Tzeyu L Michaud1,2, Mohammad Siahpush2, Paul Estabrooks1,2, Robert J Schwab3, Tricia D LeVan4,5, Brandon Grimm2, Athena K Ramos1,2, Patrik Johansson2, Dylan Scoggins1, Dejun Su1,2. 1. Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA. 2. Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA. 3. Division of General Internal Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA. 4. Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA. 5. Department of Internal Medicine and Veterans Nebraska Western Iowa Healthcare System, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Abstract
Background: Evidence-based guidelines for the management of type 2 diabetes (T2D) consist of blood glucose monitoring, medication adherence, and lifestyle modifications that may particularly benefit from reminders, consultation, education, and behavioral reinforcements through remote patient monitoring (RPM). Objectives: To identify predictors of weight loss and to examine the association between weight loss and hemoglobin A1C (HbA1C) outcomes for T2D patients who were enrolled in an RPM program for diabetes management. Materials and Methods: The study applied logistic and ordinary least-squares regression models to examine the relationship between baseline characteristics and the likelihood of weight loss during the RPM, and how the magnitude of weight loss was related to changes in HbA1C outcomes for 1,103 T2D patients who went through 3 months of RPM from 2014 to 2017. Results: Older patients were 3% more likely to have weight loss (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.05), whereas patients with higher baseline HbA1C had 9% reduced odds (OR, 0.91; 95% CI, 0.85-0.97) of experiencing weight loss. For every pound of weight lost, there was a 0.02-point (95% CI, 0.01-0.03) reduction on the HbA1C measured at the end of the RPM. Moreover, compared with those who had weight loss of ≤3%, participants who had lost 5-7%, or >7% of their baseline weight had a 0.37- and 0.58-point reduction in HbA1C, respectively. Conclusions: This study revealed a notable relationship between weight loss and positive HbA1C outcomes for T2D patients in an RPM-facilitated diabetes management program, which pointed to the potential of integrating evidence-based lifestyle modification programs into future telemedicine programs to improve diabetes management outcomes.
Background: Evidence-based guidelines for the management of type 2 diabetes (T2D) consist of blood glucose monitoring, medication adherence, and lifestyle modifications that may particularly benefit from reminders, consultation, education, and behavioral reinforcements through remote patient monitoring (RPM). Objectives: To identify predictors of weight loss and to examine the association between weight loss and hemoglobin A1C (HbA1C) outcomes for T2D patients who were enrolled in an RPM program for diabetes management. Materials and Methods: The study applied logistic and ordinary least-squares regression models to examine the relationship between baseline characteristics and the likelihood of weight loss during the RPM, and how the magnitude of weight loss was related to changes in HbA1C outcomes for 1,103 T2D patients who went through 3 months of RPM from 2014 to 2017. Results: Older patients were 3% more likely to have weight loss (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.05), whereas patients with higher baseline HbA1C had 9% reduced odds (OR, 0.91; 95% CI, 0.85-0.97) of experiencing weight loss. For every pound of weight lost, there was a 0.02-point (95% CI, 0.01-0.03) reduction on the HbA1C measured at the end of the RPM. Moreover, compared with those who had weight loss of ≤3%, participants who had lost 5-7%, or >7% of their baseline weight had a 0.37- and 0.58-point reduction in HbA1C, respectively. Conclusions: This study revealed a notable relationship between weight loss and positive HbA1C outcomes for T2D patients in an RPM-facilitated diabetes management program, which pointed to the potential of integrating evidence-based lifestyle modification programs into future telemedicine programs to improve diabetes management outcomes.
Entities:
Keywords:
diabetes; e-health; home monitoring; telehealth; telemedicine
Authors: Samuel Bonet Olivencia; Arjun H Rao; Alec Smith; Farzan Sasangohar Journal: Int J Environ Res Public Health Date: 2021-12-23 Impact factor: 3.390
Authors: Joshua C Pritchett; Bijan J Borah; Aakash P Desai; Zhuoer Xie; Antoine N Saliba; Konstantinos Leventakos; Jordan D Coffey; Kristina K Pearson; Leigh L Speicher; Robert Orenstein; Abinash Virk; Ravindra Ganesh; Jonas Paludo; Thorvardur R Halfdanarson; Tufia C Haddad Journal: JCO Oncol Pract Date: 2021-06-04