scholarly journals A Mobile Lifestyle Management Program (GlycoLeap) for People With Type 2 Diabetes: Single-Arm Feasibility Study

10.2196/12965 ◽  
2019 ◽  
Vol 7 (5) ◽  
pp. e12965 ◽  
Author(s):  
David Koot ◽  
Paul Soo Chye Goh ◽  
Robyn Su May Lim ◽  
Yubing Tian ◽  
Teng Yan Yau ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Feasibility Study ◽  
Management Program ◽  
Lifestyle Management

scholarly journals A Mobile Lifestyle Management Program (GlycoLeap) for People With Type 2 Diabetes: Single-Arm Feasibility Study (Preprint)

2018 ◽  
Author(s):  
David Koot ◽  
Paul Soo Chye Goh ◽  
Robyn Su May Lim ◽  
Yubing Tian ◽  
Teng Yan Yau ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Feasibility Study ◽  
User Satisfaction ◽  
Primary Outcome ◽  
Management Program ◽  
Secondary Outcome ◽  
Lifestyle Management ◽  
Program Engagement

BACKGROUND Singapore’s current prevalence of diabetes exceeds 13.6%. Although lifestyle modification can be effective for reducing the risks for complications of type 2 diabetes mellitus (T2DM), traditional lifestyle interventions are often difficult to administer in the primary care setting due to limited resources. Mobile health apps can address these limitations by offering low-cost, adaptable, and accessible platforms for disseminating lifestyle management interventions. OBJECTIVE Using the RE-AIM evaluation framework, this study assessed the potential effectiveness and feasibility of GlycoLeap, a mobile lifestyle management program for people with T2DM, as an add-on to standard care. METHODS This single-arm feasibility study recruited 100 patients with T2DM and glycated hemoglobin (HbA1c) levels of ≥7.5% from a single community health care facility in Singapore. All participants were given access to a 6-month mobile lifestyle management program, GlycoLeap, comprising online lessons and the Glyco mobile phone app with a health coaching feature. The GlycoLeap program was evaluated using 4 relevant dimensions of the RE-AIM framework: (1) reach (percentage who consented to participate out of all patients approached), (2) effectiveness (percentage point change in HbA1c [primary outcome] and weight loss [secondary outcome]), (3) implementation (program engagement as assessed by various participatory metrics), and (4) maintenance (postintervention user satisfaction surveys to predict the sustainability of GlycoLeap). Participants were assessed at baseline and at follow-up (≥12 weeks after starting the intervention). RESULTS A total of 785 patients were approached of whom 104 consented to participate, placing the reach at 13.2%. Four were excluded after eligibility screening, and 100 patients were recruited. Program engagement (implementation) started out high but decreased with time for all evaluated components. Self-reported survey data suggest that participants monitored their blood glucose on more days in the past week at follow-up compared to baseline (P<.001) and reported positive changes to their diet due to app engagement (P<.001) (implementation). Primary outcome data were available for 83 participants. Statistically significant improvements were observed for HbA1c (–1.3 percentage points, P<.001) with greater improvements for those who logged their weight more often (P=.007) (effectiveness). Participants also had a 2.3% reduction in baseline weight (P<.001) (effectiveness). User satisfaction was high with 74% (59/80) and 79% (63/80) of participants rating the app good or very good and claiming that they would probably or definitely recommend the app to others, respectively (maintenance). CONCLUSIONS Although measures of program engagement decreased with time, clinically significant improvements in HbA1c were achieved with the potential for broader implementation. However, we cannot rule out that these improvements were due to factors unrelated to GlycoLeap. Therefore, we would recommend evaluating the effectiveness and cost effectiveness of GlycoLeap using a randomized controlled trial of at least 12 months. CLINICALTRIAL ClinicalTrials.gov NCT03091517; https://clinicaltrials.gov/ct2/show/NCT03091517 (Archived by WebCite at http://www.webcitation.org/77rNqhwRn)

scholarly journals Assessment of a Clinical Case for A Female Patient with Type 2 Diabetes Using the 2021 Consensus Report on Type 2 Diabetes Remission Discussions Sponsored by American Diabetes Association Based on GH-Method: math-physical medicine (No. 506)

2021 ◽  
Vol 6 (6) ◽  
Keyword(s):  
Type 2 Diabetes ◽  
Female Patient ◽  
Hba1c Level ◽  
Clinical Case ◽  
American Diabetes Association ◽  
Management Program ◽  
Lifestyle Management ◽  
One Year ◽  
Consensus Report

