1. In Asian patients with type 2 diabetes, culturally contextualized smartphone-based application was effective in improving weight management and metabolic parameters within 6 months of use.
2. Patients randomized to include smartphone-based lifestyle interventions had a greater reduction in HbA1c levels and diabetes medications within 6 months of use.
Evidence Rating Level: 1 (Excellent)
Weight management through lifestyle changes is an important component of type 2 diabetes management. With advent of technology, smartphone-based lifestyle interventions are becoming increasingly available and popular. However, the effectiveness of such smart phone-based lifestyle interventions has not been rigorously tested.
This randomized control trial tested the effectiveness of smartphone-based intervention on weight and metabolic outcomes in Asian adult patients with type 2 diabetes. 204 patients with type 2 diabetes, body mass index > 23, English literacy, and smartphone access were included. Patients with co-morbidities such as heart failure, type 1 diabetes, or cognitive or psychological disabilities were excluded. 105 patients were randomized to the control group, where they received one advisory session with a dietitian, a digital scale for home use and ongoing diabetes care. 99 patients were randomized to usual care plus use of smartphone app for 6 months to track weight, diet, exercise, and blood glucose. The smartphone app supported numerous culturally contextualized features such as frequent communication with local dietitians familiar with cultural practices surrounding food, weekly educational videos, and algorithms that suggested healthier options to local cuisine. The primary outcome measured changes in body weight. Compared to those receiving usual care, patients randomized to smartphone interventions had greater weight reduction at 6 months. Furthermore, patients in smartphone group had reduced HbA1c levels, increased level of physical activity, and reduced use of diabetes medications compared to control group. However, this study had limitations such as the generalizability of results due to strict exclusion criteria. Nonetheless, this study’s results are significant and suggest a smartphone-based lifestyle intervention may be effective in achieving glycemic and weight reductions amongst Asian adults with type 2 diabetes.
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