Active assistance technology reduces glycosylated hemoglobin and weight in individuals with type 2 diabetes

Results of a theory-based randomized trial

Anna-Leena Orsama, Jaakko Lähteenmäki, K. Harno, Minna Kulju, E. Wintergerst, H. Schachner, P. Stenger, Juha Leppänen, Hannu Kaijanranta, V. Salaspuro, W.A. Fisher (Corresponding Author)

Research output: Contribution to journalArticleScientificpeer-review

46 Citations (Scopus)

Abstract

Background: Type 2 diabetes is an individual health challenge requiring ongoing self-management. Remote patient reporting of relevant health parameters and linked automated feedback via mobile telephone have potential to strengthen self-management and improve outcomes. This research involved development and evaluation of a mobile telephone-based remote patient reporting and automated telephone feedback system, guided by health behavior change theory, aimed at improving self-management and health status in individuals with type 2 diabetes. Subjects and Methods: This research comprised a randomized controlled trial. Inclusion criteria were diagnosis of type 2 diabetes, elevated glycosylated hemoglobin (HbA1c) levels (range, 6.5–11%) or use of oral diabetes medication, and 30–70 years of age. Intervention subjects (n=24) participated in remote patient reporting of health status parameters and linked health behavior change feedback. Control participants (n=24) received standard of care including diabetes education and healthcare provider counseling. Patients were followed for approximately 10 months. Results: Intervention participants achieved, compared with controls and controlling for baseline, a significantly greater mean reduction in HbA1c of −0.40% (95% confidence interval [CI] −0.67% to −0.14%) versus 0.036% (95% CI −0.23% to 0.30%) (P<0.03) and significantly greater weight reduction of −2.1 kg (95% CI −3.6 to −0.6 kg) versus 0.4 kg (95% CI −1.1 to 1.9 kg). Nonsignificant trends for greater intervention compared with control improvement in systolic and diastolic blood pressure were observed. Conclusions: Sophisticated information technology platforms for remote patient reporting linked with theory-based health behavior change automated feedback have potential to improve patient outcomes in type 2 diabetes and merit scaled-up research efforts.
Original languageEnglish
Pages (from-to)662-669
Number of pages7
JournalDiabetes Technology and Therapeutics
Volume15
Issue number8
DOIs
Publication statusPublished - 2013
MoE publication typeA1 Journal article-refereed

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Glycosylated Hemoglobin A
Type 2 Diabetes Mellitus
Technology
Weights and Measures
Health Behavior
Self Care
Confidence Intervals
Cell Phones
Health Status
Research
Blood Pressure
Health
Standard of Care
Telephone
Health Personnel
Counseling
Weight Loss
Randomized Controlled Trials
Education

Cite this

Orsama, Anna-Leena ; Lähteenmäki, Jaakko ; Harno, K. ; Kulju, Minna ; Wintergerst, E. ; Schachner, H. ; Stenger, P. ; Leppänen, Juha ; Kaijanranta, Hannu ; Salaspuro, V. ; Fisher, W.A. / Active assistance technology reduces glycosylated hemoglobin and weight in individuals with type 2 diabetes : Results of a theory-based randomized trial. In: Diabetes Technology and Therapeutics. 2013 ; Vol. 15, No. 8. pp. 662-669.
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title = "Active assistance technology reduces glycosylated hemoglobin and weight in individuals with type 2 diabetes: Results of a theory-based randomized trial",
abstract = "Background: Type 2 diabetes is an individual health challenge requiring ongoing self-management. Remote patient reporting of relevant health parameters and linked automated feedback via mobile telephone have potential to strengthen self-management and improve outcomes. This research involved development and evaluation of a mobile telephone-based remote patient reporting and automated telephone feedback system, guided by health behavior change theory, aimed at improving self-management and health status in individuals with type 2 diabetes. Subjects and Methods: This research comprised a randomized controlled trial. Inclusion criteria were diagnosis of type 2 diabetes, elevated glycosylated hemoglobin (HbA1c) levels (range, 6.5–11{\%}) or use of oral diabetes medication, and 30–70 years of age. Intervention subjects (n=24) participated in remote patient reporting of health status parameters and linked health behavior change feedback. Control participants (n=24) received standard of care including diabetes education and healthcare provider counseling. Patients were followed for approximately 10 months. Results: Intervention participants achieved, compared with controls and controlling for baseline, a significantly greater mean reduction in HbA1c of −0.40{\%} (95{\%} confidence interval [CI] −0.67{\%} to −0.14{\%}) versus 0.036{\%} (95{\%} CI −0.23{\%} to 0.30{\%}) (P<0.03) and significantly greater weight reduction of −2.1 kg (95{\%} CI −3.6 to −0.6 kg) versus 0.4 kg (95{\%} CI −1.1 to 1.9 kg). Nonsignificant trends for greater intervention compared with control improvement in systolic and diastolic blood pressure were observed. Conclusions: Sophisticated information technology platforms for remote patient reporting linked with theory-based health behavior change automated feedback have potential to improve patient outcomes in type 2 diabetes and merit scaled-up research efforts.",
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Active assistance technology reduces glycosylated hemoglobin and weight in individuals with type 2 diabetes : Results of a theory-based randomized trial. / Orsama, Anna-Leena; Lähteenmäki, Jaakko; Harno, K.; Kulju, Minna; Wintergerst, E.; Schachner, H.; Stenger, P.; Leppänen, Juha; Kaijanranta, Hannu; Salaspuro, V.; Fisher, W.A. (Corresponding Author).