This 73-year-old female patient has suffered from type 2 diabetes (T2D), hypertension, and hyperlipidemua for over 20 years. She started taking Metformin in 1999 and ceased taking it on 1/7/2019. As of 4/3/2019, her HbA1C level was at 6.6%. Since 4/4/2019, she implemented a lifestyle management program which not only focuses on diet and exercise but also factors in sleep, stress, life routines and habits, as well as environmental factors. In this article, the author applies the final conclusions from the American Diabetes Association (ADA) 2021 consensus report regarding “T2D Remission”. For this clinical case, he analyzes the patient’s present conditions to determine if she satisfies the criteria of “T2D remission” or not. The defined criteria of “remission” include timespan of at least one year, HbA1C level less than 6.5%, fasting plasma glucose (FPG) level less than 126 mg/dL, and estimated HbA1C (eA1C) values based on the mean continuous glucose monitoring (CGM) glucose data less than 6.5%. In conclusion, according to the ADA 2021 consensus report, this female patient is in “remission” for T2D. In summary, over the past year from 9/5/2020 to 9/5/2021, her average lab-A1C is 6.3%, mean CGM FPG value is 102 mg/dL, and CGM eAG is 5.7%. First, the selected one year satisfies the timespan requirement cited in the 2021 consensus report. Her set of glucose data has been collected over ~3 years, after post-Metformin (started on 1/7/2019) and her initiation of lifestyle management program that began on 4/4/2019. Second, all of her A1C values, both lab-tested and CGM eA1C, are less than 6.5% and her mean CGM FPG level is less than 126 mg/dL. Finally, she keeps a regular routine with quarterly medical examinations to monitor various diabetes complications, including macrovascular, micro- vascular, neural, and hormonal systems. The author understands and agrees with the consensus report that diabetes is non-curable and at most is “controllable” or “partially reversible”. Nevertheless, this female patient has also adopted a similar lifestyle improvement program as the author in order to deal with the root causes of her multiple metabolic disorders, particularly T2D, instead of suppressing the external symptoms of diabetes through medication intervention.

scholarly journals A Summary Note of Gestational Diabetes Control Centred on Several Evidence-Based Type 2 Diabetes Research Results Using GH-Method: Math-Physical Medicine (No. 399)

2021 ◽  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Medical Research ◽  
Management Program ◽  
Diabetes Research ◽  
Lifestyle Management ◽  
Research Results ◽  
Food Portion

The author, who has type 2 diabetes (T2D) for 26 years, conducted his diabetes research over the past 11 years. Since 2020, he has published 400+ medical research papers in various medical journals. Recently, he received invitations to submit his medical research notes to a gynecology journal but he hesitated because he was not a gynecologist. However, the editor convinced him that his research results may be beneficial to some patients with gestational diabetes mellitus (GDM) since diabetes conditions are quite similar, if not the same. Therefore, he started to review some medical papers online on the subject of gestational diabetes. Finally, he uncovered that his research results could indeed benefit some GDM patients to some degree and decided to write this summary note. Although his research specialties are in the areas of endocrinology, diabetes, and lifestyle, after 11 years of dedicated medical research with additional self-studying on GDM, he discovered that approximately 90% of his diabetes research findings are applicable to this special group. In summary, three areas with special emphasis are highlighted for GDM patients. The first and major area is food nutrition in a lifestyle management program. Due to the concerns of hyperglycemia, the author eats high-quality protein, a lot of fish and vegetables, particularly green leafy vegetables, portioncontrolled shellfish and fruits, along with avoidance of red meat and sweetened food. However, for a GDM patient, he highly recommends them to follow a “nutritional balanced” meal plan, avoiding high-carbs, sugar-based, and processed food in general to prevent unhealthy chemical additives. The fetus in utero needs good nutrition supplied by its mother; therefore, the mother must eat nutritional balanced meals that meet nutritional requirements and glucose concerns. The second area is specific weight-gain management. The author focuses on the food portion percentage with a strong willpower to resist his food cravings plus persistence each day, so that he can achieve his weight reduction target. However, for a GDM patient, she must constantly monitor the amount of weight gained according to the Mayo Clinic’s “weight-gain guidelines”. Maintenance in this area is important for the benefit of the baby’s development and mother’s health during pregnancy. However, both of his food portion percentage and persistent weight control are good examples to follow and useful for a GDM patient. The third area is medication treatment for gestational diabetes. Although the author ceased taking medications in controlling his diabetes symptoms, he decided to implement a rather stringent lifestyle management program in order to control or even reverse his diabetes conditions at the root-cause level. Nevertheless, it is a difficult route that takes a longer time span to be able to see significant improvements. Since the pregnancy period is relatively shorter, less than 10 months, a gestational diabetes patient must follow her physician’s advice to pursue all the necessary medication treatments or insulin injections. The information in particular the high correlation coefficients between any two variables, from Figures 2 through 5, provide useful knowledge for a GDM patient to learn in order to control her glucose levels during pregnancy. The most important goal is the safe delivery of a healthy new born

