BACKGROUND: We examine the changes in waist circumference (WC) and body mass index (BMI) in older adults enrolled in a diabetes telemedicine program. The subjects were elderly Medicare beneficiaries participating in the rural (upstate New York) cohort of Informatics and Diabetes Education and Telemedicine, a randomized, controlled trial using telemedicine to improve diabetes care in which the primary outcome was glycemic control. METHODS: Ninety-two percent of the subjects had BMI >25 kg/m(2), and 65.8% had a BMI > or =30 kg/m(2). Intervention subjects received home televisits with a dietitian or nurse educator every 4-6 weeks. Blood glucose and blood pressure values were reviewed, and lifestyle and medication changes were recommended. Non-intervention subjects received usual care through their primary care physicians. Change in WC, BMI, diet, and exercise behaviors and knowledge were examined at baseline and 12 and 24 months. A mixed-effects path analysis was performed to examine direct and indirect effects. RESULTS: The telemedicine participants increased diet and exercise knowledge over time (P < 0.001). It was estimated that women in the telemedicine group reduced their WC over the 2 years by 1.2 cm, whereas women in the usual care group increased their WC by almost 1 cm (P = 0.02). Path analysis demonstrated that the intervention, through improved diet and exercise knowledge, was related to the decrease in WC (P = 0.006) and BMI (P = 0.004). CONCLUSIONS: Diabetes case management using telemedicine improved self-reported diet and exercise knowledge, practices, and behaviors, which in turn was associated with reductions in WC and BMI at 2 years.
RCT Entities:
BACKGROUND: We examine the changes in waist circumference (WC) and body mass index (BMI) in older adults enrolled in a diabetes telemedicine program. The subjects were elderly Medicare beneficiaries participating in the rural (upstate New York) cohort of Informatics and Diabetes Education and Telemedicine, a randomized, controlled trial using telemedicine to improve diabetes care in which the primary outcome was glycemic control. METHODS: Ninety-two percent of the subjects had BMI >25 kg/m(2), and 65.8% had a BMI > or =30 kg/m(2). Intervention subjects received home televisits with a dietitian or nurse educator every 4-6 weeks. Blood glucose and blood pressure values were reviewed, and lifestyle and medication changes were recommended. Non-intervention subjects received usual care through their primary care physicians. Change in WC, BMI, diet, and exercise behaviors and knowledge were examined at baseline and 12 and 24 months. A mixed-effects path analysis was performed to examine direct and indirect effects. RESULTS: The telemedicine participants increased diet and exercise knowledge over time (P < 0.001). It was estimated that women in the telemedicine group reduced their WC over the 2 years by 1.2 cm, whereas women in the usual care group increased their WC by almost 1 cm (P = 0.02). Path analysis demonstrated that the intervention, through improved diet and exercise knowledge, was related to the decrease in WC (P = 0.006) and BMI (P = 0.004). CONCLUSIONS:Diabetes case management using telemedicine improved self-reported diet and exercise knowledge, practices, and behaviors, which in turn was associated with reductions in WC and BMI at 2 years.
Authors: John A Batsis; Peter R DiMilia; Lillian M Seo; Karen L Fortuna; Meaghan A Kennedy; Heather B Blunt; Pamela J Bagley; Jessica Brooks; Emma Brooks; Soo Yeon Kim; Rebecca K Masutani; Martha L Bruce; Stephen J Bartels Journal: J Am Geriatr Soc Date: 2019-05-08 Impact factor: 5.562
Authors: Ruth S Weinstock; Jeanne A Teresi; Robin Goland; Roberto Izquierdo; Walter Palmas; Joseph P Eimicke; Susana Ebner; Steven Shea Journal: Diabetes Care Date: 2011-02 Impact factor: 19.112