1 Faculty of Health Sciences, McMaster University , Hamilton, Ontario, Canada .
Diabetes Technol Ther. 2014 Jun;16(6):358-62. doi: 10.1089/dia.2013.0278. Epub 2014 Feb 28.
This study determined the impact of an online lifestyle management program on obese individuals with type 2 diabetes in a large academic diabetes clinic.
Using a single cohort design, individuals with type 2 diabetes and a body mass index (BMI) of ≥ 30 kg/m(2) were recruited to have access to the Virtual Lifestyle Management (VLM) program for 1 year, in addition to their routine care. Participants were assessed at baseline and at 6 and 12 months for the following outcomes: (a) glycated hemoglobin (A1C), (b) lipids (total cholesterol [TC] and TC/high-density lipid [HDL] ratio), (c) weight, (d) BMI, and (e) body fat percentage (BFP).
Seventy-eight individuals consented to the study, 66 (84%) logged onto the system two or more times, and 49 (62%) contributed data at the 1-year program. At baseline, the mean age of participants was 57.9 years of age, and 52% were female. At 12 months, mean differences from baseline were as follows: A1C, -0.3% (95% confidence interval [CI] -0.1, -0.5; P<0.05); TC/HDL, -0.2 (95% CI -0.01, -0.04; P<0.05); weight, -8.6 pounds (95% CI -3.7, -13.6; P<0.05); BMI, -1.5 kg/m(2) (95% CI -0.7, -2.3; P<0.05); and BFP, -1.8% (95% CI -0.9, -2.7; P<0.05). After adjusting for program use, age, and sex, changes in BMI, BFP, and self-reported daily steps taken were statistically significant at 12 months.
This before-after pilot study demonstrates that adding an Internet-based lifestyle modification program to usual care may improve clinically important outcomes.
本研究旨在探讨大型学术糖尿病诊所中，2 型糖尿病合并肥胖症（BMI≥30kg/m2）患者参加在线生活方式管理项目对其产生的影响。
采用单队列设计，2 型糖尿病合并 BMI≥30kg/m2 的个体被招募至虚拟生活方式管理（VLM）项目，在接受常规治疗的同时，还可在 1 年内使用该项目。参与者在基线、6 个月和 12 个月时接受以下结果的评估：（a）糖化血红蛋白（A1C），（b）血脂（总胆固醇[TC]和 TC/高密度脂蛋白[HDL]比值），（c）体重，（d）BMI，（e）体脂肪百分比（BFP）。
共有 78 名个体同意参加本研究，66 名（84%）个体登录系统两次或以上，49 名（62%）个体在项目进行 1 年后提供了数据。基线时，参与者的平均年龄为 57.9 岁，52%为女性。12 个月时，与基线相比的平均差异如下：A1C，-0.3%（95%置信区间[CI]：-0.1，-0.5；P<0.05）；TC/HDL，-0.2（95% CI：-0.01，-0.04；P<0.05）；体重，-8.6 磅（95% CI：-3.7，-13.6；P<0.05）；BMI，-1.5kg/m2（95% CI：-0.7，-2.3；P<0.05）；BFP，-1.8%（95% CI：-0.9，-2.7；P<0.05）。在校正项目使用、年龄和性别后，BMI、BFP 和自我报告的每日步数的变化在 12 个月时具有统计学意义。
本项前后对照的初步研究表明，在常规治疗基础上增加基于互联网的生活方式干预可能会改善具有临床意义的结局。
