Impact of a Digitally Enhanced Diabetes Self-Management Program on Glycemia and Medical Costs

Abstract

Objective: To analyze economic savings and health impacts associated with a virtual digitally enhanced diabetes self-management education and support (DSMES) program. Research design and methods: Participants (n = 1,494) were nonpregnant adults with diagnosed type 2 diabetes and baseline body mass index (BMI) of 25 kg/m2 (23 kg/m2 if of Asian descent) or higher who enrolled in virtual DSMES between February 2019 and April 2020 for at least 4 months. Participants’ changes in glycated hemoglobin (A1C) and body weight were calculated as the difference between program start and last recorded values between months 4 and 6. Outcomes for all participants were analyzed; subanalyses were done on 628 participants with starting A1C >7% (53 mmol/mol), who could benefit most from DSMES. Markov-based microsimulation approach was used to model the potential reductions in diabetes sequalae and medical expenditures if observed improvements in A1C and BMI were maintained. Results: DSMES participants with starting A1C >7% experienced average reductions of 0.9% A1C and 2.1 kg of body weight (−1.7% of BMI) within 6 months. If these improvements were maintained, simulated outcomes include reduced 5-year onset of ischemic heart disease by 9.2%, myocardial infarction by 10.6%, stroke by 12.1%, chronic kidney disease by 16.5%, and reduced onset of other sequelae. Simulated cumulative reduction in medical expenditures is $1160 after 1 year, $4150 after 3 years, $7790 after 5 years, and $18 020 after 10 years. Conclusions: Participation in virtual DSMES improves A1C and body weight, with the potential to slow onset of diabetes sequelae and reduce medical expenditures.

Long-Term Results of a Digital Diabetes Self-Management and Education Support Program Among Adults With Type 2 Diabetes: A Retrospective Cohort Study

“…28 A recent analysis also revealed that participation in this program significantly improves A1C and body weight within 6 months, with the potential to slow onset of diabetes sequelae and reduce medical expenditures. 29 Although it is evident that participation in Omada for Diabetes has clinical and cost-saving benefits, research assessing real-world evidence outcomes over a longer period of time is warranted. Therefore, the primary objective of this study is to evaluate the impact of Omada for Diabetes on A1C across 12 months, overall and stratified by A1C at baseline (≥8% vs <8%).…”

WhatsApp‐based intervention for people with type 2 diabetes: A randomized controlled trial

“…Primary outcomes of DSMES include (i) improved T2DM self-efficacy, (ii) increased diabetes knowledge, (iii) glycemic control of hemoglobin A1c (HbA1c), (iv) reduced symptoms of anxiety and depression, and (v) enhanced quality of life (Kavookjian et al, 2022;Tanaka et al, 2020). Benefits of DMSES include improved health behaviors and health outcomes such as prevention and delay of complications and improved hemoglobin A1C levels (Chen et al, 2022;Okeyo et al, 2023). Although clinical benefits of DMSES have been demonstrated, DSMES services remain widely underused (James, 2021).…”