The Livongo for Diabetes Program offers a remote monitoring technology with Certified Diabetes Educator outreach. Objective The purpose of this study was to examine health outcomes measured by changes in HbA1c, in time in target blood glucose range, and in depression symptoms for patients enrolled in a remote digital diabetes management program in a Diabetes Center of Excellence setting. Methods The impact of the Livongo for Diabetes program on hemoglobin A1c (HbA1c), blood glucose ranges, and depression screening survey results (Patient Health Questionnaire-2 [PHQ-2]) were assessed over 12 months in a prospective cohort recruited from the University of South Florida Health Diabetes Home for Healthy Living. Any patient ≥18 years old with a diagnosis of diabetes was approached for voluntary inclusion into the program. The analysis was a pre-post design for those members enrolled in the study. Data was collected at outpatient clinic visits and remotely through the Livongo glucose meter. Results A total of 86 adults were enrolled into the Livongo for Diabetes program, with 49% (42/86) female, an average age of 50 (SD 15) years, 56% (48/86) with type 2 diabetes mellitus, and 69% (59/86) with insulin use. The mean HbA1c drop amongst the group was 0.66% (P=.17), with all participants showing a decline in HbA1c at 12 months. A 17% decrease of blood glucose checks <70 mg/dL occurred concurrently. Participants with type 2 diabetes not using insulin had blood glucose values within target range (70-180 mg/dL) 89% of the time. Participants with type 2 diabetes using insulin were in target range 68% of the time, and type 1 diabetes 58% of the time. Average PHQ-2 scores decreased by 0.56 points during the study period. Conclusions Participants provided with a cellular-enabled blood glucose meter with real-time feedback and access to coaching from a certified diabetes educator in an outpatient clinical setting experienced improved mean glucose values and fewer episodes of hypoglycemia relative to the start of the program.

scholarly journals The Effect of a Cellular-Enabled Glucose Meter on Glucose Control for Patients With Diabetes: Prospective Pre-Post Study (Preprint)

2019 ◽  
Author(s):  
Jennifer B Bollyky ◽  
Stephanie T Melton ◽  
Tong Xu ◽  
Stefanie L Painter ◽  
Brian Knox
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
The United States ◽  
South Florida ◽  
World Health ◽  
Target Range ◽  
Depression Symptoms ◽  
Diabetes Educator ◽  
Glucose Meter

BACKGROUND Diabetes is a global epidemic affecting approximately 30 million people in the United States. The World Health Organization recommends using technology and telecommunications to improve health care delivery and disease management. The Livongo for Diabetes Program offers a remote monitoring technology with Certified Diabetes Educator outreach. OBJECTIVE The purpose of this study was to examine health outcomes measured by changes in HbA<sub>1c</sub>, in time in target blood glucose range, and in depression symptoms for patients enrolled in a remote digital diabetes management program in a Diabetes Center of Excellence setting. METHODS The impact of the Livongo for Diabetes program on hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>), blood glucose ranges, and depression screening survey results (Patient Health Questionnaire-2 [PHQ-2]) were assessed over 12 months in a prospective cohort recruited from the University of South Florida Health Diabetes Home for Healthy Living. Any patient ≥18 years old with a diagnosis of diabetes was approached for voluntary inclusion into the program. The analysis was a pre-post design for those members enrolled in the study. Data was collected at outpatient clinic visits and remotely through the Livongo glucose meter. RESULTS A total of 86 adults were enrolled into the Livongo for Diabetes program, with 49% (42/86) female, an average age of 50 (SD 15) years, 56% (48/86) with type 2 diabetes mellitus, and 69% (59/86) with insulin use. The mean HbA<sub>1c</sub> drop amongst the group was 0.66% (<italic>P</italic>=.17), with all participants showing a decline in HbA<sub>1c</sub> at 12 months. A 17% decrease of blood glucose checks &lt;70 mg/dL occurred concurrently. Participants with type 2 diabetes not using insulin had blood glucose values within target range (70-180 mg/dL) 89% of the time. Participants with type 2 diabetes using insulin were in target range 68% of the time, and type 1 diabetes 58% of the time. Average PHQ-2 scores decreased by 0.56 points during the study period. CONCLUSIONS Participants provided with a cellular-enabled blood glucose meter with real-time feedback and access to coaching from a certified diabetes educator in an outpatient clinical setting experienced improved mean glucose values and fewer episodes of hypoglycemia relative to the start of the program.

