Active assistance technology reduces glycosylated hemoglobin and weight in individuals with type 2 diabetes: Results of a theory-based randomized trial

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.