On-Demand, App-Delivered Coaching to Enable Diabetes Self-Management in Adults with Type 2 Diabetes—A Feasibility Study

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 50-LB
Author(s):  
JOHN B. HERNANDEZ ◽  
AMY ARMENTO LEE ◽  
SCOTT ROBERTSON ◽  
CARA SILVER ◽  
AMIT MAJITHIA
Keyword(s):  
Type 2 Diabetes ◽  
Feasibility Study ◽  
Self Management ◽  
On Demand

A Prospective, Non-randomized Feasibility and Preliminary Efficacy Study of a Telemedicine-Enabled Co-management Intervention for Adults With Type 2 Diabetes and Moderate Anxiety and/or Depression

2021 ◽  
Vol 47 (2) ◽  
pp. 144-152
Author(s):  
Michelle F. Magee ◽  
Stacey I. Kaltman ◽  
Mihriye Mete ◽  
Carine M. Nassar
Keyword(s):  
Mental Health ◽  
Type 2 Diabetes ◽  
Management Program ◽  
Post Intervention ◽  
Convenience Sample ◽  
Intervention Delivery ◽  
Management Intervention ◽  
Moderate Depression ◽  
Patient Health

Purpose The primary aim of this pilot study was to examine the feasibility of codelivering a mental health intervention with an evidence-based type 2 diabetes (T2DM) boot camp care management program. The preliminary impact of participation on symptom scores for depression and anxiety and A1C was also examined. Methods This was a 12-week, non-randomized pilot intervention conducted with a convenience sample of adults with uncontrolled T2DM and moderate depression and/or anxiety at an urban teaching hospital. Co-management intervention delivery was via in-person and telehealth visits. Participants were assessed at baseline and 90 days. Results Participants (n = 18) were African American, majority female (83%), and age 50.7 ± 13.4 years. Significant improvements in mental health outcomes were demonstrated, as measured by a reduction in Patient Health Questionnaire − 9 scores of 2.4 ± 2.9 ( P = .01) and in Generalized Anxiety Disorder − 7 scores of 2.3 ± 1.9 ( P = .001). The pre-post intervention mean A1C improved by 3.4 ± 2.1 units from 12% ± 1.4% to 8.5% ± 1.7% ( P < .001). Conclusion The data generated in this pilot support the feasibility of delivering a diabetes and mental health co-management intervention using a combination of in-person and telemedicine visits to engage adults with T2DM and coexisting moderate depression and/or anxiety. Further research is warranted.

Feasibility of a Flash Glucose Sensor Enabled Virtual Lifestyle Management Group in Patients With Type 2 Diabetes (T2DM): The STAND Study

2021 ◽  
Vol 45 (7) ◽  
pp. S26
Author(s):  
Sonja Reichert ◽  
Madison Hiemstra ◽  
Elisabeth Harvey ◽  
Amanda Mikalachki ◽  
Marc Mitchell
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Sensor ◽  
Lifestyle Management ◽  
Management Group

Measuring Outcomes of Type 2 Diabetes Disease Management Program in an HMO Setting

2002 ◽  
Vol 95 (1) ◽  
pp. 78-87 ◽  
Author(s):  
IBRAHIM AWAD IBRAHIM ◽  
JEFF BEICH ◽  
JAAN SIDOROV ◽  
ROBERT GABBAY ◽  
LUCY YU
Keyword(s):  
Type 2 Diabetes ◽  
Disease Management ◽  
Disease Management Program ◽  
Management Program ◽  
Diabetes Disease Management Program ◽  
Measuring Outcomes
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