How to Maintain a Healthy Body Weight

2006 ◽  
Vol 76 (4) ◽  
pp. 208-215 ◽  
Author(s):  
Astrup
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Body Weight ◽  
Glycemic Index ◽  
Dairy Products ◽  
Weight Control ◽  
Healthy Body Weight ◽  
Healthy Body

The epidemic of both obesity and type 2 diabetes is due to environmental factors, but the individuals developing the conditions possess a strong genetic predisposition. Observational surveys and intervention studies have shown that excess body fatness is the major environmental cause of type 2 diabetes, and that even a minor weight loss can prevent its development in high-risk subjects. Maintenance of a healthy body weight in susceptible individuals requires 45–60 minutes physical activity daily, a fat-reduced diet with plenty of fruit, vegetables, whole grain, and lean meat and dairy products, and moderate consumption of calorie containing beverages. The use of table values to predict the glycemic index of meals is of little – if any – value, and the role of a low-glycemic index diet for body weight control is controversial. The replacement of starchy carbohydrates with protein from lean meat and lean dairy products enhances satiety, and facilitate weight control. It is possible that dairy calcium also promotes weight loss, although the mechanism of action remains unclear. A weight loss of 5–10% can be induced in almost all obese patients providing treatment is offered by a professional team consisting of a physician and dieticians or nurses trained to focus on weight loss and maintenance. Whereas increasing daily physical activity and regular exercise does not significantly effect the rate of weight loss in the induction phase, it plays an important role in the weight maintenance phase due to an impact on daily energy expenditure and also to a direct enhancement of insulin sensitivity.

1014-P: Relationship between Glycemic Control and Weight Loss with Once-Weekly Efpeglenatide in Uncontrolled Type 2 Diabetes: A Subanalysis of EXCEED 203

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1014-P
Author(s):  
JULIO ROSENSTOCK ◽  
CRISTOBAL MORALES ◽  
ULRICH WENDISCH ◽  
GEORGE E. DAILEY ◽  
MICHAEL E. TRAUTMANN ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Glycemic Control

1844-P: Long-Term Remission of Type 2 Diabetes after Weight Loss Requires Effective Clearance of Hepatic VLDL-TG and Maintenance of Low Intrapancreatic Fat

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1844-P
Author(s):  
AHMAD AL-MRABEH ◽  
SVIATLANA V. ZHYZHNEUSKAYA ◽  
ALISON C. BARNES ◽  
KIEREN G. HOLLINGSWORTH ◽  
NAVEED SATTAR ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss

935-P: Effect of CTRB1/2 RS7202877 (T>G) Polymorphism on Weight Loss Response to Liraglutide Treatment in Greek People with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 935-P
Author(s):  
ANGELIKI V. KYRIAZOU ◽  
ARTEMIS KYRIAKIDOU ◽  
THEOCHARIS KOUFAKIS ◽  
YIANNIS VASILOPOULOS ◽  
IAKOVOS AVRAMIDIS ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss

Within trial cost-effectiveness of a structured lifestyle intervention in adults with overweight/obesity and type 2 diabetes: Results from the Action for Health in Diabetes (Look AHEAD) Study

2020 ◽  
Author(s):  
Ping Zhang ◽  
Karen M. Atkinson ◽  
George Bray ◽  
Haiying Chen ◽  
Jeanne M. Clark ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Lifestyle Intervention ◽  
Health Utility Index ◽  
Health Benefit ◽  
Cost Effective ◽  
Health Utility ◽  
Health Care Expenditures ◽  
Quality Adjusted Life Year

<b>OBJECTIVE </b>To assess the cost-effectiveness (CE) of an intensive lifestyle intervention (ILI) compared to standard diabetes support and education (DSE) in adults with overweight/obesity and type 2 diabetes, as implemented in the Action for Health in Diabetes study. <p><b>RESEARCH DESIGN AND METHODS</b> Data were from 4,827 participants during the first 9 years of the study from 2001 to 2012. Information on Health Utility Index-2 and -3, SF-6D, and Feeling Thermometer [FT]), cost of delivering the interventions, and health expenditures were collected during the study. CE was measured by incremental cost-effectiveness ratios (ICERs) in costs per quality-adjusted life year (QALY). Future costs and QALYs were discounted at 3% annually. Costs were in 2012 US dollars. </p> <p><b>RESULTS </b><a>Over the </a>9 years studied, the mean cumulative intervention costs and mean cumulative health care expenditures were $11,275 and $64,453 per person for ILI and $887 and $68,174 for DSE. Thus, ILI cost $6,666 more per person than DSE. Additional QALYs gained by ILI were not statistically significant measured by the HUIs and were 0.17 and 0.16, respectively, measured by SF-6D and FT. The ICERs ranged from no health benefit with a higher cost based on HUIs, to $96,458/QALY and $43,169/QALY, respectively, based on SF-6D and FT. </p> <p><b>Conclusions </b>Whether<b> </b>ILI was cost-effective over the 9-year period is unclear because different health utility measures led to different conclusions. </p>

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