Telemedical lifestyle intervention boosts glycemic control
medwireNews: A multimodal telemedical lifestyle intervention improves glycemic control compared with standard care among patients with advanced type 2 diabetes, researchers report.
“The increasing prevalence of type 2 diabetes and the concomitant increase in antidiabetes medication costs are a considerable burden for national health care systems,” meaning that “there is a strong need for alternative lifestyle-based therapeutic approaches,” say Kerstin Kempf (Düsseldorf Catholic Hospital Group, Germany) and study co-authors.
In their randomized-single blind trial, the researchers assigned participants with type 2 diabetes who were overweight or obese, had insufficient glycemic control, and were being treated with at least two antidiabetic drugs to receive either the 12-week TeLiPro intervention – combining telemonitoring, telemedical coaching, motivation, protein-rich meal replacement therapy, and self-monitoring of blood glucose – or usual care, involving the provision of weighing scales and step counters.
They found that glycated hemoglobin (HbA1c) levels decreased from 8.4% (68.3 mmol/mol) at baseline to 7.3% (56.3 mmol/mol) at 12 weeks among the 93 participants in the TeLiPro group, compared with a corresponding reduction from 8.2% (66.1 mmol/mol) to 8.0% (63.9 mmol/mol) among the 74 participants receiving usual care.
These findings translated into a significant estimated treatment difference of 0.8% for TeLiPro versus usual care at 12 weeks after adjustment for repeated measurements and factors including age, diabetes duration, blood pressure, and body mass index.
The effect of the TeLiPro intervention was maintained over follow-up, with a significant estimated treatment difference of 0.6% at both the 26 week and 52 week timepoints, explain the researchers in Diabetes Care.
The team also observed significant improvements in bodyweight, body mass index, blood pressure, cardiovascular risk factors, and quality of life among participants receiving the TeLiPro intervention compared with those in the control group. And the need for antidiabetic drugs was decreased, with 53% versus 11% of patients experiencing a reduction of at least 20% in the medication effect score at 12 weeks. No adverse events were reported.
Together, these findings indicate that “in patients with advanced stages of type 2 diabetes, metabolic control can be significantly improved by lifestyle intervention,” write Kempf and colleagues.
And they conclude that: “If TeLiPro were to be integrated into routine care, long-term supervision could show whether improved clinical outcomes could be maintained and whether the development of diabetes complications could be inhibited.”
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