Diabetes Study Suggests Smartphone Apps Are More Effective Than Conventional Treatment

F.J. Thomas

Sarasota, FL (WorkersCompensation.com) – While recent studies indicate that working from home has caused the majority of workers to gain weight from an increased intake in homemade junk food, another recent study published this month in The Journal of the American Medical Association suggests a solution might be on the horizon.

In a randomized clinical trial, researchers from Singapore studied the effects that a smartphone app had on weight and metabolic outcomes in 204 adults with Type 2 Diabetes. Researchers posed the question of how the outcomes of Type 2 diabetic patients monitored by the smartphone app compared to the outcomes accomplished through usual medical channels.

The participants were recruited from health screenings that were conducted from October 2017 through September 2019. Criteria to qualify for the study included physician diagnosed Type 2 diabetes, being 21-to-75 years of age, and having a Body Mass Index (BMI) of 23.0 or greater, as well as English literacy and access to a smartphone. Participants with comorbidities such as untreated hypothyroidism, blood disorders, severe depression, or those who were pregnant were not included in the study. Additionally, participants with insulin use were excluded, as well as patients with untreated anemia, or those that exhibited medication noncompliance.

All participants received counseling sessions from a registered dietitian, and continued to receive standard diabetes follow up care from their usual physicians. Additionally, all the participants received a standard scale to use for the course of the study.

The participants in the intervention group were tasked with tracking their weight twice a week on the app for 6 months. Physical activity and food intake was logged daily. Each participant chose a weight-loss goal from 3 to 10 percent, and chose a carbohydrate goal as well. All participants were encouraged to get in at least 10,000 steps daily, which were also monitored by the app. In addition to calorie and activity levels, fasting and post-meal blood glucose levels were recorded twice a week.

In the first 3 months, the participants received educational videos once a week on nutrition. The research team included 2 dieticians that reached out to counsel the participants on diet and lifestyle changes every few days for the first half of the study, and then weekly during the second half.

The control group consisted of 105 participants, and the intervention group totaled 99. Four participants from the control group, and 5 from the intervention group left the study. The average age of the participants was 51.2, with an average BMI of 30.6. The average hemoglobin A1C level was 7.4 percent.

The average A1C levels improved for both groups. Overall fasting glucose levels improved by 14.4 mg/dL, with an improvement of 1.8 mg/dL in each of the groups.

In addition to improving A1C levels, the intervention group lost more than double the amount of weight as the control group. Average weight loss in the intervention group was 7.9 pounds, while the average loss in the control group was 2.6 pounds.

At 6 months, those in the intervention group showed a sustained increase in physical activity, and sustained reductions in carbohydrate, saturated fat, and overall calories.

A noticeable reduction in medications was also noted in the intervention group. Only 4 participants in the control group reduced their medications, while 17 participants – a total of 23 percent – in the intervention group were able to reduce their medication. Additionally, the number of participants that increased the medication was greater in the control group. Of the control group, 24.3 percent increased their medications, compared to 6.8 percent of the intervention group. A corresponding change in annual medication costs were seen as well.

Of the intervention group, 62 percent used the app at least 75 percent of the time during the 6-month period.

The full study is available on the JAMA website.

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