The Effectiveness of a Traditional Chinese Medicine–Based Mobile Health App for Individuals With Prediabetes: Randomized Controlled Trial

Abstract

Background Traditional Chinese medicine (TCM) theories assert that body constitution and meridian energy lay the foundation for disease prevention. TCM-based health concepts have not yet been incorporated into mobile health (mHealth) apps for individuals with prediabetes. Objective The aim of this study was to examine the effectiveness of a TCM mHealth app for individuals with prediabetes. Methods This randomized controlled trial recruited 121 individuals with prediabetes at a teaching hospital in New Taipei City between February 2020 and May 2021. The participants were randomly assigned to the TCM mHealth app group (n=42), ordinary mHealth app group (n=41), or control group (n=38). All participants received the usual care that included 15-20 minutes of health education about the disease, along with healthy diet and exercise encouragement. The ordinary mHealth app included physical activity (PA), diet, and disease education, along with individual records. The TCM mHealth app additionally included qi and body constitution information, along with constitution-based PA and diet advice. The control group received the usual care alone and did not have access to any app. Data were collected at baseline, at the end of the 12-week intervention, and 1 month after the intervention. Body constitution, including yang-deficiency, yin-deficiency, and phlegm-stasis, was measured according to the Body Constitution Questionnaire, with higher scores indicating a greater deficiency. Body energy was examined using the Meridian Energy Analysis Device. The Short-Form 36 questionnaire was used to evaluate health-related quality of life (HRQOL), which yielded physical component scores and mental component scores, with higher scores indicating better physical and mental aspects of HRQOL, respectively. Results Compared to the control group, the TCM mHealth app group showed greater improvement in hemoglobin A1c (HbA1c), yang-deficiency and phlegm-stasis body constitution, and BMI; however, no significant differences were found in these outcomes between the TCM mHealth app and ordinary mHealth app groups. The TCM mHealth app group showed better improvement in body energy and mental component scores than the ordinary mHealth app group. There were no significant differences in fasting plasma glucose, yin-deficiency body constitution, Dietary Approaches to Stop Hypertension dietary behavior, and total PA among the three groups after the intervention. Conclusions Use of either the ordinary or TCM mHealth app improved HRQOL among individuals with prediabetes. Compared to the outcomes of controls not using any app, use of the TCM mHealth app was effective at improving HbA1c, BMI, yang-deficiency and phlegm-stasis body constitution, and HRQOL. Moreover, using the TCM mHealth app seemed to improve the body energy and HRQOL more than when using the ordinary mHealth app. Further studies with a larger sample size and longer follow-up period may be necessary to determine whether the differences favoring the TCM app are clinically meaningful. Trial Registration ClinicalTrials.gov NCT04096989; https://clinicaltrials.gov/ct2/show/NCT04096989

Impact of Different Traditional Chinese Medicine Constitutions on the Clinical Outcomes of COVID-19 Patients Infected with SARS-CoV-2 Omicron Variant: A Retrospective Observational Study

“…[7][8][9][10][11][12] Traditional Chinese medicine constitution theory believes that through diet, exercise, 28 drug conditioning and other methods can improve people's unbalanced constitution, so as to prevent the occurrence of disease, or improve the condition of patients who have been sick, and promote the recovery of disease. 29,30 Therefore, the TCM constitution has enormous potential for disease prevention and treatment applications. Our research revealed that among all patients with COVID-19, 43.8% had a balanced constitution, consistent with the constitution proportion in the Chinese population, 31 indicating that all constitutional groups are susceptible to the COVID-19 Omicron variant.…”

Concerns on Generalizability

“…We read the study by Chung et al [ 1 ], which evaluated the effectiveness of a mobile health (mHealth) app based on traditional Chinese medicine (TCM) in patients with prediabetes. This randomized controlled trial showed that the TCM mHealth app improved physical energy, fitness, and quality of life in patients with prediabetes.…”

“…Third, an interaction is an action that occurs when 2 or more objects interact with each other [ 4 ]. Since many variables are described in the first table of Chung et al’s [ 1 ] paper, prespecified subgroup analyses based on these variables are necessary. Subgroup analyses based on age, gender, BMI, body composition, and blood pressure were not performed in this study.…”

Authors’ Reply: Concerns on Generalizability

“…We appreciate the thoughtful comments by Lin [ 1 ] on our study [ 2 ]. We have mentioned that the limitations of our study include a small sample size and a short follow-up period.…”