Dataset Information

Requirements of an Application to Monitor Diet, Physical Activity and Glucose Values in Patients with Type 2 Diabetes: The Diameter.

ABSTRACT: Adherence to a healthy diet and regular physical activity are two important factors in sufficient type 2 diabetes mellitus management. It is recognized that the traditional treatment of outpatients does not meet the requirements for sufficient lifestyle management. It is hypothesised that a personalized diabetes management mHealth application can help. Such an application ideally measures food intake, physical activity, glucose values, and medication use, and then integrates this to provide patients and healthcare professionals insight in these factors, as well as the effect of lifestyle on glucose values in daily life. The lifestyle data can be used to give tailored coaching to improve adherence to lifestyle recommendations and medication use. This study describes the requirements for such an application: the Diameter. An iterative mixed method design approach is used that consists of a cohort study, pilot studies, literature search, and expert meetings. The requirements are defined according to the Function and events, Interactions and usability, Content and structure and Style and aesthetics (FICS) framework. This resulted in 81 requirements for the dietary (n = 37), activity and sedentary (n = 15), glycaemic (n = 12), and general (n = 17) parts. Although many applications are currently available, many of these requirements are not implemented. This stresses the need for the Diameter as a new personalized diabetes application.

SUBMITTER: den Braber N

PROVIDER: S-EPMC6413029 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Requirements of an Application to Monitor Diet, Physical Activity and Glucose Values in Patients with Type 2 Diabetes: The Diameter.

den Braber Niala N Vollenbroek-Hutten Miriam M R MMR Oosterwijk Milou M MM Gant Christina M CM Hagedoorn Ilse J M IJM van Beijnum Bert-Jan F BF Hermens Hermie J HJ Laverman Gozewijn D GD

Nutrients 20190215 2

Adherence to a healthy diet and regular physical activity are two important factors in sufficient type 2 diabetes mellitus management. It is recognized that the traditional treatment of outpatients does not meet the requirements for sufficient lifestyle management. It is hypothesised that a personalized diabetes management mHealth application can help. Such an application ideally measures food intake, physical activity, glucose values, and medication use, and then integrates this to provide pati ...[more]

PMID: 30781348

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Project description:BACKGROUND:The Onduo virtual diabetes clinic (VDC) for people with type 2 diabetes (T2D) combines a mobile app, remote personalized lifestyle coaching, connected devices, and live video consultations with board-certified endocrinologists for medication management and prescription of real-time continuous glucose monitoring (RT-CGM) devices for intermittent use. OBJECTIVE:This prospective single-arm study evaluated glycemic outcomes associated with participation in the Onduo VDC for 4 months. METHODS:Adults aged ?18 years with T2D and a baseline glycated hemoglobin (HbA1c) of ?8% to ?12% were enrolled from 2 primary care centers from February 2019 to October 2019. Participants were asked to engage at ?1 time per week with their care team and to participate in a telemedicine consultation with a clinic endocrinologist for diabetes medication review. Participants were asked to use a RT-CGM device and wear six 10-day sensors (total 60 days of sensor wear) intermittently over the course of 4 months. The primary outcome was change in HbA1c at 4 months from baseline. Other endpoints included change in weight and in RT-CGM glycemic metrics, including percent time <70, 70-180, 181-250, and >250 mg/dL. Changes in blood pressure and serum lipids at 4 months were also evaluated. RESULTS:Participants (n=55) were 57.3 (SD 11.6) years of age, body mass index 33.7 (SD 7.2), and 40% (22/55) female. HbA1c decreased significantly by 1.6% (SD 1%; P<.001). When stratified by baseline HbA1c of 8.0% to 9.0% (n=36) and >9.0% (n=19), HbA1c decreased by 1.2% (SD 0.6%; P<.001) and 2.4% (SD 1.3%; P<.001), respectively. Continuous glucose monitoring-measured (n=43) percent time in range (TIR) 70-180 mg/dL increased by 10.2% (SD 20.5%; P=.002), from 65.4% (SD 23.2%) to 75.5% (SD 22.7%), which was equivalent to a mean increase of 2.4 hours TIR per day. Percent time 181-250 mg/dL and >250 mg/dL decreased by 7.2% (SD 15.4; P=.005) and 3.0% (SD 9.4; P=.01), respectively. There was no change in percent time <70 mg/dL. Mean weight decreased by 9.0 lb (SD 10.4; P<.001). Significant improvements were also observed in systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, and triglycerides (P=.04 to P=<.001). CONCLUSIONS:Participants in the Onduo VDC experienced significant improvement in HbA1c, increased TIR, decreased time in hyperglycemia, and no increase in hypoglycemia at 4 months. Improvements in other metabolic health parameters including weight and blood pressure were also observed. In conclusion, the Onduo VDC has potential to support people with T2D and their clinicians between office visits by increasing access to specialty care and advanced diabetes technology including RT-CGM. TRIAL REGISTRATION:ClinicalTrials.gov NCT03865381; https://clinicaltrials.gov/ct2/show/NCT03865381.

Project description:BackgroundDiet and physical activity (PA) are fundamental aspects of care in type 1 diabetes, but scant longitudinal data exist on these behaviors in adolescents with type 1 diabetes, especially compared to non-diabetic controls.MethodsData in 211 adolescents with type 1 diabetes (baseline age?=?15.3?±?2.2 years, diabetes duration?=?8.8?±?3.1 years, A1c?=?9.0?±?1.5%, 51% male) and 67 non-diabetic (age?=?14.9?±?1.7 years, 52% male) controls were collected at baseline (V1) and again at 2-year follow-up (V2) (mean follow up?=?2.2?±?0.4 years). Diet data (meals/day, snacks/day, and weekly consumption of breakfast, fruit, vegetables and fried foods), and PA were collected using interviewer administered questionnaires. T-tests and chi-squared tests were used for comparisons.ResultsBoth adolescents with type 1 diabetes and non-diabetic controls reported increased vegetable (2.8 v. 3.6 and 3.1 v. 3.8 times weekly, respectively, p?<?0.0001) and fruit (2.9 v. 3.8, both groups, p?<?0.0001) intake (times per week) and increased PA (hours/day; 1.8 v. 2.2, p?=?0.005 and 1.5 v. 1.9, p?=?0.008, respectively) from V1 to V2. Adolescents with type 1 diabetes reported eating breakfast (3.3 v. 3.8 weekly, p?=?0.0002) but also fried foods (1.9 v. 2.3, p?=?0.0005) weekly more often from V1 to V2. Adolescents with and without type 1 diabetes met PA recommendations of 60 minutes or more of moderate-to-hard PA daily at both V1 (74% v. 70%, respectively, p?=?0.58) and V2 (70% v. 78%, respectively, p?=?0.78).ConclusionsOver 2 years, adolescents with and without type 1 diabetes had a healthier diet with increased fruit and vegetable intake and increased PA. However, neither group met the guidelines of daily breakfast, fruit and vegetable intake. Some diet and PA improvements were seen in adolescents with type 1 diabetes over a 2-year period. Therefore, adolescence could be a beneficial time to target diet and lifestyle interventions to take advantage of this time period when behaviors are being modified.

Dataset Information

Requirements of an Application to Monitor Diet, Physical Activity and Glucose Values in Patients with Type 2 Diabetes: The Diameter.

Publications

Requirements of an Application to Monitor Diet, Physical Activity and Glucose Values in Patients with Type 2 Diabetes: The Diameter.

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