Digital Health–Supported Lifestyle Change Programs to Prevent Type 2 Diabetes

Kirley, Kate; Sachdev, Neha

doi:10.2337/ds18-0019

Cited by 25 publications

(16 citation statements)

References 37 publications

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“…Virtual lifestyle change programs have shown benefits in terms of weight loss for a broader population with prediabetes and may be particularly attractive to women with young children and/or time constraints. 28 We found that even women with a postcollege degree who presumably have higher household incomes were only theoretically willing to pay approximately onethird of the ''true'' cost of providing the DPP curriculum. Efforts to engage women with a GDM history in diabetes prevention, including SDM, will only be successful if insurance plans, workplaces, or other stakeholders with an interest in diabetes prevention continue to cover most of the up-front cost of the DPP for this high-risk population.…”

Section: Discussionmentioning

confidence: 72%

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Educational Attainment, Decision-Making Preferences, and Interest in Evidence-Based Diabetes Prevention among Women with a History of Gestational Diabetes Mellitus

Panchal

Turk

Moin

et al. 2021

Women's Health Reports

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Background: The Diabetes Prevention Program (DPP) showed that lifestyle change or metformin is equally efficacious in preventing diabetes in women who have had gestational diabetes mellitus (GDM). Few studies have investigated the relationship between education and willingness to engage in either intervention and between education and preferred decision-making style. Methods: Within a large health system, we surveyed insured women 18–64 years old with a history of GDM, identified through the electronic health record. We estimated preference for decision-making style and interest in DPP lifestyle change and/or metformin by educational level, using multivariate logistic regression models controlling for age, race, and ethnicity. Results: Our sample ( n = 264) was 36% Latino, 29% Asian, 28% non-Latino white, and 5% African American, with a mean age of 37 years. In terms of education, 31% had a postgraduate degree, 41% were college graduates, and 29% did not graduate from college. In multivariate analyses, willingness to engage in either intervention did not vary by education. Women who did not graduate from college were more likely to leave medical decisions to their provider ( p = 0.004) compared to women with a college or postgraduate degree. However, regardless of education, over 80% of women preferred to make medical decisions themselves or jointly with their provider. Conclusions: Most women prefer to play an active role in their own medical decisions and have an interest in both evidence-based diabetes prevention strategies. This suggests that shared decision-making is appropriate for many women with a history of GDM and different levels of educational attainment.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Educational Attainment, Decision-Making Preferences, and Interest in Evidence-Based Diabetes Prevention among Women with a History of Gestational Diabetes Mellitus

Panchal

Turk

Moin

et al. 2021

Women's Health Reports

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“…Similar to in-person programs, digital DPPs have been tested in workforce populations, and have shown comparable clinical performance to in-person programs. 16,17 The economic value of traditional, group-based, in-person DPPs has been demonstrated in cost-effectiveness and health care cost saving studies, with estimates of savings in the range of US$3000+ within 3 years. [18][19][20] However, very few cost analyses of workplace-based DPPs have been performed.…”

Section: Introductionmentioning

confidence: 99%

“…Similar to in-person programs, digital DPPs have been tested in workforce populations, and have shown comparable clinical performance to in-person programs. 16 , 17 …”

Section: Introductionmentioning

confidence: 99%

Cost Savings and Reduced Health Care Utilization Associated with Participation in a Digital Diabetes Prevention Program in an Adult Workforce Population

Sweet¹,

Jasik²,

Diebold³

et al. 2023

JHEOR

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Background: Though in-person delivery of the Diabetes Prevention Program (DPP) has demonstrated medical cost savings, the economic impact of digital programs is not as well understood. Objective: This study examines the impact of a digital DPP program on reducing all-cause health care costs and utilization among 2027 adult participants at 12 months. Methods: A longitudinal, observational analysis of health care claims data was conducted on a workforce population who participated in a digital diabetes prevention program. Differences in utilization and costs from the year prior to program delivery through 1 year after enrollment were calculated using medical claims data for digital DPP participants compared to a propensity matched cohort in a differences-in-differences model. Results: At 1 year, the digital DPP population had a reduction in all-cause health care spend of US$1169 per participant relative to the comparison group (P = 0.01), with US$699 of that savings coming from reduced inpatient spend (P = 0.001). Cost savings were driven by fewer hospital admissions and shorter length of stay (P < 0.001). No other significant results in cost differences were detected. There was a trend toward savings extending into the second year, but the savings did not reach statistical significance. Conclusions: These results demonstrated significant short-term health care cost savings at 1 year associated with digital DPP program delivery.

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“…There is some existing evidence that suggests that technology can help support weight management in people living with nondiabetic hyperglycemia [10] or T2DM [11]. The Diabetes Prevention Recognition Program in the United States recognizes more than 120 organizations delivering lifestyle change programs through digital or remote channels.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a Digital Lifestyle Change Program in Obese and Type 2 Diabetes Populations: Service Evaluation of Real-World Data (Preprint)

Idris¹,

Hampton²,

Moncrieff³

et al. 2019

Preprint

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BACKGROUND The prevalence of type 2 diabetes mellitus (T2DM) and obesity is increasing, and the way people interact with health care is evolving. People traditionally access advice and support to improve their lifestyle and learn more about the self-management of T2DM in a face-to-face setting. Although these services have a strong evidence base, they have limitations for reaching specific groups of people. Digital programs could provide a new delivery model to help more people access health education and behavior change support, but long-term data supporting these programs are limited. OBJECTIVE The purpose of this service evaluation was to analyze the weight change of people who participated in OurPath (also known as Second Nature), a UK-based digital lifestyle change program, for either weight management or diabetes-related weight management and structured education at 6 and 12 months. METHODS Participants either paid to access the program privately (self-funded clients) or were referred by their general practitioner to participate in the program free of charge (funded by the National Health Service). Additional follow-up support was provided to help people to maintain lifestyle changes. To retrospectively assess potential weight loss, the analysis included data from participants who submitted weight readings at baseline and 6 and 12 months after starting the program. Changes in weight after 6 and 12 months were primary outcome measures. RESULTS For the 896 participants who submitted baseline and 6- and 12-month data, a significant change in mean weight of −7.12 kg (−7.50%; SD 6.37; <italic>P</italic><.001) was observed at 6 months. Data from the same participants at 12 months showed a change in mean weight when compared with a baseline of −6.14 kg (−6.48%; SD 6.97; <italic>P</italic><.001). CONCLUSIONS The data presented here had several limitations, and there were too many uncertainties to make any reliable conclusions. However, these results suggest that digital lifestyle change programs could provide a new way to help people to access nutritional advice and support to achieve weight loss. Further research into digital education and coaching platforms is needed to establish their effectiveness.

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Digital Health–Supported Lifestyle Change Programs to Prevent Type 2 Diabetes

Cited by 25 publications

References 37 publications

Educational Attainment, Decision-Making Preferences, and Interest in Evidence-Based Diabetes Prevention among Women with a History of Gestational Diabetes Mellitus

Educational Attainment, Decision-Making Preferences, and Interest in Evidence-Based Diabetes Prevention among Women with a History of Gestational Diabetes Mellitus

Cost Savings and Reduced Health Care Utilization Associated with Participation in a Digital Diabetes Prevention Program in an Adult Workforce Population

Effectiveness of a Digital Lifestyle Change Program in Obese and Type 2 Diabetes Populations: Service Evaluation of Real-World Data (Preprint)

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