Diabetes Prevention and Weight Loss with a Fully Automated Behavioral Intervention by Email, Web, and Mobile Phone: A Randomized Controlled Trial Among Persons with Prediabetes

糖尿病前期 医学 糖化血红素 减肥 体质指数 超重 糖尿病 老年学 健康指导 物理疗法 随机对照试验 2型糖尿病 肥胖 内科学 内分泌学
作者
Gladys Block,Kristen M.J. Azar,Robert J. Romanelli,Torin Block,Donald R. Hopkins,Heather A Carpenter,Marina Dolginsky,Mark Hudes,Latha Palaniappan,Clifford H. Block
出处
期刊:Journal of Medical Internet Research [JMIR Publications]
卷期号:17 (10): e240-e240 被引量:173
标识
DOI:10.2196/jmir.4897
摘要

One-third of US adults, 86 million people, have prediabetes. Two-thirds of adults are overweight or obese and at risk for diabetes. Effective and affordable interventions are needed that can reach these 86 million, and others at high risk, to reduce their progression to diagnosed diabetes.The aim was to evaluate the effectiveness of a fully automated algorithm-driven behavioral intervention for diabetes prevention, Alive-PD, delivered via the Web, Internet, mobile phone, and automated phone calls.Alive-PD provided tailored behavioral support for improvements in physical activity, eating habits, and factors such as weight loss, stress, and sleep. Weekly emails suggested small-step goals and linked to an individual Web page with tools for tracking, coaching, social support through virtual teams, competition, and health information. A mobile phone app and automated phone calls provided further support. The trial randomly assigned 339 persons to the Alive-PD intervention (n=163) or a 6-month wait-list usual-care control group (n=176). Participants were eligible if either fasting glucose or glycated hemoglobin A1c (HbA1c) was in the prediabetic range. Primary outcome measures were changes in fasting glucose and HbA1c at 6 months. Secondary outcome measures included clinic-measured changes in body weight, body mass index (BMI), waist circumference, triglyceride/high-density lipoprotein cholesterol (TG/HDL) ratio, and Framingham diabetes risk score. Analysis was by intention-to-treat.Participants' mean age was 55 (SD 8.9) years, mean BMI was 31.2 (SD 4.4) kg/m(2), and 68.7% (233/339) were male. Mean fasting glucose was in the prediabetic range (mean 109.9, SD 8.4 mg/dL), whereas the mean HbA1c was 5.6% (SD 0.3), in the normal range. In intention-to-treat analyses, Alive-PD participants achieved significantly greater reductions than controls in fasting glucose (mean -7.36 mg/dL, 95% CI -7.85 to -6.87 vs mean -2.19, 95% CI -2.64 to -1.73, P<.001), HbA1c (mean -0.26%, 95% CI -0.27 to -0.24 vs mean -0.18%, 95% CI -0.19 to -0.16, P<.001), and body weight (mean -3.26 kg, 95% CI -3.26 to -3.25 vs mean -1.26 kg, 95% CI -1.27 to -1.26, P<.001). Reductions in BMI, waist circumference, and TG/HDL were also significantly greater in Alive-PD participants than in the control group. At 6 months, the Alive-PD group reduced their Framingham 8-year diabetes risk from 16% to 11%, significantly more than the control group (P<.001). Participation and retention was good; intervention participants interacted with the program a median of 17 (IQR 14) of 24 weeks and 71.1% (116/163) were still interacting with the program in month 6.Alive-PD improved glycemic control, body weight, BMI, waist circumference, TG/HDL ratio, and diabetes risk. As a fully automated system, the program has high potential for scalability and could potentially reach many of the 86 million US adults who have prediabetes as well as other at-risk groups.Clinicaltrials.gov NCT01479062; https://clinicaltrials.gov/ct2/show/NCT01479062 (Archived by WebCite at http://www.webcitation.org/6bt4V20NR).
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
1秒前
1秒前
张豪杰发布了新的文献求助10
2秒前
闻元杰完成签到,获得积分10
2秒前
LISHAN驳回了Arlene应助
2秒前
钩子89完成签到,获得积分10
3秒前
李健应助lili采纳,获得20
3秒前
孙琪发布了新的文献求助10
4秒前
耳机单蹦完成签到,获得积分10
4秒前
欢呼妙菱发布了新的文献求助10
4秒前
an12138完成签到,获得积分10
4秒前
星辰大海应助lorixu采纳,获得10
4秒前
5秒前
sdniuidifod发布了新的文献求助10
5秒前
丰富的妙柏完成签到,获得积分20
5秒前
无昵称发布了新的文献求助10
5秒前
小马甲应助zy采纳,获得10
6秒前
6秒前
隐形曼青应助苹果从菡采纳,获得10
6秒前
6秒前
快乐小狗发布了新的文献求助20
7秒前
林深完成签到,获得积分10
7秒前
8秒前
xiaokk完成签到,获得积分20
9秒前
9秒前
哈哈完成签到,获得积分10
9秒前
哇哦完成签到,获得积分10
10秒前
美满棉花糖完成签到,获得积分10
10秒前
rich应助善良身影采纳,获得10
10秒前
10秒前
11秒前
之乡坞完成签到,获得积分10
11秒前
雾里看花水中望月完成签到,获得积分10
11秒前
咕噜咕噜完成签到,获得积分20
11秒前
xiaozhang完成签到,获得积分10
12秒前
12秒前
i3utter发布了新的文献求助10
12秒前
飞云发布了新的文献求助10
12秒前
cheng4046完成签到,获得积分10
13秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Picture Books with Same-sex Parented Families: Unintentional Censorship 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3969335
求助须知:如何正确求助?哪些是违规求助? 3514162
关于积分的说明 11172430
捐赠科研通 3249456
什么是DOI,文献DOI怎么找? 1794853
邀请新用户注册赠送积分活动 875437
科研通“疑难数据库(出版商)”最低求助积分说明 804809