Evaluating the feasibility and impact of an internet-based lifestyle management program in a diabetes care setting

Diabetes Technol Ther. 2014 Jun;16(6):358-62. doi: 10.1089/dia.2013.0278. Epub 2014 Feb 28.

Abstract

Background: This study determined the impact of an online lifestyle management program on obese individuals with type 2 diabetes in a large academic diabetes clinic.

Subjects and methods: Using a single cohort design, individuals with type 2 diabetes and a body mass index (BMI) of ≥ 30 kg/m(2) were recruited to have access to the Virtual Lifestyle Management (VLM) program for 1 year, in addition to their routine care. Participants were assessed at baseline and at 6 and 12 months for the following outcomes: (a) glycated hemoglobin (A1C), (b) lipids (total cholesterol [TC] and TC/high-density lipid [HDL] ratio), (c) weight, (d) BMI, and (e) body fat percentage (BFP).

Results: Seventy-eight individuals consented to the study, 66 (84%) logged onto the system two or more times, and 49 (62%) contributed data at the 1-year program. At baseline, the mean age of participants was 57.9 years of age, and 52% were female. At 12 months, mean differences from baseline were as follows: A1C, -0.3% (95% confidence interval [CI] -0.1, -0.5; P<0.05); TC/HDL, -0.2 (95% CI -0.01, -0.04; P<0.05); weight, -8.6 pounds (95% CI -3.7, -13.6; P<0.05); BMI, -1.5 kg/m(2) (95% CI -0.7, -2.3; P<0.05); and BFP, -1.8% (95% CI -0.9, -2.7; P<0.05). After adjusting for program use, age, and sex, changes in BMI, BFP, and self-reported daily steps taken were statistically significant at 12 months.

Conclusions: This before-after pilot study demonstrates that adding an Internet-based lifestyle modification program to usual care may improve clinically important outcomes.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / metabolism*
  • Body Mass Index
  • Computer-Assisted Instruction / statistics & numerical data*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / psychology
  • Diabetes Mellitus, Type 2 / therapy*
  • Feasibility Studies
  • Female
  • Glycated Hemoglobin / metabolism
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Internet*
  • Male
  • Middle Aged
  • Obesity / blood
  • Obesity / prevention & control*
  • Obesity / psychology
  • Patient Compliance
  • Pilot Projects
  • Risk Reduction Behavior
  • Self Care*
  • Treatment Outcome

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human