In: Diabetes Technology and Therapeutics, Vol. 15, No. 8, 2013, p. 662-669.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Active assistance technology reduces glycosylated hemoglobin and weight in individuals with type 2 diabetes

T2 - Results of a theory-based randomized trial

AU - Orsama, Anna-Leena

AU - Lähteenmäki, Jaakko

AU - Harno, K.

AU - Kulju, Minna

AU - Wintergerst, E.

AU - Schachner, H.

AU - Stenger, P.

AU - Leppänen, Juha

AU - Kaijanranta, Hannu

AU - Salaspuro, V.

AU - Fisher, W.A.

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N2 - Background: Type 2 diabetes is an individual health challenge requiring ongoing self-management. Remote patient reporting of relevant health parameters and linked automated feedback via mobile telephone have potential to strengthen self-management and improve outcomes. This research involved development and evaluation of a mobile telephone-based remote patient reporting and automated telephone feedback system, guided by health behavior change theory, aimed at improving self-management and health status in individuals with type 2 diabetes. Subjects and Methods: This research comprised a randomized controlled trial. Inclusion criteria were diagnosis of type 2 diabetes, elevated glycosylated hemoglobin (HbA1c) levels (range, 6.5–11%) or use of oral diabetes medication, and 30–70 years of age. Intervention subjects (n=24) participated in remote patient reporting of health status parameters and linked health behavior change feedback. Control participants (n=24) received standard of care including diabetes education and healthcare provider counseling. Patients were followed for approximately 10 months. Results: Intervention participants achieved, compared with controls and controlling for baseline, a significantly greater mean reduction in HbA1c of −0.40% (95% confidence interval [CI] −0.67% to −0.14%) versus 0.036% (95% CI −0.23% to 0.30%) (P<0.03) and significantly greater weight reduction of −2.1 kg (95% CI −3.6 to −0.6 kg) versus 0.4 kg (95% CI −1.1 to 1.9 kg). Nonsignificant trends for greater intervention compared with control improvement in systolic and diastolic blood pressure were observed. Conclusions: Sophisticated information technology platforms for remote patient reporting linked with theory-based health behavior change automated feedback have potential to improve patient outcomes in type 2 diabetes and merit scaled-up research efforts.

AB - Background: Type 2 diabetes is an individual health challenge requiring ongoing self-management. Remote patient reporting of relevant health parameters and linked automated feedback via mobile telephone have potential to strengthen self-management and improve outcomes. This research involved development and evaluation of a mobile telephone-based remote patient reporting and automated telephone feedback system, guided by health behavior change theory, aimed at improving self-management and health status in individuals with type 2 diabetes. Subjects and Methods: This research comprised a randomized controlled trial. Inclusion criteria were diagnosis of type 2 diabetes, elevated glycosylated hemoglobin (HbA1c) levels (range, 6.5–11%) or use of oral diabetes medication, and 30–70 years of age. Intervention subjects (n=24) participated in remote patient reporting of health status parameters and linked health behavior change feedback. Control participants (n=24) received standard of care including diabetes education and healthcare provider counseling. Patients were followed for approximately 10 months. Results: Intervention participants achieved, compared with controls and controlling for baseline, a significantly greater mean reduction in HbA1c of −0.40% (95% confidence interval [CI] −0.67% to −0.14%) versus 0.036% (95% CI −0.23% to 0.30%) (P<0.03) and significantly greater weight reduction of −2.1 kg (95% CI −3.6 to −0.6 kg) versus 0.4 kg (95% CI −1.1 to 1.9 kg). Nonsignificant trends for greater intervention compared with control improvement in systolic and diastolic blood pressure were observed. Conclusions: Sophisticated information technology platforms for remote patient reporting linked with theory-based health behavior change automated feedback have potential to improve patient outcomes in type 2 diabetes and merit scaled-up research efforts.

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DO - 10.1089/dia.2013.0056

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JO - Diabetes Technology and Therapeutics

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SN - 1520-9156

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ER -